Acesso das pessoas menores de quinze anos com tuberculose aos serviços de saúde
The access to the care network is essential for the tuberculosis diagnosis and treatment in children and adolescents. The objective of this study is to analyze the access to health services for people under 15 years old with tuberculosis, in the perception of the parents, nurses and coordinators of...
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Acesso aos serviços de saúde Tuberculose Criança Adolescente CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA |
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Acesso aos serviços de saúde Tuberculose Criança Adolescente CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA Pinto, Juliana Teixeira Jales Menescal Acesso das pessoas menores de quinze anos com tuberculose aos serviços de saúde |
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The access to the care network is essential for the tuberculosis diagnosis and treatment in children and adolescents. The objective of this study is to analyze the access to health services for people under 15 years old with tuberculosis, in the perception of the parents, nurses and coordinators of the tuberculosis control program of the priority cities for the control of the disease in the state of Rio Grande do Norte. This research consists of a case study with a qualitative approach carried out in two priority cities to control tuberculosis in a Brazilian state. Initially, the number of tuberculosis cases in children under 15 years old in 2014 was surveyed. Subsequently, there were semi-structured interviews with 11 parents of people under 15 years old with tuberculosis, 11 nurses from the basic health units and three coordinators of the Program, selected in an intentional way. The interviews were recorded, transcribed and organized in Atlas Software ti. For the analysis of the statements, the methodological assumptions of Bardin (2011) was used. As a result, three categories emerged: Paths traveled: the search for the diagnosis and treatment of tuberculosis; The experience of tuberculosis: factors that hindered and facilitated the access to health services; The stigma and prejudice of tuberculosis in the family and in the society. This study identifies that parents used the emergency services as an entry point into the health system, showing the fragility of the family bond with the primary care. The diagnosis was done in children´s hospitals, confirmed through imaging tests. It evidences the failures in the suspicion of tuberculosis during the approach of the professionals and the difficulty in performing examinations in this age group. The treatment was carried out in the primary health units and the follow-up was done by two services at the same time. The closure of the cases shows difficulties due to the lack of information on the parents and the non-accomplishment of home visits by the professionals. The evaluation of the process is positive in the distance between the residence and the health service, the time spent, the availability of collective transportation, the service by spontaneous demand, the assistance incentive, by basic grocery package and the free supply of medicines. Factors such as violence in the territory, problems of mobility, lack of knowledge about the organization and the opening hours of the units are barriers to this access. The expenses from this process are related to transportation, food, hygiene material, absences from parents to work, hiring of people to take care of the child, loss of employment, routine or imaging examinations and acquisition of financial loans. Stigma and prejudice were observed in the family, in professionals and in the community. Because it is difficult to diagnose in children, the study suggests investigating adults with tuberculosis, to train professionals at different levels of care on children´s tuberculosis and to increase health education about the disease in the most accessible media. Therefore, the political, financial and personnel investment is fundamental, as well as an integrated and resolute health care network. |
| author2 |
Freitas, Cláudia Helena Soares de Morais |
| author_facet |
Freitas, Cláudia Helena Soares de Morais Pinto, Juliana Teixeira Jales Menescal |
| format |
doctoralThesis |
| author |
Pinto, Juliana Teixeira Jales Menescal |
| author_sort |
Pinto, Juliana Teixeira Jales Menescal |
| title |
Acesso das pessoas menores de quinze anos com tuberculose aos serviços de saúde |
| title_short |
Acesso das pessoas menores de quinze anos com tuberculose aos serviços de saúde |
| title_full |
Acesso das pessoas menores de quinze anos com tuberculose aos serviços de saúde |
| title_fullStr |
Acesso das pessoas menores de quinze anos com tuberculose aos serviços de saúde |
| title_full_unstemmed |
Acesso das pessoas menores de quinze anos com tuberculose aos serviços de saúde |
| title_sort |
acesso das pessoas menores de quinze anos com tuberculose aos serviços de saúde |
| publisher |
Brasil |
| publishDate |
2017 |
| url |
https://repositorio.ufrn.br/jspui/handle/123456789/23523 |
| work_keys_str_mv |
AT pintojulianateixeirajalesmenescal acessodaspessoasmenoresdequinzeanoscomtuberculoseaosservicosdesaude |
| _version_ |
1773965833358278656 |
| spelling |
ri-123456789-235232017-11-04T20:08:33Z Acesso das pessoas menores de quinze anos com tuberculose aos serviços de saúde Pinto, Juliana Teixeira Jales Menescal Freitas, Cláudia Helena Soares de Morais http://lattes.cnpq.br/7001176243211270 http://lattes.cnpq.br/8905654343063318 Uchoa, Severina Alice da Costa http://lattes.cnpq.br/8414233332373275 Cavalcante, Elisângela Franco de Oliveira http://lattes.cnpq.br/9020549482920149 Coelho, Ardigleusa Alves http://lattes.cnpq.br/2622051143015642 Carvalho, Rafael Nicolau http://lattes.cnpq.br/3494692575372499 Acesso aos serviços de saúde Tuberculose Criança Adolescente CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA The access to the care network is essential for the tuberculosis diagnosis and treatment in children and adolescents. The objective of this study is to analyze the access to health services for people under 15 years old with tuberculosis, in the perception of the parents, nurses and coordinators of the tuberculosis control program of the priority cities for the control of the disease in the state of Rio Grande do Norte. This research consists of a case study with a qualitative approach carried out in two priority