Acesso aos serviços de atenção à tuberculose: análise da satisfação dos doentes

Abstract

A tuberculose persiste como desafio para a saúde pública. Inúmeros esforços são empreendidos para o controle da doença, sendo o tratamento e o acesso do doente aos serviços de saúde entraves para a sua cura. Este artigo tem como objetivo analisar a satisfação dos doentes de tuberculose com relação aos serviços que atuam no controle da tuberculose. Trata-se de um estudo epidemiológico, do tipo inquérito prospectivo, com abordagem quantitativa e qualitativa. Os dados foram coletados por meio de um questionário semi-estruturado. Participaram do estudo 77 doentes. Os dados quantitativos apresentaram avaliação positiva e os qualitativos permitiram compreender a vivência dos doentes quanto ao acesso e tratamento. Aspectos como critérios para a realização do Tratamento Diretamente Observado e proximidade do serviço à moradia do doente influenciam na satisfação, o que leva à necessidade de reorganização dos serviços de saúde para que eles propiciem uma atenção adequada aos doentes de TB.

Tuberculosis Control Program and patient satisfaction, Rio de Janeiro, Brazil

“…Dissatisfaction with the unavailability of exams coincides to some extent with findings presented by Palha et al, 10 and is a problem that needs to be addressed within the context of tuberculosis care, irrespective of whether based on the Family Health Program or reference outpatient unities. 9 , 13 Access to treatment is an attribute that is highly valued by public health service users, who, particularly in situations of socioeconomic vulnerability, have no other health care alternatives.…”

“…There have been several studies of tuberculosis patient satisfaction regarding treatment received, 1 , 7 , 10 with descriptive national findings consistent with the observed trend of elevated satisfaction. Although these national studies suggest explanations or factors influencing user satisfaction, they are restricted to specific contexts, not based on probability samples and lacking analytical approaches capable of differentiating between levels of satisfaction.…”

“…This is consistent with the idea of an effect of ‘elevation’ of the rates of satisfaction measured, regardless of the variability of concepts and methods employed. 3 , 5 , 7 , 10 …”

“…The results presented here for the metropolitan region of Rio de Janeiro confirm a trend of higher incidence of tuberculosis among relatively young men (average age approximately 41 years old) and with low level of education, in accordance with other studies conducted in Brazilian municipalities. 7 , 10 …”

“…Satisfaction is understood as the convergence between patents’ prior expectations of care and the perception of care actually received from the services, 4 , 10 , 15 highlighting the following aspects: prompt care, being dealt with courteously and respectfully by health care professionals, accurate diagnosis and hope of a good prognosis, continuity and coordination of care, the absence of costs constituting a burden to the individual’s budget and, lastly, the technical quality of the medical care received. 2 , 16 Patients also value the physical structure and organization of the health care services, the availability of human resources and materials and, where relevant, the operation logic of the care program.…”