Discursos sobre a terapia de curta duração para o controle da tuberculose

Abstract

Objective: to analyze the meanings produced through the experiences and perceptions of healthcare professionals on the implementation of the strategy of directly observed treatment short course for tuberculosis control. Method: qualitative study carried out in Mozambique with 15 healthcare professionals. Inclusion criteriawerehaving acted in the Tuberculosis Control Program for more than one year, and exercising professional activity at the time of interview. A semi-structured script was used for data collection, and individual interviews were recorded. Results: three discursive units emerged: patient treatment procedures; community health agent and family roles; diffi culties in the application of directly observed treatment short course. Conclusion: treatment of tuberculosis requires constant involvement of the family, community, and especially the State in the creation and implementation of personnel training policies and infrastructure improvement. Descriptors: Nursing Care; Community Health Nursing; Public Health Nursing; Tuberculosis; Public Policies. RESUMO Objetivo: analisar os sentidos produzidos por meio das experiências e percepções dos profi ssionais de saúde sobre a implementação da estratégia do tratamento diretamente observado de curta duração para o controle da tuberculose. Método: estudo qualitativo realizado em Moçambique com 15 profi ssionais de saúde. Critérios de inclusão: atuação no Programa de Controle da Tuberculose há mais de um ano e estar em atividade profi ssional no período da entrevista. Para a coleta de dados foi usado um roteiro semiestruturado e as entrevistas realizadas individualmente foram gravadas. Resultados: emergiram três unidades discursivas: os procedimentos no tratamento do doente; o papel de Agente Comunitário da Saúde e da família; as difi culdades na aplicação do tratamento diretamente observado de curta duração. Conclusão: o tratamento da tuberculose requer um envolvimento constante da família, da comunidade e principalmente do Estado na criação e aplicação de políticas de formação dos recursos humanos e melhoria de infraestruturas. Descritores: Cuidados de Enfermagem; Enfermagem em Saúde Comunitária; Enfermagem em Saúde Pública; Tuberculose; Políticas Públicas. RESUMENObjetivo: analizar los sentidos generados a partir de experiencias y visiones de profesionales de salud sobre la implementación de la estrategia del tratamiento directamente observado de corta duración para el control de la tuberculosis. Método: estudio cualitativo realizado en Mozambique con 15 profesionales de salud. Criterios de inclusión: actuación en Programa de Control de la Tuberculosis mayor a un año y estar activo profesionalmente durante el período de la entrevista. Datos recolectados utilizando rutina semiestructurada; las entrevistas individuales fueron grabadas. Resultados: surgieron tres unidades discursivas: procedimientos en el tratamiento del enfermo; papel del Agente Comunitario de Salud y de la familia; difi cultades en aplicación del tratamiento directamente observado de c...

The Discourses of Health Professionals on the Tuberculosis Patient in Mozambique: Reproduction and Resistance

“…It indicates that the health professionals occupy the position of subjects with specific knowledge, which would assure them places hierarchically superior, in relation to the subjects affected by TB. Based on institutionally recognized and socially valued positions (coordinator, clinician), specific knowledge produces meaningful effects of "speeches of truth" [2,3], being imagined and treated by patients who suffer from TB as speeches irrefutable, almost definitive, as we show in our doctoral thesis [17]. We wish to emphasize the aspect of medical tutelage, which, if on the one hand, gives supposed assistance, in the form of care, examinations, prescriptions, examination requisitions, on the other hand, demands obedience, understood as "natural," in a society where there is a division between those who rule and those who obey, as is the case with Mozambican women.…”

“…Initially, we observed that the subjects affected by the bacillus are not identified by name, surname, cognomen, surname, or initials. They are referred to as "the patient," which allows us to think about the enrollment of health professionals in discursive formations in which stigmatizations about the disease are prevalent, for example, TB would be associated with poor behaviors such as prostitution, alcohol consumption and other drugs, lack of hygiene, and poverty [16,17].…”