cities to control tuberculosis in a Brazilian state. Initially, the number of tuberculosis cases in children under 15 years old in 2014 was surveyed. Subsequently, there were semi-structured interviews with 11 parents of people under 15 years old with tuberculosis, 11 nurses from the basic health units and three coordinators of the Program, selected in an intentional way. The interviews were recorded, transcribed and organized in Atlas Software ti. For the analysis of the statements, the methodological assumptions of Bardin (2011) was used. As a result, three categories emerged: Paths traveled: the search for the diagnosis and treatment of tuberculosis; The experience of tuberculosis: factors that hindered and facilitated the access to health services; The stigma and prejudice of tuberculosis in the family and in the society. This study identifies that parents used the emergency services as an entry point into the health system, showing the fragility of the family bond with the primary care. The diagnosis was done in children´s hospitals, confirmed through imaging tests. It evidences the failures in the suspicion of tuberculosis during the approach of the professionals and the difficulty in performing examinations in this age group. The treatment was carried out in the primary health units and the follow-up was done by two services at the same time. The closure of the cases shows difficulties due to the lack of information on the parents and the non-accomplishment of home visits by the professionals. The evaluation of the process is positive in the distance between the residence and the health service, the time spent, the availability of collective transportation, the service by spontaneous demand, the assistance incentive, by basic grocery package and the free supply of medicines. Factors such as violence in the territory, problems of mobility, lack of knowledge about the organization and the opening hours of the units are barriers to this access. The expenses from this process are related to transportation, food, hygiene material, absences from parents to work, hiring of people to take care of the child, loss of employment, routine or imaging examinations and acquisition of financial loans. Stigma and prejudice were observed in the family, in professionals and in the community. Because it is difficult to diagnose in children, the study suggests investigating adults with tuberculosis, to train professionals at different levels of care on children´s tuberculosis and to increase health education about the disease in the most accessible media. Therefore, the political, financial and personnel investment is fundamental, as well as an integrated and resolute health care network. O acesso à rede de atenção é fundamental para o diagnóstico e tratamento da tuberculose em crianças e adolescentes. O objetivo deste estudo é analisar o acesso das pessoas menores de 15 anos com tuberculose aos serviços de saúde, na percepção dos pais, das enfermeiras e dos coordenadores do programa de controle da tuberculose dos municípios prioritários para o controle da doença no estado do Rio Grande do Norte. Esta pesquisa consiste em um estudo de caso, com abordagem qualitativa, realizado em dois municípios prioritários para controle da tuberculose em um estado brasileiro. Inicialmente, faz o levantamento do número de casos de tuberculose em menores de 15 anos no ano de 2014. Posteriormente, realiza entrevistas semiestruturadas com 11 pais de pessoas menores de 15 anos com tuberculose, 11 enfermeiras das unidades básicas de saúde e três coordenadores do Programa, selecionados de maneira intencional. As entrevistas foram gravadas, transcritas e organizadas no Software Atlas ti. Para análise das falas, utiliza os pressupostos metodológicos de Bardin (2011). Como resultado, emergiram três categorias: Caminhos percorridos: a busca pelo diagnóstico e tratamento da tuberculose; A experiência da tuberculose: fatores que dificultaram e facilitaram o acesso aos serviços de saúde; O estigma e o preconceito da tuberculose na família e na sociedade. Este estudo identifica que os pais utilizaram como porta de entrada no sistema de saúde os serviços de urgência e emergência, o que mostra a fragilidade do vínculo da família com a atenção primária. O diagnóstico ocorreu em hospitais infantis, confirmados através de exames de imagem. Isso evidencia falhas na suspeição da tuberculose durante a abordagem dos profissionais e a dificuldade em realizar exames nessa faixa etária. O tratamento ocorreu nas unidades básicas de saúde e o acompanhamento feito por dois serviços concomitantemente. O encerramento dos casos apresenta dificuldades pela falta de informações dos pais e pela não realização de visitas domiciliares pelos profissionais. A avaliação do processo é positiva em relação à distância entre a residência e o serviço de saúde, ao tempo gasto, à disponibilidade de transporte coletivo, ao atendimento por demanda espontânea, ao incentivo assistencial, na forma da cesta básica e ao fornecimento gratuito dos medicamentos. Fatores como violência no território, problemas de mobilidade, desconhecimento sobre a organização e os horários de funcionamento das unidades são barreiras citadas ao acesso. Os gastos ocorridos nesse processo estão relacionados a transporte, alimentação, material de higiene, faltas dos pais ao trabalho, contratação de pessoas para cuidar do filho, perda de emprego, exames de rotina ou de imagem e aquisição de empréstimos financeiros. O estigma e o preconceito foram observados na própria família, em profissionais e na comunidade. Por ser de difícil diagnóstico em crianças, o estudo aponta ser necessário investigar os adultos com tuberculose, capacitar os profissionais nos diversos níveis de atenção sobre tuberculose infantil e intensificar a educação em saúde sobre a doença nos meios de comunicação mais acessíveis a população. Para tanto, é fundamental o investimento político, financeiro e de pessoal, além de uma rede de atenção à saúde integrada e resolutiva. 2017-06-19T15:12:54Z 2017-06-19T15:12:54Z 2017-02-14 doctoralThesis PINTO, Juliana Teixeira Jales Menescal. Acesso das pessoas menores de quinze anos com tuberculose aos serviços de saúde. 2017. 191f. Tese (Doutorado em Saúde Coletiva) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2017. https://repositorio.ufrn.br/jspui/handle/123456789/23523 por Acesso Aberto application/pdf Brasil UFRN PROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE COLETIVA |