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1.
Interface (Botucatu, Online) ; 24: e190160, 2020.
Article in Portuguese | LILACS (Americas) | ID: biblio-1040195

ABSTRACT

O presente artigo discute a descentralização do Tratamento Diretamente Observado (TDO) da tuberculose (TB) em um município da região metropolitana de Porto Alegre, RS. Após a implementação da estratégia, as taxas de abandono do tratamento diminuíram, mas o município não alcançou a meta preconizada pela Organização Mundial de Saúde (OMS). Trata-se de uma pesquisa qualitativa que entrevistou profissionais da atenção primária e da vigilância em saúde. Os resultados apontaram que a descentralização apenas do procedimento pode significar somente o acréscimo de mais uma tarefa para a atenção primária e alimentar a compreensão de uma responsabilidade parcial, não coerente com esse nível de atenção. Como possibilidade para diminuir o abandono, sugere-se a descentralização completa do cuidado para atenção primária e a constituição de apoio matricial que envolva profissionais especializados e o núcleo de vigilância.(AU)


Abstract This article addresses decentralization of Directly Observed Therapy (DOT) for treating tuberculosis (TB) in a Brazilian city in the metropolitan region of Porto Alegre, state of Rio Grande do Sul. After implementing the strategy, treatment dropout rates decreased, but the city has not achieved the goal recommended by the World Health Organization (WHO). This qualitative research was conducted through interviews with primary care and health surveillance professionals. The results showed that decentralizing the procedure can mean adding another task to primary care and can base the understanding of a partial responsibility that is not coherent with this level of care. As a possibility to reduce dropout, we suggest a complete decentralization of primary health care and the constitution of a matrix support involving specialized professionals and the surveillance center.(AU)


Resumen El artículo discute la descentralización del Tratamiento Directamente Observado (TDO) de la tuberculosis en un municipio de la región metropolitana de Porto Alegre/Estado de Rio Grande do Sul. Después de la implementación de la estrategia, las tasas de abandono del tratamiento disminuyeron, pero el municipio no alcanzó la meta determinada por la OMS. Encuesta cualitativa que entrevistó a profesionales de la atención primaria y de la vigilancia en salud. Los resultados señalaron que la descentralización únicamente del procedimiento puede significar tan solo añadir una tarea más a la atención primaria y alimentar la comprensión de una responsabilidad parcial no coherente con ese tipo de atención. Como una posibilidad de disminuir el abandono se sugiere la descentralización completa del cuidado para la atención primaria y la construcción de apoyo matricial que envuelva a profesionales especializados y el núcleo de vigilancia.(AU)


Subject(s)
Humans , Primary Health Care , Tuberculosis/therapy , Directly Observed Therapy/methods , Treatment Outcome , Public Health Surveillance , Treatment Adherence and Compliance/statistics & numerical data
2.
Article in English | WPRIM (Western Pacific) | ID: wprim-742447

ABSTRACT

BACKGROUND: Tuberculosis (TB) is the most important disease screened for upon patient history review during preimmigration medical examinations as performed in South Korea in prospective immigrants to certain Western countries. In 2007, the U.S. Centers for Disease Control and Prevention (CDC) changed the TB screening protocol from a smear-based test to the complete Culture and Directly Observed Therapy Tuberculosis Technical Instructions (CDOT TB TI) for reducing the incidence of TB in foreign-born immigrants. METHODS: This study evaluated the effect of the revised (as compared with the old) protocol in South Korea. RESULTS: Of the 40,558 visa applicants, 365 exhibited chest radiographic results suggestive of active or inactive TB, and 351 underwent sputum tests (acid-fast bacilli smear and Mycobacterium tuberculosis culture). To this end, using the CDOT TB TI, 36 subjects (88.8 per 105 of the population) were found to have TB, compared with only seven using the older U.S. CDC technical instruction (TI) (p<0.001). In addition, there were six drug-resistant cases which were identified (16.7 per 105 of the population), two of whom had multidrug-resistance (5.6 per 105 of the population). CONCLUSION: The culture-based 2007 TI identified a great deal of TB cases current to the individuals tested, as compared to older U.S. CDC TI.


Subject(s)
Directly Observed Therapy , Emigrants and Immigrants , Humans , Incidence , Korea , Mass Screening , Mycobacterium tuberculosis , Prospective Studies , Radiography, Thoracic , Republic of Korea , Sputum , Tuberculosis
3.
Article in English | LILACS (Americas) | ID: biblio-961188

ABSTRACT

ABSTRACT Objective: to investigate the planning pathways in the transfer of Directly Observed Treatment of tuberculosis. Method: a qualitative study conducted using interviews and a semi-structured guide, administered to five subjects who were among the coordinators and managers of the tuberculosis control programs, and the secretary of health of a municipality in the south of Brazil. Situational Strategic Planning and Discourse Analysis of the French matrix were the theoretical and analytical references used, respectively. Results: three reflexive axes were identified: weaknesses in the process of planning the Directly Observed Treatment transfer, antagonism between planning and daily requirements and formulation of planning and execution. Lack of systematization regarding the planning and execution for transfer the Directly Observed Treatment policy, demonstrates the fragility and incipience of this activity, and the possibility of its non-existence. Conclusion: the urgent need for managers and coordinators to better appropriate the theoretical framework for changing public policies, and the related planning mechanisms, includes a proposal for reorganization and qualification of the diffusion process, both practical-operative and political-organization.


RESUMO Objetivo: investigar o processo de planejamento da transferência da política do Tratamento Diretamente Observado da tuberculose. Método: estudo qualitativo, realizado por meio de entrevistas e roteiro semiestruturado aplicado a cinco sujeitos, dentre coordenadores e gestores dos programas de controle da tuberculose e o secretário de saúde de um município do Sul do Brasil. O Planejamento Estratégico Situacional e a Análise de Discurso de matriz francesa foram os referenciais teórico e analítico utilizados, respectivamente. Resultados: três eixos reflexivos sobressaíram: as fragilidades no processo de planejamento da transferência do Tratamento Diretamente Observado; o antagonismo entre o planejamento e as exigências cotidianas; e a formulação do planejamento e sua execução. A assistematização do planejamento para a execução da transferência do Tratamento Diretamente Observado indica não apenas a fragilidade e incipiência dessa atividade, mas também a possibilidade de sua inexistência. Conclusão: é notória a premente necessidade de os gestores e coordenadores se apropriarem melhor tanto do referencial teórico da transferência de políticas públicas quanto dos próprios mecanismos de planejamento em si, incluindo, nesse sentido, uma proposta de reorganização e qualificação do processo difusor, prático-operativo e político-organizativo.


