O retardo no diagnóstico da tuberculose e a adesão ao tratamento na atenção primária à saúde: a influência de concepções do processo saúde-doença e de determinantes sociais da saúde

Detalhes bibliográficos
Autor(a) principal: Oliveira, Luana Carla Santana
Data de Publicação: 2012
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da UFPB
Texto Completo: https://repositorio.ufpb.br/jspui/handle/tede/5091
Resumo: The comprehension of the factors that condition the permanence of the tuberculosis (TB) on the top of the diseases of public health makes possible the implementation of efficient action of control of the disease. The delay in the diagnostic of the TB is a relevant question in the control of the TB, as it implies a negative prognostic of the sick person and a higher transmission of the disease. The late diagnostic of the cases increases the gravity of the clinic situation causing internship and the lack of an adequate assessment contribute for abandoning the treatment. Therefore, this research aims to analyze the discursivity of the subjects with TB, regarding to the idiosyncrasies which influenced the delay in the diagnostic of the TB and the adhesion to the treatment, in the environment of the Primary Health Care (PHC). It is an evaluation research with qualitative nature, performed with 9 patients treating TB, 18 years old and older living in the city of Cabedelo PB. The empiric material was produced with the technique of semi-structured interview in the period from August to October 2011. The French matrix of analysis of speech was used as theoretical-analytical referential. Two discursive formation were produced: Discursive Formation I The delay in the Diagnostic of the Tuberculosis in the Ambit of the Primary Attention to the Health in the perception of the Patients: the influence of social determiners of the health and of conceptions of the health-disease process; Discursive Formation II Idiosyncrasies in the Adhesion to the treatment: Facing the disease and living the stigma. As findings, we found: the low socioeconomic level of the patients of TB; the association of risk behaviors alcoholism and smoking with the difficulty of adhesion to the treatment; the curative demanding of the disease in opposition to the prevention; the use of strategies of self-attention, highlighting the self-medication; the relation posted between getting sick with TB and dying; the denial of the TB as a transmissible disease, configuring a potential factor to delay the search for a therapeutic solution; the search for assistance due to the aggravation of the symptoms and consequent living of the hospital internship; In some cases, the delay of the diagnostic was due to medical error and of the lack of problem-solving of the PHC; the lack of qualification of the professionals in diagnosing the disease, not only in the ambit of the PHC, but also in the hospital service; the lack of problem-solving in the assistance to the prison system health, revealing an institutional violence; the stigma associated to the disease. Therefore, it is highlighted the necessity of promoting the inter-sector actions, the qualification of the professionals for the adequate handling of the cases and the popular education in health to perform the actions of control of the TB.
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spelling O retardo no diagnóstico da tuberculose e a adesão ao tratamento na atenção primária à saúde: a influência de concepções do processo saúde-doença e de determinantes sociais da saúdeDelay in the diagnostic of the tuberculosis and adhesion to the treatment in the primary health attention: the influence of conceptions of the health-disease process and of social determiners of the health. 2012. 113 p. Dissertation of Master Degree (post-graduation in nursing).TuberculoseAtenção Primária à SaúdeDiagnóstico tardioAdesão à medicaçãoTuberculosisPrimary Health CareDelayed diagnosisMedication adherenceCIENCIAS DA SAUDE::ENFERMAGEMThe comprehension of the factors that condition the permanence of the tuberculosis (TB) on the top of the diseases of public health makes possible the implementation of efficient action of control of the disease. The delay in the diagnostic of the TB is a relevant question in the control of the TB, as it implies a negative prognostic of the sick person and a higher transmission of the disease. The late diagnostic of the cases increases the gravity of the clinic situation causing internship and the lack of an adequate assessment contribute for abandoning the treatment. Therefore, this research