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

• Ano de defesa: 2012
• Autor(a) principal: Oliveira, Luana Carla Santana
• Orientador(a): Nogueira, Jordana de Almeida
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal da Paraí­ba
• Programa de Pós-Graduação: Programa de Pós-Graduação em Enfermagem
• Departamento: Enfermagem
• País: BR
• Palavras-chave em Português: Tuberculose; Atenção Primária à Saúde; Diagnóstico tardio; Adesão à medicação
• Palavras-chave em Inglês: Tuberculosis; Primary Health Care; Delayed diagnosis; Medication adherence
• Área do conhecimento CNPq: CIENCIAS DA SAUDE::ENFERMAGEM
• Link de acesso: https://repositorio.ufpb.br/jspui/handle/tede/5091

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.