RESUMEN Objetivo: investigar el proceso de planificación de la transferencia de la política del Tratamiento Directamente Observado de la tuberculosis. Método: estudio cualitativo realizado por medio de entrevistas y con guión semiestructurado, aplicado en cinco sujetos: coordinadores y gestores de los programas de control de la tuberculosis y el secretario de salud de un municipio del sur de Brasil. La Planificación Estratégica Situacional y el Análisis de Discurso de matriz francesa fueron los referenciales teóricos y analíticos utilizados, respectivamente. Resultados: tres ejes reflexivos se destacaron: las fragilidades en el proceso de planificación de la transferencia del Tratamiento Directamente Observado; el antagonismo entre la planificación y las exigencias cotidianas y la formulación de la planificación; y su ejecución. La falta de sistematización, de la planificación para la ejecución de la transferencia del Tratamiento Directamente Observado, nos indica no apenas la fragilidad e insipiencia de esta actividad, pero además la posibilidad de que este no exista. Conclusión: es notaria la urgente necesidad de los gestores y coordinadores de conocer mejor tanto el referencial teórico de la transferencia de políticas públicas como los propios mecanismos de planificación, incluyendo con ese propósito una propuesta de reorganización y calificación del proceso difusor, práctico operativo y político organizativo.


Subject(s)
Humans , Tuberculosis/drug therapy , Planning Techniques , Directly Observed Therapy , Delivery of Health Care/organization & administration , Public Policy , Brazil , Qualitative Research
4.
J. bras. pneumol ; 43(6): 472-486, Nov.-Dec. 2017. tab
Article in English | LILACS (Americas) | ID: biblio-893876

ABSTRACT

ABSTRACT Tuberculosis treatment remains a challenge due to the need to consider, when approaching it, the context of individual and collective health. In addition, social and economic issues have been shown to be variables that need to be considered when it comes to treatment effectiveness. We conducted a critical review of the national and international literature on the treatment of tuberculosis in recent years with the aims of presenting health care workers with recommendations based on the situation in Brazil and better informing decision-making regarding tuberculosis patients so as to minimize morbidity and interrupt disease transmission.


RESUMO O tratamento da tuberculose permanece um desafio em função da necessidade de que, em sua abordagem, seja considerado o contexto da saúde do indivíduo e da saúde coletiva. Adicionalmente, as questões sociais e econômicas têm-se mostrado como variáveis a ser consideradas na efetividade do tratamento. Ao revisarmos de forma crítica a literatura científica nacional e internacional sobre o tratamento da tuberculose nos últimos anos, tivemos como objetivos apresentar aos profissionais da área de saúde as recomendações baseadas na realidade brasileira e fornecer os subsídios necessários para a melhor tomada de decisão frente ao paciente com tuberculose, de modo a minimizar a morbidade e interromper a transmissão da doença Em função disso, o TDO é recomendado.


Subject(s)
Humans , Child , Adult , Tuberculosis, Pulmonary/drug therapy , Directly Observed Therapy/standards , Tuberculosis, Pulmonary/complications , Brazil , Risk Factors , Health Personnel , Tuberculosis, Multidrug-Resistant/drug therapy , Decision Making
5.
Rev. cuba. anestesiol. reanim ; 16(3): 1-10, set.-dic. 2017. ilus, tab
Article in Spanish | LILACS (Americas), CUMED | ID: biblio-960313

ABSTRACT

Introducción: la transfusión autóloga presenta tres modalidades: transfusión autóloga con predepósito, hemodilución preoperatoria (normovolémica o hipervolémica) y el sistema de recuperación de sangre autóloga (cell saver) intraoperatoria o posoperatoria. Objetivo: demostrar la efectividad del uso del sistema de recuperación de sangre autóloga en pacientes quirúrgicos de alta complejidad en el Hospital Alcívar. Método: estudio retrospectivo, no experimental, de observación indirecta, con análisis correlacional. La muestra fue de 112 pacientes intervenidos por afecciones cardiovasculares, ortopédicas y traumatológicas, incluidos según criterios de inclusión y exclusión. Se utilizó cell saver en 56 pacientes, y 56 pacientes utilizaron transfusiones de sangre homóloga. Resultados. el cell saver fue beneficioso en 93 por ciento de los pacientes; la morbilidad y la mortalidad disminuyeron, principalmente en los pacientes intervenidos de cualquier afección cardiovascular y aumentó el índice costo/beneficio, debido a que se priorizaron los recursos económicos. En traumatología y ortopedia no fue muy beneficioso, pues la cantidad de sangre recuperada fluctuó entre 300 y 500 mL en intervenciones convencionales, lo que motivó el uso de hemoderivados y aumentó el costo. En resecciones tumorales e instrumentaciones en diferentes segmentos de la columna vertebral se recuperó hasta 800 mL de sangre, lo que resultó significativo. La tasa de complicaciones fue menor en pacientes que utilizaron cell saver (7 por ciento) frente a los pacientes que utilizaron hemoderivados homólogos (32 por ciento). Se constató una menor estancia hospitalaria en el grupo cell saver (1-20 días) en comparación con los que usaron hemoderivados homólogos (> 10 días, en 5 casos fue > 21 días). Conclusiones: el uso de sistema de recuperación de sangre autóloga constituye un procedimiento efectivo para infundir hemoderivados con mayor seguridad(AU)


Introduction: Autologous transfusion has three modalities: autologous transfusion with predeposit, preoperative hemodilution (normovolemic or hypervolemic), and the system for autologous blood recovery (cell saver), whether intraoperative or postoperative. Objective: To show the effectiveness of the use of the autologous blood recovery system in highly complex surgical patients at Alcívar Hospital. Method: Nonexperimental, retrospective study, of indirect observation and with correlational analysis. The sample consisted of 112 patients who underwent surgery for cardiovascular, orthopedic and traumatological conditions, chosen based on inclusion and exclusion criteria. The cell saver system was used in 56 patients and 56 patients used homologous blood transfusions. Results: The cell saver system was beneficial in 93 percent of patients; morbidity and mortality decreased, mainly in patients operated for any cardiovascular condition, while the cost-benefit ratio increased, due to the fact prioritization of economic resources. In traumatology and orthopedics, it was not so beneficial, since the amount of blood recovered fluctuated between 300 and 500 mL in conventional interventions, which motivated the use of blood products and increased the cost. In tumor resections and instrumentation of different spine segments, up to 800 mL of blood were recovered, which was significant. The complication rate was lower in patients who used the cell saver system (7 percent), compared to patients who used homologous blood products (32 percent). A shorter hospital stay was observed in the cell saver group (1-20 days), compared to those who used homologous blood products (over 10 days, while in 5 cases it was over 21 days). Conclusions: The use of the autologous blood recovery system is an effective procedure to infuse blood products with greater safety(AU)


