Tratamento da tuberculose em unidades de saúde da família: histórias de abandono

Abstract

Este estudo objetivou identificar e analisar os motivos de abandono do tratamento da tuberculose pelos usuários das Unidades de Saúde da Família do Distrito Sanitário IV, na cidade de João Pessoa - PB. A coleta de dados foi realizada por meio de entrevistas, utilizando-se a história oral temática como referencial metodológico. Foram entrevistados quatro usuários com história de abandono do tratamento. Os dados foram analisados conforme a técnica da análise de conteúdo, modalidade temática. Os resultados apresentam dois eixos temáticos: fatores que fragilizam a obtenção do sucesso terapêutico e o envolvimento dos profissionais de Saúde da Família no desenvolvimento de estratégias para potencializar a adesão do usuário ao tratamento da tuberculose. Verificou-se que os fatores associados ao abandono são diversos e complexos, existindo dificuldades relacionadas ao usuário, ao tratamento e à operacionalização da assistência de saúde. Observa-se que o vínculo e o acolhimento são essenciais para assegurar a continuidade do tratamento.

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.…”

“…20 Although the interviewed managers did not report this, aspects related to the Health Center/ Service, such as service quality, organization, medication distribution irregularities, precarious attendance, access difficulties and negligence in patient monitoring are reported in literature as possible causes of non-adherence to treatment. [9][10][12][13] Long waiting times at the service discourage return to that service, and perhaps even treatment continuity, mainly among asymptomatic patients. 12 Other factors are related to health professionals, such as non compliance with times, affecting the quality of clinical exams and patient interaction.…”

“…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 …”

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

“…7 Literature reveals that social problems such as unemployment and financial burdens contribute to the TB patients' noncompliance with the treatment. 14 (N4). Based on the content of the statements, it is observed that these women have numerous social needs, which motivates reflection regarding the challenges inherent to the practice of healthcare in the perspective of comprehensive care and from the gender issue.…”

“…7,14 Primary healthcare involves dimensions that should guide health care, including: accessibility, first contact care , bond , range of services, coordination, family focus, community centeredness and professional training. This study, specifically, is founded on the family focus dimension, as it contemplates the individual in their everyday life, and, in this sense, the health needs assessment should take into consideration the family context and the exposure to health threats of any kind, in addition to the challenge of having limited family resources.…”