Tuberculose diagnóstico e tratamento: análise dos desafios e das perspectivas do paciente em tratamento

Abstract

Tuberculosis, despite being one of the most ancient known diseases, remains a serious public health problem due to its severity. The study has the general objective of analyzing the challenges and perspectives of patients diagnosed and undergoing treatment for tuberculosis, and specific objectives such as outlining the sociodemographic and economic profile of users diagnosed with the pathology, analyzing the relationship between cases diagnosed in symptomatic patients and thru contacts, and identifying the difficulties and perspectives that patients face in continuing their treatment. The research is descriptive with a quantitative and qualitative approach, data collection was carried out in August and September at the Medical Assistance Post in the municipality of Picos-PI, with users undergoing tuberculosis treatment. Information was collected by searching the records in the Notification of Complications Information System and thru interviews with the users. Based on the questionnaires, the technique used to organize the quantitative data (percentage – simple rule of three and tables) and qualitative data (thematic categories or grouping of similar meanings from the collected statements, aiming for subsequent analysis and interpretation). The study was previously presented to the PAM coordination, then submitted to the Brazil platform, and reviewed by the Ethics and Research Committee of the Faculty of Technology of Teresina, with the approved opinion number 7.658.710. Guided by the ethical principles of the National Health Council (CNS) Resolution No. 466/2012, under the perspective of bioethical references such as autonomy, non-maleficence, beneficence, justice, and equity. The clinical profile according to the study observed that predominantly the age group in treatment is between 30 to 59 years (50.00%), the majority are men (62.50%), the most affected race among the users were the mixed-race individuals (68.75%), they have a monthly income of up to a minimum wage (62.50%), have a low level of education, work mainly in rural labor, and among the areas, they reside in urban areas (68.75%) while 5 live in rural areas (31.25%). Related to the type of user entry, it is observed that (81.25%) are new cases, while (18.75%) reentered after abandonment, (6.25%) are individuals deprived of liberty, and (6.25%) are homeless. Among the findings of this research, (81.25%) correspond to pulmonary TB, (18.75%) to extrapulmonary form, distributed among three clinical manifestations, with (6.25%) being lymphatic, (6.25%) ocular, and (6.25%) bone. Of the household contacts, 40 people were identified, but only 20 underwent the examination. During the interviews, the difficulties and perceptions of the patients in treatment were observed and described, revealing an experience marked by physical, emotional, and social challenges that directly affect their motivation to continue the treatment. It is concluded that the influence of social determinants has an impact on the ways of transmission, adherence to treatment, and cure of tuberculosis. There are still challenges related to understanding the treatment and accepting care; in addition to personal resistance, there are failures in communication and the provision of accessible mental health services. The present study highlights the ongoing need for directly observed treatment actions by health teams in primary care thru the Family Health Strategy. This approach allows for continuous monitoring of the patient's social and emotional conditions, fostering comprehensive and humanized care.