Subject(s)
Surgical Procedures, Operative/methods , Blood Transfusion, Autologous/methods , Operative Blood Salvage/methods , Retrospective Studies , Directly Observed Therapy
6.
Ciênc. saúde coletiva ; 22(6): 1969-1977, jun. 2017. tab
Article in Portuguese | LILACS (Americas) | ID: biblio-839997

ABSTRACT

Resumo O objetivo deste artigo é analisar fontes de registro da tuberculose (TB) antes e após a implantação do Sistema Informatizado para Registro da Assistência à TB em Ribeirão Preto (SP). Estudo epidemiológico descritivo-analítico, do tipo intervenção. Os dados foram coletados em fontes secundárias, a partir de um formulário estruturado, e analisados através de teste Qui-quadrado ou Exato de Fisher com nível de significância de 5%. Identificou-se associação entre o período anterior da implantação do sistema com o arquivamento da Ficha do Tratamento Diretamente Observado no prontuário e o registro de orientação de retorno às consultas pela equipe de enfermagem. O posterior esteve associado com o aumento do registro do contato telefônico e endereço do doente de TB, data de término do tratamento, situação de encerramento, resultado da baciloscopia de escarro para controle mensal, teste anti-HIV, consultas mensais e solicitação de exames realizados pelo médico, atendimento com assistente social, condições de vida do doente, controle de comunicantes, incentivos sociais e uso de álcool e drogas. A implantação do sistema possibilitou a melhora no registro de algumas variáveis, ainda que outras fontes de registro tenham permanecido que não fossem o próprio sistema.


Abstract Objective to analyze sources of data for tuberculosis (TB) before and after the implementation of the Computerized System to Record Care for TB in Ribeirão Preto - SP. Method Intervention, descriptive-analytical epidemiological study. Data was collected from secondary sources using a structured form, and analyzed using Chi-squared or Fisher’s Exact Test, with a significance level of 5%. Results We found an association between the period before implementation of the system and placing the Directly Observed Treatment Card in the file, and registration of instructions for the return visit by the nursing team. The latter was associated with an increase in registered data regarding TB patient telephone number, address, end of treatment date, status at closing, sputum smear results for monthly control, HIV test, monthly checkups, tests ordered by physician, social worker visits, patient living conditions, contact control, social incentives and the use of drugs and alcohol. Conclusion Implementing the system improved the registration of a number of variables, despite the fact that other sources of data other than the system continue to exist.


Subject(s)
Humans , Delivery of Health Care/methods , Directly Observed Therapy/methods , Health Information Systems , Tuberculosis/therapy , Antitubercular Agents/administration & dosage , Brazil
7.
Rev. Esc. Enferm. USP ; 51: e03275, 2017. graf
Article in English, Portuguese | LILACS (Americas), BDENF | ID: biblio-956649

ABSTRACT

RESUMO Objetivo Avaliar o tratamento diretamente observado da tuberculose na Atenção Primária à Saúde, segundo dimensões da transferência de políticas. Método Estudo descritivo, realizado com profissionais de Unidades Básicas de Saúde, do município de São Paulo, SP. As entrevistas foram realizadas de maio a julho/2016, mediante instrumento validado, autoaplicável, com 39 itens, em escala Likert com cinco níveis. As variáveis foram organizadas nas dimensões: informação, conhecimento e inovação. Calculou-se a média das respostas dos entrevistados e classificaram-se como satisfatórias as médias entre quatro e cinco, regulares entre dois e meio e três e meio e insatisfatórias entre um e dois. Resultados Participaram do estudo 112 profissionais de saúde. Em informação, a participação da comunidade no tratamento foi considerada regular. Em conhecimento, a rotina do tratamento na unidade e a participação dos profissionais em treinamentos apresentaram classificação regular. Em inovação, a infraestrutura da unidade, o uso de recursos comunitários e a criação de estratégias para promover a adesão do doente ao tratamento obtiveram avaliação regular. As demais variáveis foram satisfatórias. Conclusão A transferência do tratamento diretamente observado da tuberculose para a Atenção Primária à Saúde, no local estudado, vem ocorrendo gradativamente e com sucesso.


RESUMEN Objetivo Evaluar el tratamiento directamente observado de la tuberculosis en la Atención Primaria de Salud, según dimensiones de la transferencia de políticas. Método Estudio descriptivo, realizado con profesionales de Unidades Básicas de Salud del municipio de São Paulo, SP. Las entrevistas fueron realizadas de mayo a julio/2016, mediante instrumento validado, autoaplicable, con 39 puntos, en escala Likert con cinco niveles. Las variables fueron organizadas en las dimensiones: información, conocimiento e innovación. Se calculó el promedio de las respuestas de los entrevistados y se clasificaron como satisfactorios los promedios entre cuatro y cinco; regulares, entre dos y medio y tres y medio; e insatisfactorios, entre uno y dos. Resultados Participaron en el estudio 112 profesionales sanitarios. En información, la participación de la comunidad en el tratamiento se consideró regular. En conocimiento, la rutina del tratamiento en la unidad y la participación de los profesionales en entrenamientos presentaron clasificación regular. En innovación, la infraestructura de la unidad, el uso de recursos comunitarios y la creación de estrategias para promover la adhesión del enfermo al tratamiento lograron evaluación regular. Las demás variables fueron satisfactorias. Conclusión La transferencia del tratamiento directamente observado de la tuberculosis a la Atención Primaria de Salud, en el sitio estudiado, está ocurriendo gradualmente y con éxito.


ABSTRACT Objective To evaluate the directly observed therapy for treating tuberculosis in the Primary Health Care Service according to the dimensions of policy transfer. Method Descriptive study, conducted with professionals from Basic Health Units in the city of São Paulo, SP state. The interviews were conducted from May to July/2016, using a validated, self-administered instrument with 39 items on a five-point Likert scale. The variables were organized in the dimensions: information, knowledge and innovation. The mean of the responses was calculated: the means between four and five were classified as adequate, between two and a half and three and a half as fair, and between one and two as inadequate. Results 112 health professionals participated in the study. In the dimension of information, participation of the community in the treatment was considered fair. In the dimension of knowledge, the treatment routine in the unit and the participation of the professionals in trainings were classified as fair. In the dimension of innovation, the unit infrastructure, the use of community resources and the creation of strategies to promote patient adherence were evaluated as fair. The other variables were adequate. Conclusion The transfer of the directly observed therapy for treating tuberculosis in the Primary Health Care assessed has been occurring gradually and successfully.


