Communication on Disclosure of Tuberculosis Diagnosis and Adherence to Treatment: Social Representations of Professionals and Patients

Abstract

Objective: identifying social representations of health professionals and patients with tuberculosis in an initial interview for diagnostic disclosure and analyzing discursive content regarding the relation of this mode of communication during the interview for adherence of these patients to tuberculosis treatment.Method: a descriptive and qualitative study. A semi-structured interview was conducted with 39 health professionals involved in the initial tuberculosis diagnosis disclosure interview and 34 adult patients undergoing treatment in 22 health units in the southern region of São Paulo (Brazil). Discourse analysis was based on the discussions about "Awareness", developed by Paulo Freire.Results: a lack of explanations resulted in patients not understanding the diagnosis, abrasiveness by health professionals, the need for health education and how to approach the patient have emerged as conditions that influence patient adherence to treatment.Conclusion: regarding communication, we have identified a professional exercise that is contrary to promoting patient adherence to treatment, since it does not allow them to critically reflect on their current situation, and consequently does not modify their reality (in choosing adhesion and cure), thus characterizing incompetent communication. DESCRIPTORS: COMUNICAÇÃO NA REVELAÇÃO DO DIAGNÓSTICO E ADESÃO AO TRATAMENTO DA TUBERCULOSE: REPRESENTAÇÕES SOCIAIS DE PROFISSIONAIS E DE PACIENTES RESUMOObjetivo: identificar as representações sociais de profissionais de saúde e de pacientes com tuberculose sobre a entrevista inicial de diagnóstico da doença, e analisar o conteúdo discursivo, no que se refere à relação deste modo de comunicação, durante a entrevista com a adesão destes pacientes ao tratamento da tuberculose.Método: estudo descritivo e qualitativo. Realizou-se entrevista semiestruturada com 39 profissionais de saúde envolvidos com a entrevista inicial de diagnóstico da tuberculose e 34 pacientes adultos em tratamento, em 22 unidades de saúde da região sul de São Paulo (Brasil). A análise dos discursivos foi baseada nas discussões sobre "Conscientização", desenvolvidas por Paulo Freire.Resultados: a ausência de explicações e consequente não entendimento sobre o diagnóstico, a brutalidade de profissionais da saúde, a necessidade de educação em saúde e a forma de abordar o paciente surgiram como condições que influenciam a adesão ao tratamento por parte do doente.Conclusão: identificou-se um exercício profissional, no que se refere à comunicação, contrário à promoção da adesão ao tratamento por parte do paciente, já que não permite a ele uma reflexão crítica sobre a situação atual, e, consequentemente, uma não modificação da sua realidade (escolha pela adesão e cura), caracterizando, portanto, uma comunicação não competente. DESCRITORES: COMUNICACIÓN EN LA REVELACION DEL DIAGNOSTICO Y ADHESION AL TRATAMIENTO DE LA TUBERCULOSIS: REPRESENTACIONES SOCIALES DE PROFESIONALY PACIENTES RESUMENObjetivo: identificar las representaciones sociales de profesionales de ...

Prevalência e fatores associados ao abandono do tratamento da tuberculose

“…Entre elas estão o tratamento diretamente observado (TDO), que ajuda os pacientes na tomada regular de medicamentos, bem como alternativas ao TDO, como o observado por vídeo (17)(18) . Outro aspecto importante é a participação ativa da equipe de saúde, assim como da família (19)(20) . A forma extrapulmonar foi identificada nesta pesquisa como fator de decréscimo do abandono do tratamento.…”

Professional skills for health promotion in caring for tuberculosis patients

“…However, something different is actually observed. Study identified that the education model for patients about the disease is still based on traditional education and not on their protagonism as to their health situation (8) . Other research also revealed that educational actions were carried out in educational campaigns or when cases of tuberculosis in the territory increased.…”

“…A study that aimed to rescue the social representations of health practitioners and patients in the diagnosis of tuberculosis showed that there may be impairment in treatment and their continuity when there is no bond. It has been reported that the way in which news of the patient's condition is given to the person, directly and with little explanation, did not contribute to treatment adherence and that along with disrespect and inattention of service could lead some to treatment withdrawal (8) .…”

Parents’ Perspectives on the Health Education Provided by Clinicians in Portuguese Pediatric Hospitals and Primary Care for Children Aged 1 to 10 Years

“…However, in a study about nurses’ social representations, it was found that the education model aimed at individuals about disease was still guided by traditional education, and not at the centrality of these regarding their health situation [ 14 ]. In another study, HE was also understood as an information transmission tool [ 15 ].…”