Estudo de casos sobre abandono do tratamento da tuberculose: avaliação do atendimento, percepção e conhecimentos sobre a doença na perspectiva dos clientes (Fortaleza, Ceará, Brasil)

Abstract

This research was developed in 1995-1996 in the Oliveira Pombo Health Center (CSOP), Fortaleza, Ceará, Brazil. The aim was to explore factors influencing non-adherence to tuberculosis treatment. Specific objectives were: dynamics of tuberculosis notification and treatment of non-adherence cases at the CSOP; demographic, social, economic, and cultural profiles of clientele (social actors); default reasons that interrupt treatment; and knowledge and perception of the disease. The methodological approach was based on descriptive epidemiology and on sociological interpretivism. A semi-structured interview was used for questions related to the social actors, such as: demographic, social, economic, cultural, and behavioral factors; knowledge and perceptions of tuberculosis and treatment; impact of the disease on patients' lives; and perspectives concerning health service attendance. Results show that treatment non-compliance involved multiple and complex interrelated factors.

O abandono do tratamento da tuberculose sob a perspectiva dos gerentes de diferentes centros de saúde de Belo Horizonte-MG, Brasil

“…5,[9][10][11][12][13] Treatment abandonment associated with individual problems has already been well described in literature. Research is lacking, however, about health professionals' perception of the dynamics of health services and the way they have confronted the treatment abandonment problem.…”

“…12 Other factors are related to health professionals, such as non compliance with times, affecting the quality of clinical exams and patient interaction. 11,13 Patients' lifestyle, personal and social characteristics and treatment abandonment …”

“…Different studies appoint that drinking is one of the main treatment abandonment factors, as well as drugs use. 5,[9][10][11][12][13][26][27][28] Another factor mentioned was the action of medication side effects and the improvement after the start of treatment: 'I'm gonna throw up The patients' feeling of wellbeing after the initial treatment phase and the occurrence of medi-cation side effects have also been one of the most appointed reasons for abandonment. 5,[12][13]21,26,29 One manager's report is interesting, mentioning that, after explaining that improvement does not mean cure, the patient returned to the treatment, again revealing the importance of the professional's relation with the patient.…”

Health services in tuberculosis control: family focus and community orientation

“…The traditional care model needs to be replaced by a modern model, incorporating patients' expectations, with active involvement of families and organized sectors of the community with a view to a greater inclusion of social actors in the disease's treatment, the most comprehensive dimension for the conception of the health promotion model (14) .…”

O cuidado à saúde da mulher com tuberculose na perspectiva do enfoque familiar

“…Alcoholism, smoking and drug abuse are conditions that, when undergoing TB treatment, hinder achievement of an effective outcome, as they worsen the clinical condition of the disease, increase the chances of noncompliance to treatment, and compromise cure. 20 Regarding the stigma that accompanies TB patients, it is recognized that they experience situations that can be traumatic and embarrassing, often pushing them towards giving up on treatment because of issues rooted in the social imaginary. 21 Because TB is a disease surrounded by prejudice, healthcare professionals of the Family Health Team must use strategies to clarify and inform the population about the disease.…”