Subject(s)
Male , Female , Adult , Middle Aged , Aged , Tuberculosis/therapy , Directly Observed Therapy , Family Health Strategy , Public Health Policy , Primary Health Care , Primary Nursing
8.
Rev. bras. enferm ; 69(6): 1154-1163, nov.-dez. 2016.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-829854

ABSTRACT

RESUMO Objetivo: analisar os sentidos produzidos pelos profissionais de enfermagem sobre o tratamento diretamente observado (TDO) para tuberculose (TB) em município do estado de São Paulo. Método: trata-se de estudo qualitativo, desenvolvido em março e abril de 2014, por meio de entrevista semidirigida, com nove profissionais de enfermagem. O material empírico produzido foi analisado conforme o aporte teórico-metodológico de Análise de Discurso de matriz francesa. Resultados: emergiram como resultados três blocos discursivos: Condições de produção das práticas de controle da tuberculose; Condições de produção que facilitam o tratamento da tuberculose; Condições de produção que dificultam o tratamento da tuberculose. Conclusão: os dizeres desses profissionais produzem diversos sentidos, os quais sugerem que as práticas dos profissionais de Enfermagem possibilitam ao doente a busca pela cura, reforçada por incentivos de caráter social, não obstante, permeadas por vicissitudes circunscritas nas condições de produção do cotidiano da pessoa adoecida.


RESUMEN Objetivo: analizar los sentidos producidos por profesionales de enfermería acerca del tratamiento por observación directa (TDO) para tuberculosis (TB) en municipio del estado de São Paulo. Método: estudio cualitativo desarrollado en marzo y abril de 2014, mediante entrevistas semidirigidas con nueve profesionales de enfermería. El material empírico generado fue analizado conforme el aporte teórico-metodológico del Análisis del Discurso de matriz francesa. Resultados: surgieron como resultados tres bloques discursivos: condiciones de producción de las prácticas de control de la tuberculosos; Condiciones de producción que facilitan el tratamiento de la tuberculosis; Condiciones de producción que dificultan el tratamiento de la tuberculosos. Conclusión: los dichos de los profesionales determinan diversos sentidos, los cuales sugieren que las prácticas de profesionales de Enfermería le brindan al enfermo la búsqueda de la cura, reforzada con incentivos de carácter social; aunque permeadas por vicisitudes circunscriptas a las condiciones de producción del cotidiano de la persona enferma.


ABSTRACT Objective: to analyze the meanings produced by nursing professionals in the directly observed treatment (DOT) for tuberculosis (TB) in the city of São Paulo. Method: this is a qualitative study, conducted in March and April 2014 through semi-directed interviews with nine nurses. The empirical material produced was analyzed according to the theoretical and methodological support of the Discourse Analysis of French matrix. Results: results have emerged as three discursive blocks: conditions for the production of tuberculosis control practices; production conditions facilitating the treatment of tuberculosis; and production conditions hindering the treatment of tuberculosis. Conclusion: these professionals' words produce different meanings, which suggest that the practices of nursing professionals allow the patient to search for a cure, which is reinforced by incentives of a social nature, but permeated by the vicissitudes that are circumscribed in the ill person's everyday production conditions.


Subject(s)
Humans , Attitude of Health Personnel , Directly Observed Therapy , Nurse's Role , Tuberculosis, Pulmonary/drug therapy , Brazil , Interviews as Topic , Tuberculosis, Pulmonary/nursing
9.
Rev. Esc. Enferm. USP ; 50(2): 247-254, tab, graf
Article in English | LILACS (Americas) | ID: lil-785768

ABSTRACT

Abstract OBJECTIVE To assess the degree of implementation of the Directly Observed Treatment, Short-course - DOTS for tuberculosis (TB) in a large city. METHOD Assessment of the implementation of the logic model, whose new cases of infectious pulmonary TB were recruited from specialized clinics and followed-up in basic health units. The judgment matrix covering the five components of the DOTS strategy were used. RESULTS The result of the logic model indicates DOTS was partially implemented. In external, organizational and implementation contexts, the DOTS strategy was partially implemented; and, the effectiveness was not implemented. CONCLUSION: The partial implementation of the DOTS strategy in the city of Manaus did not reflect in TB control compliance, leading to low effectiveness of the program.


Resumen OBJETIVO Evaluar el grado de implantación de la estrategia de tratamiento directamente observado (Directly Observed Treatment, Short-course - DOTS) para tuberculosis (TB) en un municipio de gran porte. MÉTODO Evaluación de implantación por medio de modelo lógico, cuyos casos nuevos de TB pulmonar bacilífera fueron obtenidos en ambulatorios especializados y seguidos en la unidades básicas de salud. Se utilizó matriz de juicio que abarca los cinco componentes de la estrategia DOTS. RESULTADOS El resultado del modelo lógico señala DOTS implantada parcialmente. En el marco exterior, organizacional y de implantación, la estrategia DOTS está implantada parcialmente; y, en la efectividad, no está implantada. CONCLUSIÓN La implantación parcial de la estrategia DOTS, en la ciudad de Manaus, refleja la no conformidad del control de la TB, llevando a la baja efectividad del programa.


Resumo OBJETIVO Avaliar o grau de implantação da estratégia de tratamento diretamente observado (Directly Observed Treatment, Short-course - DOTS) para tuberculose (TB) em um município de grande porte. MÉTODO Avaliação de implantação por meio de modelo lógico, cujos casos novos de TB pulmonar bacilífera foram recrutados em ambulatórios especializados e acompanhados nas unidades básicas de saúde. Utilizou-se matriz de julgamento que abrange os cinco componentes da estratégia DOTS. RESULTADOS O resultado do modelo lógico indica DOTS implantada parcialmente. Nos contextos externo, organizacional e de implantação, a estratégia DOTS está implantada parcialmente; e, na efetividade não está implantada. CONCLUSÃO A implantação parcial da estratégia DOTS, na cidade de Manaus, reflete na não conformidade do controle da TB, levando à baixa efetividade do programa.


Subject(s)
Humans , Directly Observed Therapy/statistics & numerical data , Medication Adherence/statistics & numerical data , Tuberculosis, Pulmonary/drug therapy
10.
Rev. eletrônica enferm ; 18: 1-11, 20160331. ilus, tab
Article in English, Portuguese | LILACS (Americas), BDENF | ID: biblio-832823

ABSTRACT

Objetivou-se analisar o percurso do doente de tuberculose (TB) durante o tratamento no sistema de serviços de saúde. Estudo epidemiológico, descritivo, realizado em Ribeirão Preto, São Paulo. Como fontes de dados utilizaram-se os registros relacionados ao tratamento da TB do Sistema de prontuários eletrônicos municipal e o sistema de notificação estadual. As variáveis selecionadas para o estudo foram categorizadas nas dimensões de análise: demanda, recursos, processos/produtos e resultados. Foram selecionados 109 registros de doentes de TB acompanhados em ambulatórios de referência para o tratamento da doença. Frente a alguma intercorrência notou-se a preferência por procurar o Pronto-atendimento 67(61,5%). O atendimento era centrado em médicos e auxiliares/técnicos de enfermagem 108(99,1%), sendo estes os principais responsáveis pelas visitas domiciliares e pela supervisão medicamentosa (71,6%). Os resultados permitiram observar a centralização do atendimento no nível secundário da atenção, privilegiando equipes especializadas e mantendo este ponto como o principal ordenador do cuidado


