The establishment of bonds between professional and patient in TB treatment: the performance of primary health care services in a city in the interior of São Paulo

Abstract

This study evaluated the performance of health care services implementing TB control actions in relation to the establishment of bonds between health professionals and patients in São José do Rio Preto, SP, Brazil from the perspective of patients, health professionals, and managers.A total of 108 patients, 37 health professionals and 15 managers were interviewed through a questionnaire containing 10 indicators of bond-establishment based on the instruments of the Primary Care Assessment Tool, adapted to evaluate tuberculosis control in Brazil. The three groups of actors considered the establishment of bonds satisfactory, though opinions of patients and managers differed in almost all indicators. This fact indicates that the view of managers is still predominantly focused on bureaucratic and administrative aspects, which shows the need for managers to integrate more management and care actions. Vínculo entre profesional y enfermo en el tratamiento de la tuberculosis: desempeño de la atención básica en un municipio del estado de Sao PauloEl objetivo del estudio fue evaluar el desempeño de los servicios de salud que realizan acciones de control de la TB relacionado al vínculo entre el profesional y el enfermo, en el municipio de Sao José del Rio Preto, en Sao Paulo, en la percepción de enfermos, profesionales de la salud y gestores. Fueron entrevistados 108 enfermos, 37 profesionales y 15 gestores utilizando un cuestionario elaborado con 10 indicadores para la dimensión vínculo construidos con base en el Primary Care Asesment Tool, adaptado para evaluar de la atención a la tuberculosis en Brasil. El vínculo fue evaluado como satisfactorio por los tres actores, entre tanto hubo variabilidad entre las opiniones de los enfermos y los gestores en casi todos los indicadores, lo que permite inferir que la visión de los gestores todavía está orientada predominantemente por los aspectos burocrático/administrativos, necesitando que estos integren más las acciones gerenciales y asistenciales.

Desfecho dos casos de tuberculose em pessoas com HIV: subsídios para intervenção

“…However, factors such as male gender, economically active age, active employment status, recurrence and re-treatment of TB, pulmonary clinical form of TB, presence of comorbidities, use of drugs and alcohol, and irregular ART withdrawal. (14,15,22,27,29,39) This result prompts reflections on data quality of information systems used in this study and the truthfulness of the self-reported information. In this sense, it is believed that there may be an information bias due to secondary data sources use consulted for the study development.…”

“…However, close interaction of the two diseases demands an articulated work developed by TB and HIV/AIDS programs, as well as those with the other points of the network of health care and support. (15) In addition to biological and clinical factors, both HIV/AIDS and TB have a strong social, cultural and behavioral determination regarding infection, development and control of both conditions. This represents an important challenge for public policies and specific and equanimous actions implementation in the confrontation and management of the two diseases and their coexistence.…”

Capacidade de oferta e execução dos serviços de atenção primária à saúde às pessoas com tuberculose

“…O paciente em tratamento precisa compreender a doença, a conduta terapêutica adotada e assim estar ciente de seu papel diante desse processo 15 . A maioria dos profissionais que participou deste estudo, não relatou preocupação com medidas que estimulem o autocuidado dos pacientes em tratamento de TB, o que dificulta essa percepção do usuário de que ele é o autor principal e responsável no seu cuidado.…”

Knowledge and practices in care focused on individuals with wounds

“…Some studies show that delaying the search for health services is associated with clients' knowledge about their disease, the distance between their home and the health unit, transport expenses, the impossibility of being absent at work or cancelling appointments, the satisfaction with the service provided and the search for alternative care. 18,19 Clients' speech revealed an association between the habit of body hygiene and a possible improvement in wounds. Habits are the result of ritualized social practices and their purpose is to integrate individuals into the group, thus representing ways of being and acting to maintain life.…”