Avaliação da integração das ações e serviços na assistência ao portador de Tuberculose em Uberaba/MG

• Ano de defesa: 2014
• Autor(a) principal: SOUZA, Rebeca Ainoã
• Orientador(a): CASTRO, Sybelle de Souza
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Triângulo Mineiro
• Programa de Pós-Graduação: Programa de Pós-Graduação Stricto Sensu em Atenção à Saúde
• Departamento: Instituto de Ciências da Saúde - ICS::Curso de Graduação em Enfermagem
• País: Brasil
• Palavras-chave em Português: Tuberculose; Atenção Primária à Saúde; Avaliação de Serviços de Saúde
• Palavras-chave em Inglês: Tuberculosis; Primary Healthcare; Health Services Assessment
• Palavras-chave em Espanhol: Tuberculosis; Salud de Atención Primaria; Evaluación de Servicios de Salud
• Área do conhecimento CNPq: Enfermagem
• Link de acesso: http://bdtd.uftm.edu.br/handle/tede/275

This researched aimed to assess the integration of actions and services in Tuberculosis (TB) patient assistance in Uberaba/MG and identify, within the analyzed scope, actions and services with biggest and smallest integration. In order to do that, an observational and sectional research with a quantitative approach was carried out in Uberaba/MG. Data collecting took place from April to June 2014 via a structured questionnaire adapted to the TB scenario. The survey was made with 101 professionals from primary healthcare units (USs), from a regional health unit and from the city reference clinic. Data were analyzed by descriptive techniques, analysis of variance and Tukey test. The following dimensions of care to TB were evaluated: organization of TB care; interaction with the community; support to self care; support to decision; service system design; clinical information system and integration of the components of the model of care to TB carriers. Each dimension consisted of 4 or 6 components. Each component and dimensions as a whole were classified as limited, elementary, reasonable and excellent capacity of care to TB according to these standards: average < 3 = limited capacity; 3 ≤ average < 6 = elementary capacity; 6 ≤ average < 9 = reasonable capacity and average ≥ 9 = excellent capacity. Finally, the city was ranked according to the arithmetic mean of the assessed dimensions. None of the dimensions was ranked excellent capacity. The service system design dimension was the only one ranked reasonable capacity whereas the others were ranked elementary. Interaction with the community had the worst performance. As potentials to TB healthcare, it was possible to identify directly observed treatment (TDO) done in all USs, the presence of community workers joining the health team and the community, and the information recommendation offer about TB to everybody who uses the researched USs. On the other hand, the absence of benefits and incentives to TB patients, the small interest USs managers have towards controlling the disease, few strategies to strengthen basic healthcare (AB) as preferential place for TB treatment, the lack of partnerships between healthcare service and community resources (NGOs, churches, community centers, among others.) to handle severity, the absence of action from local health councils in decisions regarding TB, poor training of professionals in health teams, incomplete registries and lack of a computerized registry system are some of the critical points found in the assistance to the TB patient in the city and they undermine care continuity due to its fragmentation and compromise the resolution of actions and services. Health service ought to, by employing strategies which strengthen AB as a care center and promote the dissolution of the identified fragilities, stablish a network of actions and services for facing and meeting the demands presented by TB carriers and their families, giving them continuous and full assistance.