The objective was to analyze the route of the tuberculosis (TB) patient during treatment in the health service system. An epidemiologic, descriptive study conducted in Ribeirão Preto, São Paulo. We used tuberculosis-related registries from the municipal system of electronic records and the state notification system as data sources. The selected variables for the study were categorized in the analysis dimensions: demand, resources, processes/products and results. We selected 109 TB patients' registries accompanied in reference ambulatories for TB treatment. When facing a complication, we noted the preference to search for emergency care 67 (61.5%). The attention was centered in physicians and nursing assistant/technicians 108 (99.1%), and it was the main responsible for home visitations and medication supervision (71.6%). The results allowed us to observe the attention centralized at the secondary attention level, privileging specialized teams and maintaining this point as the main care ordaining


Subject(s)
Humans , Male , Female , Directly Observed Therapy , Health Information Systems , Health Services , Tuberculosis/epidemiology , Tuberculosis/therapy
11.
Rev. enferm. UERJ ; 24(1): e8425, jan.-fev. 2016.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-947071

ABSTRACT

Objetivo: conhecer a opinião dos profissionais de saúde sobre o tratamento diretamente observado da tuberculose. Método: estudo descritivo de natureza qualitativa, realizado com enfermeiros e médicos que atuam na atenção primária em 15 municípios que integram a 15ª Regional de Saúde do Paraná. Os dados foram coletados nos meses de junho e julho de 2013, por meio de entrevistas semiestruturadas. Utilizou-se análise de conteúdo, o que deu origem à categoria Tratamento diretamente observado: potencialidades e fragilidades. Foram entrevistados 20 enfermeiros e 10 médicos que atuam em ações de controle da tuberculose. Resultados: embora o tratamento diretamente observado não esteja implantado em todos os municípios, devido ao baixo número de casos, os profissionais reconhecem sua importância. Contudo, existem dificuldades para a implementação dessa estratégia, como a falta de tempo, de recursos humanos e de transporte. Conclusão: neste sentido, é imprescindível a melhoria da organização e oferta de serviços de saúde.


Objective: to discover the opinions of directly observed treatment for tuberculosis. Method: qualitative, descriptive study held by primary care nurses and doctors in the 15 municipalities that make up the 15th Health Region of Paraná State. Data were collected by semi-structured interviews of 20 nurses and 10 physicians working in tuberculosis control actions in June and July 2013. Content analysis yielded the category Directly observed treatment: strengths and weaknesses. Results: although, due to the low number of cases, directly observed treatment is not implemented in all municipalities, practitioners do recognize its importance. However, difficulties in implementing the strategy include lack of time, human resources and transport. Conclusion: in this regard, it is essential to improve health service organization and delivery.


Objetivo: conocer la opinión de los profesionales de salud sobre el tratamiento directamente observado de la tuberculosis. Método: estudio descriptivo, cualitativo, realizado junto a enfermeros y médicos que trabajan en la atención primaria en 15 ciudades que componen la 15ª Regional de Salud de Paraná. Los datos fueron recolectados en junio y julio de 2013, a través de entrevistas semiestructuradas. Se ha utilizado el análisis de contenido, lo que originó la categoría Tratamiento Directamente Observado: fortalezas y debilidades. Fueron entrevistados 20 enfermeros y 10 médicos que trabajan en las acciones de control de la tuberculosis. Resultados: aunque el tratamiento directamente observado no se haya implementado en todos los municipios, debido al bajo número de casos, los profesionales están conscientes de su importancia. Sin embargo, existen dificultades en la aplicación de esa estrategia: falta de tiempo, de recursos humanos y de transporte. Conclusión: en este sentido, es esencial la mejora de la organización y la prestación de servicios de salud.


Subject(s)
Humans , Primary Health Care , Tuberculosis , Nursing , Directly Observed Therapy , Patient Care Team , Tuberculosis/drug therapy , Tuberculosis/therapy , Evaluation Studies as Topic , Epidemiology, Descriptive , Family Health Strategy
12.
Acta Medica Philippina ; : 136-143, 2016.
Article in English | WPRIM (Western Pacific) | ID: wprim-632745

ABSTRACT

OBJECTIVE: The main objective of the study is to determine the factors which contribute to the delay in the initiation of treatment of TB patients enrolled in the TB control program in a highly urbanized city in the Philippines.METHODS: A descriptive, cross-sectional study was conducted in 14 health centers in the city; from which the proportion of TB patients who experienced delay in the initiation of treatment (>1 day after diagnosis) was obtained through records review. The health system and patient factors which contributed to the patients' delay were determined through face-to-face interviews. The information obtained was analyzed with supplemental information from interviews with selected health workers in the tuberculosis control program of the city. RESULTS: These showed that 20.95% of the TB patients enrolled in the TB control program of the city experienced delay in the initiation of treatment. They experienced a mean delay of 9.48 days. The health system and patient factors which affected the patients the most were the referral system (24.5%) and conflict between treatment and work or household responsibilities (22.4%), respectively.CONCLUSION: These existing delay imply he need to implement interventions directed to improving current measures to control TB in the country.


Subject(s)
Humans , Male , Female , Middle Aged , Adult , Young Adult , Adolescent , Patients , Diagnosis , Sputum , Cross-Sectional Studies , Family Characteristics , Philippines , Referral and Consultation , Tuberculosis , Urbanization , Directly Observed Therapy , Time-to-Treatment
13.
Recife; s.n; 2016. graf, ilus, tab.
Thesis in Portuguese | LILACS (Americas), ECOS | ID: biblio-988361