aims to analyze the discursivity of the subjects with TB, regarding to the idiosyncrasies which influenced the delay in the diagnostic of the TB and the adhesion to the treatment, in the environment of the Primary Health Care (PHC). It is an evaluation research with qualitative nature, performed with 9 patients treating TB, 18 years old and older living in the city of Cabedelo PB. The empiric material was produced with the technique of semi-structured interview in the period from August to October 2011. The French matrix of analysis of speech was used as theoretical-analytical referential. Two discursive formation were produced: Discursive Formation I The delay in the Diagnostic of the Tuberculosis in the Ambit of the Primary Attention to the Health in the perception of the Patients: the influence of social determiners of the health and of conceptions of the health-disease process; Discursive Formation II Idiosyncrasies in the Adhesion to the treatment: Facing the disease and living the stigma. As findings, we found: the low socioeconomic level of the patients of TB; the association of risk behaviors alcoholism and smoking with the difficulty of adhesion to the treatment; the curative demanding of the disease in opposition to the prevention; the use of strategies of self-attention, highlighting the self-medication; the relation posted between getting sick with TB and dying; the denial of the TB as a transmissible disease, configuring a potential factor to delay the search for a therapeutic solution; the search for assistance due to the aggravation of the symptoms and consequent living of the hospital internship; In some cases, the delay of the diagnostic was due to medical error and of the lack of problem-solving of the PHC; the lack of qualification of the professionals in diagnosing the disease, not only in the ambit of the PHC, but also in the hospital service; the lack of problem-solving in the assistance to the prison system health, revealing an institutional violence; the stigma associated to the disease. Therefore, it is highlighted the necessity of promoting the inter-sector actions, the qualification of the professionals for the adequate handling of the cases and the popular education in health to perform the actions of control of the TB.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESA compreensão dos fatores que condicionam a permanência da tuberculose (TB) no topo dos agravos de saúde pública possibilita a implementação de medidas eficazes de controle da doença. O retardo no diagnóstico da TB é uma questão relevante no controle da TB, pois implica em um mau prognóstico do doente e em uma maior transmissão da doença. O diagnóstico tardio dos casos acentua a gravidade do quadro clínico ocasionando internação e a falta de um acompanhamento adequado contribui para o abandono do tratamento. Dessa forma, esta pesquisa objetiva analisar a discursividade dos sujeitos com TB, no que concerne às idiossincrasias que influenciam o retardo do diagnóstico da TB e a adesão ao tratamento, no âmbito da Atenção Primária à Saúde (APS). Este estudo encontra-se articulado ao projeto multicêntrico denominado Retardo no diagnóstico da tuberculose: análise das causas em diferentes regiões do Brasil , coordenado pela Rede Brasileira de Pesquisa em Tuberculose. Trata-se de uma pesquisa avaliativa de natureza qualitativa, realizada com nove doentes em tratamento de TB, maiores de 18 anos e residentes no município de Cabedelo - PB. O material empírico foi produzido com a técnica de entrevista semi-estruturada, no período de agosto a outubro de 2011. Como referencial teórico-analítico utilizou-se a análise de discurso de matriz francesa. Foram produzidas duas formações discursivas: Formação Discursiva I O Retardo do Diagnóstico da Tuberculose no Âmbito da Atenção Primária à Saúde na Percepção dos Doentes: a influência dos determinantes sociais da saúde e de concepções do processo saúde-doença; Formação Discursiva II Idiossincrasias na Adesão ao Tratamento: o enfrentamento da doença e a vivência do estigma. Como achados, encontramos: o baixo nível socioeconômico dos doentes de TB; a associação de comportamentos de risco etilismo e tabagismo com a dificuldade de adesão ao tratamento; a demanda curativa da doença em detrimento da prevenção; a utilização de estratégias de auto-atenção, destacando-se a automedicação; a relação posta entre o adoecer por TB e o morrer; a negação da TB como doença transmissível, configurando-se em um fator potencial para retardar a procura por uma solução terapêutica; a busca por assistência