Caracterização de um serviço público no Sul do Brasil referência para tratamento das patologias da tireóide

• Autor(a) principal: Koga, Marilu Rita Villa
• Data de Publicação: 2012
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações do UTP
• Texto Completo: http://tede.utp.br:8080/jspui/handle/tede/1477
• topic: Cirurgia de tireoide; Perfil epidemiológico; Serviço público; Assistência de enfermagem; Thyroid surgery; Epidemiological profile; Public service; Nursing care; CIENCIAS DA SAUDE::FONOAUDIOLOGIA

Introduction: Nodular thyroid illnesses affect population as a whole, with variable incidence and severity, which makes relevant their access to specialized health services for early differential diagnosis and qualified treatment for the pathology. Objective: to feature a reference public health service for the treatment of thyroid pathologies through patients’ data referred to thyroidectomy, aiming to improve patients’ care delivery, specially nursing care. Method: It is a crosscutting descriptive quantitative study. Forty-eight (48) patients referred to thyroid surgery, participated in the study, treated at a public teaching hospital in the municipality of Curitiba, Parana State/Brazil. For data collection, a semi-structured questionnaire was used, taking up questions on patients’ sociodemographic and health profile, pointing out voice-related communicative disorders, questions on knowledge and received information about their pathology and surgery, and access conditions to treatment. The Voice-Related Quality of Life instrument was used in order to measure voice-related problems. Data were stored and processed at SPHINX program, and tables were elaborated with frequencies, percentiles, averages and standard bias. Results: It was evidenced that the studied service delivers care to patients with an average age of 51 years, predominantly female sex (95.83%), white (66.67%), low educational level and family income, having nontoxic multinodular goiter (35.42%) as main diagnosis, followed by follicular injuries (16.67%) and substernal goiter (14.58%). The most frequent neoplasia was papillary carcinoma (8.33%). Signs and symptoms presented were: neck nodule or lump (78.13%), swallowing problems (56.25%), voice changes (40.63%), and shortness of breath (34.38%). Analysis of voice-related quality of life showed that voice changes are present in the pre-surgical phase, and control over physical functioning had the greatest impact on quality of life. The pathology entails limitations in patients’ work and activities. Most of the interviewed (64.58%) considered scarce the received information on pathology and surgery. Most patients (66.67%) are forwarded by primary health care units by means of the centralized municipality consultation service. It was evidenced that patients undergo a long wait to have access to surgery. Conclusion: The study pointed out that a service redesign is deemed necessary in order to broaden patient access to thyroid surgery as well as the qualification of health care actions and education. Voice-related quality of life is affected by nodular thyroid pathologies, being important a multidisciplinary attention. Pre-surgical nursing consultation may minimize some difficulties pointed in this diagnosis.