ABSTRACT

A tuberculose (TB) é uma das doenças infecciosas mais antigas no mundo, e até os dias atuais ainda permanece sendo um sério problema para a saúde pública global. O Tratamento Diretamente Observado (TDO) caracteriza-se como elemento chave, no fortalecimento da adesão ao tratamento da TB e na prevenção do aparecimento de cepas resistentes aos medicamentos, uma vez que ainda existem taxas de cura inferiores a meta preconizada e um número ainda elevado de abandono do tratamento. Em Pernambuco a estratégia TDO foi implantada inicialmente pela capital Recife a partir de 2005-2007 e segundo dados, no ano de 2013 chegou a uma cobertura de 63,5% em todo o estado. Para o presente estudo foram utilizados dados secundários retirados do Sistema de Informação de Agravos e Notificações (SINAN) no período 2005 a 2014. Os resultados apontam que a maioria dos pacientes são adultos jovens do sexo masculino, não brancos, alfabetizados, moradores de zona urbana e entre as doenças e agravos o mais presente foi o alcoolismo. A taxa de incidência da TB apresentou uma média em torno de 48,6%. Os casos de óbitos, no estado, apresentou uma média de 4,3. A forma pulmonar predomina diante das demais, com uma média de mais de 4000 (85%) casos ao ano no Estado. A média de cura e abandono ficou em torno de 71,3% e 9,9% respectivamente. A realização do TDO só veio a surtir efeito no estado a partir de 2007 (53,86%) seguindo até o ano de 2014 com 60,37%.Foi observado que nos últimos 10 anos de estudo (2005-2014) a probabilidade de cura, a partir da diferença de médias entre os grupos, foi de 26% a mais para o grupo dos tratados (TDO) do que para o grupo controle (não TDO). Esses resultados são corroborados por três diferentes critérios de Matching (pareamento) via Propensity Score (escore de propensão): o vizinho mais próximo, indicando que os indivíduos submetidos ao TDO têm em média 23% de chances a mais de cura, com base nos Estratos, este percentual é de 21% e o Kernel, apresentou 23% a mais de chances de cura.(AU)


Tuberculosis (TB) is one of the oldest infectious diseases in the world, and to this day still remains a serious problem for global public health. The Directly Observed Treatment Short-Course (DOTS) is characterized as a key element in strengthening adherence to TB treatment and prevention of the emergence of resistant strains to drugs, since there are still healing rates below the recommended target and an even higher number abandonment of treatment. In Pernambuco the DOTS strategy was implemented initially by Recife capital from 2005-2007 and second data, in 2013 reached a 63.5% coverage throughout the state. For the present study were used secondary data taken from Diseases and Notifications Information System (SINAN) in the period 2005 to 2014. The results show that most patients are young, adult males, not white, literate, urban residents and among the diseases and disorders the most present was alcoholism. The TB incidence rate in PE averaged around 48.6%. The cases of deaths, in the state, showing that PE is an average of 4.3. The pulmonary form predominates on the others, with an average of more than 4000 (85%) cases per year in the state. The average healing and abandonment was around 71.3% and 9.9% respectively. The realization of the DOTS only came to take effect in the state from 2007 (53.86%) followed by the year 2014 with 60.37%. It was observed that in the last 10 years of study (2005-2014) the probability of cure from the mean of difference between the groups was 26% higher for the group of treated (DOTS) than for the control group ( not DOT). These results are supported by three different criteria Matching by Propensity Score: the nearest neighbor matching, indicating that individuals submitted to DOTS have averaged 23% chance more healing, based on Strata this percentage is 21% and Kernel, showed 23% more chances of cure.(AU)


Subject(s)
Humans , Tuberculosis/epidemiology , Directly Observed Therapy , Propensity Score , Tuberculosis/mortality , Brazil , Incidence , Health Impact Assessment
14.
Epidemiol. serv. saúde ; 24(3): 559-564, jul.-set. 2015. tab
Article in Portuguese | LILACS (Americas) | ID: lil-762995

ABSTRACT

OBJETIVO: descrever a experiência da implementação do Programa Municipal de Controle da Tuberculose (PMCT) no município de Marataízes-ES, Brasil, em 2012. MÉTODOS: relato de experiência sobre as ações de controle da tuberculose no município; realizou-se busca ativa de sintomáticos respiratórios (SR) e casos de abandono do tratamento do ano anterior, incluindo locais de uso comum de drogas, além da capacitação dos profissionais de saúde envolvidos no manejo clínico e cuidado dos doentes e palestras educativas sobre tuberculose nas escolas municipais; a assistência foi realizada também durante finais de semana e feriados. RESULTADOS: foram identificados 98 SR (35 usuários de droga); 27 pacientes foram diagnosticados, notificados e submetidos à terapia diretamente observada (TDO); não houve abandono do tratamento; 25 casos de tuberculose foram encerrados por cura. CONCLUSÃO: a implementação do PMCT mediante uma rede integrada fortaleceu os mecanismos organizacionais de assistência ao portador de tuberculose e aprimorou os indicadores epidemiológicos municipais.


OBJECTIVE: to describe the experience of Municipal Tuberculosis Control Program (MTCP) implementation in the city of Marataízes, State of Espírito Santo, in 2012. METHODS: this is an report the experience of tuberculosis control actions. Respiratory symptomatic (RS) subjects and patients who abandoned treatment in the previous year were actively traced, including in places where drug use is common. Training was provided to healthcare professionals involved in patient clinical management and care. Educational talks on tuberculosis were given in municipal schools. Healthcare was also provided on weekends and holidays. RESULTS: 98 RS were identified (35 drug users); 27 patients were diagnosed, notified and underwent directly observed therapy (DOT); there was no treatment abandonment; 25 tuberculosis cases were cured. CONCLUSION: MTCP implementation through an integrated network strengthened the organizational mechanisms of healthcare to those with tuberculosis and improved municipal epidemiological indicators.


OBJETIVO: describir la experiencia de la implementación del Programa Municipal de Control de Tuberculosis (PMCT) en el municipio de Marataízes-ES, en 2012. MÉTODOS: relato de experiencia sobre las acciones de control de tuberculosis en el municipio. Se realizó una búsqueda activa de personas con síntomas respiratorios (SR) e casos de abandono de tratamiento, durante el último año, incluyendo locales de uso común de drogas, además de la capacitación de profesionales de la salud, envueltos en el manejo clínico y cuidado de los enfermos y de dar conferencias educativas sobre tuberculosis en las escuelas públicas. La asistencia fue también realizada durante finales de semana y feriados. RESULTADOS: se identificaron 98 SR (35 usuarios de drogas); 27 pacientes fueron diagnosticados, notificados y sometidos a terapia por observación directa (TOD); no hubo abandonos, siendo que 25 casos de tuberculosis fueron finalizados con cura. CONCLUSIÓN: la implementación del PMCT por medio de una red integrada fortaleció los mecanismos organizacionales de asistencia al portador de tuberculosis y mejoró los indicadores epidemiológicos municipales.