devido ao agravamento dos sintomas e consequente vivência da internação hospitalar; em alguns casos, o retardo do diagnóstico foi decorrente de erro médico e da falta de resolutividade da APS; a falta de capacitação dos profissionais em diagnosticar a doença, não apenas no âmbito da APS, mas também no serviço hospitalar; a falta de resolutividade na assistência à saúde prisional, desvelando uma violência institucional; o estigma associado à doença. Destarte, ressalta-se a necessidade de promover a intersetorialidade das ações, a capacitação dos profissionais para o adequado manejo dos casos e a educação popular em saúde para efetivar as medidas de controle da TB.Universidade Federal da Paraí­baBREnfermagemPrograma de Pós-Graduação em EnfermagemUFPBNogueira, Jordana de Almeidahttp://lattes.cnpq.br/8338527087554463Oliveira, Luana Carla Santana2015-05-08T14:47:26Z2018-07-21T00:00:25Z2012-10-112018-07-21T00:00:25Z2012-03-07info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfOLIVEIRA, Luana Carla Santana. Delay in the diagnostic of the tuberculosis and adhesion to the treatment in the primary health attention: the influence of conceptions of the health-disease process and of social determiners of the health. 2012. 113 p. Dissertation of Master Degree (post-graduation in nursing).. 2012. 114 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal da Paraí­ba, João Pessoa, 2012.https://repositorio.ufpb.br/jspui/handle/tede/5091porinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFPBinstname:Universidade Federal da Paraíba (UFPB)instacron:UFPB2018-09-06T01:26:05Zoai:repositorio.ufpb.br:tede/5091Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufpb.br/PUBhttp://tede.biblioteca.ufpb.br:8080/oai/requestdiretoria@ufpb.br|| diretoria@ufpb.bropendoar:2018-09-06T01:26:05Biblioteca Digital de Teses e Dissertações da UFPB - Universidade Federal da Paraíba (UFPB)false
dc.title.none.fl_str_mv O retardo no diagnóstico da tuberculose e a adesão ao tratamento na atenção primária à saúde: a influência de concepções do processo saúde-doença e de determinantes sociais da saúde
Delay in the diagnostic of the tuberculosis and adhesion to the treatment in the primary health attention: the influence of conceptions of the health-disease process and of social determiners of the health. 2012. 113 p. Dissertation of Master Degree (post-graduation in nursing).
title O retardo no diagnóstico da tuberculose e a adesão ao tratamento na atenção primária à saúde: a influência de concepções do processo saúde-doença e de determinantes sociais da saúde
spellingShingle O retardo no diagnóstico da tuberculose e a adesão ao tratamento na atenção primária à saúde: a influência de concepções do processo saúde-doença e de determinantes sociais da saúde
Oliveira, Luana Carla Santana
Tuberculose
Atenção Primária à Saúde
Diagnóstico tardio
Adesão à medicação
Tuberculosis
Primary Health Care
Delayed diagnosis
Medication adherence
CIENCIAS DA SAUDE::ENFERMAGEM
title_short O retardo no diagnóstico da tuberculose e a adesão ao tratamento na atenção primária à saúde: a influência de concepções do processo saúde-doença e de determinantes sociais da saúde
title_full O retardo no diagnóstico da tuberculose e a adesão ao tratamento na atenção primária à saúde: a influência de concepções do processo saúde-doença e de determinantes sociais da saúde
title_fullStr O retardo no diagnóstico da tuberculose e a adesão ao tratamento na atenção primária à saúde: a influência de concepções do processo saúde-doença e de determinantes sociais da saúde
title_full_unstemmed O retardo no diagnóstico da tuberculose e a adesão ao tratamento na atenção primária à saúde: a influência de concepções do processo saúde-doença e de determinantes sociais da saúde
title_sort O retardo no diagnóstico da tuberculose e a adesão ao tratamento na atenção primária à saúde: a influência de concepções do processo saúde-doença e de determinantes sociais da saúde
author Oliveira, Luana Carla Santana
author_facet Oliveira, Luana Carla Santana
author_role author
dc.contributor.none.fl_str_mv Nogueira, Jordana de Almeida
http://lattes.cnpq.br/8338527087554463
dc.contributor.author.fl_str_mv Oliveira, Luana Carla Santana
dc.subject.por.fl_str_mv Tuberculose
Atenção Primária à Saúde
Diagnóstico tardio
Adesão à medicação
Tuberculosis
Primary Health Care
Delayed diagnosis
Medication adherence
CIENCIAS DA SAUDE::ENFERMAGEM
topic Tuberculose
Atenção Primária à Saúde
Diagnóstico tardio
Adesão à medicação
Tuberculosis
Primary Health Care
Delayed diagnosis
Medication adherence
CIENCIAS DA SAUDE::ENFERMAGEM
