Discursos de profissionais sobre o controle da tuberculose: pontos de estrangulamento na Atenção Primária à Saúde

• Ano de defesa: 2016
• Autor(a) principal: Pinheiro, Patrícia Geórgia Oliveira Diniz
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal da Paraíba; Brasil; Enfermagem; Programa de Pós-Graduação em Enfermagem; UFPB
• Palavras-chave em Português: Tuberculose; Atenção Primária de Saúde; Política de saúde; Atención Primaria de Salud; Política de salud; Tuberculosis; Primary Health Care; Health policy; CIENCIAS DA SAUDE::ENFERMAGEM
• Link de acesso: https://repositorio.ufpb.br/jspui/handle/tede/8717

The severity of tuberculosis (TB) in Brazil stipulated that the illness should be considered as one of the priority lines of the Brazilian National Policy of Primary Care. In the city of João Pessoa-PB, statistics show that there are bottlenecks concerning the performance of Primary Health Care (PHC) as an entry point to the accomplishment of actions and services to control TB. Although the local health policy has provided, almost a decade ago, the decentralization of disease control actions for PHC services, people affected by TB in the city of João Pessoa-PB continue to seek the reference service of the State, in other words, the Clementino Fraga Hospital Complex (CFHC), with the purpose of being diagnosed and treated, thereby highlighting the weakness of the local PHC with regard to the effectiveness of the first contact, longitudinality, comprehensiveness of actions and services, as well as coordination of care, as essential PHC attributes in the care for people affected by TB. Objective: To analyze, based on the speeches of professionals who work in the reference service for controlling TB, the bottlenecks that affect the essential attributes of PHC and their relationship with the actions to control TB. Method: This is a study with qualitative approach, which was held between the months of August to October 2014 in the city of João Pessoa-PB. The subjects who collaborated with the study were 12 health professionals who worked in CFHC. In order to analyze the empirical material, it was used the theoretical-analytical device of Discourse Analysis in its French branch. This study was submitted and approved in 2013 by the Committee of the Center for Health Sciences of the Federal University of the State of Paraíba, under Protocol nº 0404/13 and CAAE nº 18257113.2.0000.5188. Results: The speeches of CFHC professionals have clarified the bottlenecks related to disease control in the scope of PHC services, such as the absence of bond and welcoming actions on the part of professionals in relation to people affected by TB; attitudes that suggest prejudice on the part of professionals from the Family Health Units; difficulties of access to the accomplishment of examinations and consultations for the diagnosis and follow-up of people affected by TB; difficulties in achieving the treatment because of the lack of trust of people affected by TB towards the services provided by the Family Health Units; failures in the supply of medications for treatment; and weaknesses in the reference and counter-reference system between PHC and CFHC services. Thus, these clues were identified as compromising factors for the early diagnosis and effective treatment, and they are interpreted as points that produce hurdles to the first contact, comprehensiveness, longitudinality and coordination, as PHC attributes. Conclusion: One should make managers aware of the results found in such a way as to think, design and accomplish coping actions, in order to minimize the existing bottlenecks and promote a comprehensive care for people affected by TB under the coordination of PHC services.