Subject(s)
Humans , Male , Female , Directly Observed Therapy , Health Information Systems , Health Programs and Plans , Tuberculosis/prevention & control
15.
Clinics ; 70(6): 429-434, 06/2015. tab, graf
Article in English | LILACS (Americas) | ID: lil-749788

ABSTRACT

OBJECTIVES: Fixed-dose combination formulations, which simplify the administration of drugs and prevent the development of drug resistance, have been recommended as a standard anti-tuberculosis treatment regimen. However, the composition and dosage recommendations for fixed-dose combination formulations differ from those for separate formulations. Thus, questions about the effectiveness and side effects of combination formulations remain. The aim of this study was to compare the safety and efficacy of these two types of anti-tuberculosis regimens for pulmonary tuberculosis treatment. METHOD: A prospective, randomized controlled study was conducted using the directly observed treatment short-course strategy. Patients were randomly allocated to one of two short-course regimens. One year after completing the treatment, these patients’ outcomes were analyzed. ClinicalTrials.gov: NCT00979290. RESULTS: A total of 161 patients were enrolled, 142 of whom were evaluable for safety assessment. The two regimens had a similar incidence of adverse effects. In the per-protocol population, serum bilirubin concentrations at the peak level, at week 4, and at week 8 were significantly higher for the fixed-dose combination formulation than for the separate formulations. All patients had negative sputum cultures at the end of the treatment, and no relapse occurred after one year of follow-up. CONCLUSIONS: In this randomized study, transient higher serum bilirubin levels were noted for the fixed-dose combination regimen compared with the separate formulations during treatment. However, no significant difference in safety or efficacy was found between the groups when the directly observed treatment short-course strategy was used. .


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Antitubercular Agents/administration & dosage , Tuberculosis, Pulmonary/drug therapy , Antitubercular Agents/adverse effects , Bilirubin/blood , Drug Administration Schedule , Drug Combinations , Directly Observed Therapy/methods , Drug Therapy, Combination/adverse effects , Drug Therapy, Combination/methods , Follow-Up Studies , Hyperuricemia/chemically induced , Prospective Studies , Skin Diseases/chemically induced , Sputum/microbiology , Treatment Outcome , Tuberculosis, Pulmonary , Vision Disorders/chemically induced
16.
Singapore medical journal ; : 274-279, 2015.
Article in English | WPRIM (Western Pacific) | ID: wprim-337176

ABSTRACT

<p><b>INTRODUCTION</b>The 'DOT & Shop' scheme is sponsored by SATA CommHealth, a local non-governmental organisation. It was launched in July 2009, in collaboration with Singapore's Tuberculosis Control Unit (TBCU). Under this scheme, grocery vouchers are disbursed to low-income patients with tuberculosis (TB) at each clinic visit if they have been adherent to directly observed therapy (DOT). This study aimed to determine the effect of this incentive scheme on treatment completion rates and to report the characteristics of patients who were non-adherent to the scheme.</p><p><b>METHODS</b>This descriptive study used data from the TBCU medical social worker database and the National TB Registry.</p><p><b>RESULTS</b>From July 2009 to December 2012, a total of 883 TB patients were enrolled in the scheme. The overall treatment completion rates of the patients before (July 2006-June 2009) and after (July 2009-December 2012) the implementation of the scheme improved from 85.3% to 87.2% (p = 0.02). Patients under this scheme had a higher treatment completion rate (90.0%) than those not under this scheme (86.4%) (p < 0.01). It was found that the non-adherent patients were more likely to be of Malay ethnicity, younger and unemployed.</p><p><b>CONCLUSION</b>We demonstrate the salutary effect of a non-governmental organisation-funded grocery voucher incentive scheme for low-income TB patients on DOT in Singapore.</p>


Subject(s)
Adult , Age Factors , Aged , Antitubercular Agents , Databases, Factual , Directly Observed Therapy , Methods , Female , Food Assistance , Humans , Male , Middle Aged , Motivation , Patient Compliance , Poverty , Program Evaluation , Singapore , Tuberculosis , Drug Therapy , Unemployment
17.
Article in English | WPRIM (Western Pacific) | ID: wprim-264541

ABSTRACT

Preventive treatment has an essential effect on latent tuberculosis infection (LTBI) [purified protein derivative (PPD) induration ⋝ 15 mm]. Between 2010 and 2013, there were 6 tuberculosis (TB) outbreaks in the universities in Dalian, China. So far, in Dalian, the directly observed therapy (DOT) and full course management (FCM) were widely used in the preventive treatment of LTBI. However, it is yet to be determined which one of them has better efficacy. Therefore, the purpose of our study was to explore the performance of these two strategies for LTBI preventive treatment. The chi-square test and exact test were used to perform statistical analysis. In total, 794 LTBI patients were enrolled in this study, of which 443 were included in the DOT group and 351 in the FCM group. In 287 students who said ditto to take prophylactic treatment (DOT 149 and FCM 79), the compliance rate for the DOT group was 90.3% (149/165), while that for the FCM group was 64.8% (79/122). This difference between the two groups was statistically significant (χ²=28.03, P=1.19E-07). The DOT group showed an effective intervention rate of 81.5%, while that for the FCM group was 28.5%. Again, this difference was significant (χ²=56.17, P=6.63E-14). Further, in 228 students who truly started taking treatment, 26 cases exhibited various adverse reactions (11.4%, 26/228), the most frequent one being elevated liver enzyme levels (6.6%, 15/228). In addition, the major reason for the treatment interruption was adverse reactions in the DOT group, and 6 (28.6%) LTBI patients discontinued treatment due to the adverse reactions of the anti-TB drugs. We also performed a one-year follow-up after the completion of the 3-month treatment. Out of the 794 close contacts, a total of 9 cases (1.1%) developed active TB. These results show that DOT is an effective preventive treatment for LTBI and would play an irreplaceable role in improving preventive treatment adherence and treatment outcomes.


Subject(s)
Adult , Antitubercular Agents , China , Directly Observed Therapy , Female , Humans , Latent Tuberculosis , Drug Therapy , Male , Patient Compliance , Young Adult
18.
Rev. Esc. Enferm. USP ; 48(6): 1044-1053, 12/2014. graf
Article in English | LILACS (Americas) | ID: lil-736340

ABSTRACT

Objective Evaluating the performance of primary care services for the treatment of tuberculosis according to the assessment referential of health services (structure/process) in Cabedelo, a port city in the state of Paraíba. Method An evaluation quantitative, cross-sectional study, in which were carried out 117 interviews with health professionals using a structured instrument. The analysis was based on the construction of indicators using a standardized value for the reduced variable (z=1). Results The structural indicators showed regular performance for the following variables: professional training, access to record instruments and coordination with other services. The process indicators related to external actions and information about the disease had unsatisfactory performance. The directly observed treatment and the flows of reference/counter-reference had regular performance. Conclusion The focused professional qualification, the fragmentation of practices and the unsystematic home care constitute obstacles for carrying out actions aimed at providing expanded, continuous and resolute care.

 .