description The comprehension of the factors that condition the permanence of the tuberculosis (TB) on the top of the diseases of public health makes possible the implementation of efficient action of control of the disease. The delay in the diagnostic of the TB is a relevant question in the control of the TB, as it implies a negative prognostic of the sick person and a higher transmission of the disease. The late diagnostic of the cases increases the gravity of the clinic situation causing internship and the lack of an adequate assessment contribute for abandoning the treatment. Therefore, this research aims to analyze the discursivity of the subjects with TB, regarding to the idiosyncrasies which influenced the delay in the diagnostic of the TB and the adhesion to the treatment, in the environment of the Primary Health Care (PHC). It is an evaluation research with qualitative nature, performed with 9 patients treating TB, 18 years old and older living in the city of Cabedelo PB. The empiric material was produced with the technique of semi-structured interview in the period from August to October 2011. The French matrix of analysis of speech was used as theoretical-analytical referential. Two discursive formation were produced: Discursive Formation I The delay in the Diagnostic of the Tuberculosis in the Ambit of the Primary Attention to the Health in the perception of the Patients: the influence of social determiners of the health and of conceptions of the health-disease process; Discursive Formation II Idiosyncrasies in the Adhesion to the treatment: Facing the disease and living the stigma. As findings, we found: the low socioeconomic level of the patients of TB; the association of risk behaviors alcoholism and smoking with the difficulty of adhesion to the treatment; the curative demanding of the disease in opposition to the prevention; the use of strategies of self-attention, highlighting the self-medication; the relation posted between getting sick with TB and dying; the denial of the TB as a transmissible disease, configuring a potential factor to delay the search for a therapeutic solution; the search for assistance due to the aggravation of the symptoms and consequent living of the hospital internship; In some cases, the delay of the diagnostic was due to medical error and of the lack of problem-solving of the PHC; the lack of qualification of the professionals in diagnosing the disease, not only in the ambit of the PHC, but also in the hospital service; the lack of problem-solving in the assistance to the prison system health, revealing an institutional violence; the stigma associated to the disease. Therefore, it is highlighted the necessity of promoting the inter-sector actions, the qualification of the professionals for the adequate handling of the cases and the popular education in health to perform the actions of control of the TB.
publishDate 2012
dc.date.none.fl_str_mv 2012-10-11
2012-03-07
2015-05-08T14:47:26Z
2018-07-21T00:00:25Z
2018-07-21T00:00:25Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv OLIVEIRA, Luana Carla Santana. Delay in the diagnostic of the tuberculosis and adhesion to the treatment in the primary health attention: the influence of conceptions of the health-disease process and of social determiners of the health. 2012. 113 p. Dissertation of Master Degree (post-graduation in nursing).. 2012. 114 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal da Paraí­ba, João Pessoa, 2012.
https://repositorio.ufpb.br/jspui/handle/tede/5091
identifier_str_mv OLIVEIRA, Luana Carla Santana. Delay in the diagnostic of the tuberculosis and adhesion to the treatment in the primary health attention: the influence of conceptions of the health-disease process and of social determiners of the health. 2012. 113 p. Dissertation of Master Degree (post-graduation in nursing).. 2012. 114 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal da Paraí­ba, João Pessoa, 2012.
url https://repositorio.ufpb.br/jspui/handle/tede/5091
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dc.publisher.none.fl_str_mv Universidade Federal da Paraí­ba
BR
Enfermagem
Programa de Pós-Graduação em Enfermagem
UFPB
publisher.none.fl_str_mv Universidade Federal da Paraí­ba
BR
Enfermagem
Programa de Pós-Graduação em Enfermagem
UFPB
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instname:Universidade Federal da Paraíba (UFPB)
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reponame_str Biblioteca Digital de Teses e Dissertações da UFPB
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