Objetivo Avaliar o desempenho dos serviços de Atenção Básica para o tratamento da tuberculose segundo o referencial de avaliação dos serviços de saúde (estrutura/processo) em Cabedelo, município portuário da Paraíba. Método Pesquisa avaliativa, quantitativa, de corte transversal onde foram realizadas 117 entrevistas com os profissionais de saúde, através de um instrumento estruturado. A análise pautou-se na construção de indicadores, utilizando-se valor padronizado para a variável reduzida (z=1). Resultados Os indicadores estruturais apresentaram desempenho regular para as variáveis: capacitação profissional; acesso a instrumentos de registro; articulação com outros serviços. Quanto ao processo, os indicadores relacionados às ações externas e informações sobre a doença apresentaram desempenho insatisfatório. O tratamento diretamente observado e os fluxos de referência/contrarreferência tiveram desempenho regular. Conclusão A qualificação profissional focalizada, a fragmentação das práticas e a atenção domiciliária assistemática, constituem em obstáculos para o desempenho de ações voltadas à prestação do cuidado ampliado, contínuo e resolutivo. .


Objetivo Evaluar el desempeño de los servicios de Atención Básica para el tratamiento de la tuberculosis según el marco de referencia de evaluación de los servicios de salud (estructura/proceso) en Cabedelo, municipio portuario de Paraíba. Método Investigación evaluativa, cuantitativa, de corte transversal en donde se llevaron a cabo 117 entrevistas con los profesionales de salud, mediante un instrumento estructurado. El análisis se pautó en la construcción de indicadores, utilizándose valor estandarizado para la variable reducida (z=1). Resultados Los indicadores estructurales presentaron desempeño regular para las variables: capacitación profesional; acceso a instrumentos de registro; articulación con otros servicios. En cuanto al proceso, los indicadores relacionados con las acciones exteriores e informaciones acerca de la enfermedad presentaron desempeño insatisfactorio. El tratamiento directamente observado y los flujos de referencia/contrarreferencia tuvieron desempeño regular. Conclusión La cualificación profesional enfocada, la fragmentación de las prácticas y la atención domiciliaria asistemática se constituyen en obstáculos para el desempeño de acciones dirigidas a la prestación del cuidado ampliado, continuo y resolutivo. .


Subject(s)
Humans , Primary Health Care/standards , Tuberculosis, Pulmonary/therapy , Cross-Sectional Studies , Directly Observed Therapy/standards , Health Care Surveys , Quality Indicators, Health Care
19.
Article in English | IMSEAR (South-East Asia), GHL | ID: sea-159744

ABSTRACT

Introduction: Tuberculosis (TB) is a major public health problem worldwide. Two deaths occur for every three minutes in India due to tuberculosis and two people become sputum positive for tuberculosis every minute. Designated Microscopic Centre (DMC) is the most peripheral laboratory unit under RNTCP catering to population of one lakh. Objective: To know the outcome of tuberculosis patients in terms of treatment success, cured, treatment completed, transferred out, died and defaulted among registered TB cases under DMC. Methodology: Five years’ secondary data about tuberculosis patients on DOTS under the Designated Microscopic Centre (DMC), Vantamuri (R) PHC, Belgaum from January 2008 to March 2013 was included. Total of 182 patients on DOTS, who were enrolled under Vantamuri (R) DMC during this period were included for data analysis. Revised International Union Against Tuberculosis and Lung Diseases (IUATLD, 2001) definitions in tuberculosis control were used. Data was analysed using percentages. Results: Among 182 study participants, 105 patients (57.7%) were males and 77 (42.3%) were females. Overall treatment success rate was 90.7% among TB patients enrolled under Vantamuri (R) DMC. Conclusion: Males were affected more than females by TB. Eight out of ten TB patients were in the age group of 20-60 years. Study area DMC performed similar to national averages.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Directly Observed Therapy/methods , Female , Humans , India , Infant , Infant, Newborn , Male , Middle Aged , Primary Health Care/organization & administration , Retrospective Studies , Treatment Outcome , Tuberculosis/drug therapy , Tuberculosis/mortality , Young Adult
20.
Rev. Esc. Enferm. USP ; 48(5): 874-882, 10/2014. tab
Article in English | LILACS (Americas) | ID: lil-730681

ABSTRACT

Objective Analyzing the policy transfer of directly observed treatment of tuberculosis from the perspective of nursing. Method This is a descriptive study with qualitative approach, which had 10 nurses of the Family Health Strategy in São Paulo as subjects. The interviews were carried out between May and June 2013, and were adopted the technique of thematic content analysis and the referential of policy transfer. Results On the signification of this treatment, are related the senses of disciplinary monitoring, the bond and approximation to the context of patients’ lives. Operationally, nurses, community health agents and nursing technicians stand out as agents of implementation of this policy, developing multiple actions of user embracement. The nurse is evidenced as an educator in health, leader in the family health team, and capable of creating emotional bond with users. Conclusion It was found that the innovations proposed in the treatment are incipient in the daily work of nurses. .


Objetivo Analizar el traslado de política del tratamiento directamente observado en la tuberculosis bajo la perspectiva de la Enfermería. Método Estudio descriptivo, con abordaje cualitativo que tuvo como sujetos 10 enfermeras de la Estrategia Salud de la Familia del municipio de São Paulo. Las entrevistas se llevaron a cabo entre mayo y junio de 2013. Se adoptó la técnica del análisis de contenido temático y lo referencial del traslado de políticas. Resultados En la significación de dicho tratamiento, se relacionan sentidos de monitoreo disciplinar, vínculo y aproximación al marco de vida del enfermo. Operacionalmente, el enfermero, el agente comunitario de salud y el técnico de enfermería se destacan como agentes de la implantación de esa política, desarrollando acciones múltiples y acogedoras. Al enfermero se le evidencia como educador en salud, líder del equipo de salud de la familia y capaz de producir vínculo afectivo con el usuario. Conclusión Se identificó que las innovaciones propuestas al tratamiento son incipientes en el cotidiano de trabajo de los enfermeros. .


Objetivo Avaliar a prática dos enfermeiros da Estratégia Saúde da Família na atenção à saúde auditiva infantil. Método Avaliação normativa, da estrutura e processo, com 37 enfermeiros nas Unidades de Saúde da Família, no município de Recife, Pernambuco. O instrumento de coleta de dados originou-se do modelo lógico da atenção à saúde auditiva infantil prestada pelo enfermeiro da Estratégia Saúde da Família e da matriz de indicadores para avaliação da prática dos enfermeiros. Resultados Todos os enfermeiros identificaram os marcos do desenvolvimento auditivo, 94,5%, pelo menos, dois fatores de risco, e 21,6% realizaram atividades educativas. Conclusão A avaliação normativa foi considerada adequada apesar de haver limitações na estrutura e no processo.
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Subject(s)
Adult , Female , Humans , Directly Observed Therapy , Nursing Process , Tuberculosis/drug therapy , Tuberculosis/nursing , Directly Observed Therapy/standards , Health Policy
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