• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Master's Dissertation
DOI
https://doi.org/10.11606/D.22.2010.tde-14012011-102453
Document
Author
Full name
Monalise Lemos
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2010
Supervisor
Committee
Palha, Pedro Fredemir (President)
Assolini, Filomena Elaine Paiva
Monroe, Aline Aparecida
Title in Portuguese
Atraso no diagnóstico da tuberculose na percepção dos gerentes da atenção básica a saúde de Ribeirão Preto - São Paulo
Keywords in Portuguese
Atenção Primária à Saúde
Gerência
Serviços de Saúde
Tuberculose
Abstract in Portuguese
O presente estudo objetivou analisar os fatores relacionados ao atraso no diagnóstico da tuberculose (TB) na percepção dos gerentes da Atenção Básica (AB). O cenário foi o município de Ribeirão Preto, prioritário para o controle da TB no estado de São Paulo. O projeto que deu origem a este trabalho foi aprovado pelo Comitê de Ética em Pesquisa da Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo (CEP/EERP/USP - 012/2009). Participaram do estudo 17 sujeitos, representando 43,6% dos gerentes dos cinco distritos sanitários. Para produção do material empírico foram realizadas entrevistas semidirigidas, gravadas, no período de junho a agosto de 2009, e norteadas por um roteiro temático. As entrevistas se deram após o consentimento livre e esclarecido. Após transcrição das entrevistas, as informações foram organizadas com recurso do software Atlas. Ti versão 6.0. Para interpretação utilizou-se o referencial teórico-metodológico da Análise de Discurso, de matriz pêcheuxtiana. O atraso no diagnóstico da TB, na percepção dos gerentes, possui fatores relacionados à doença, ao doente, aos serviços e profissionais de saúde. À doença, são mencionadas características do bacilo; ao doente, identifica-se a estigmatização da TB e a demora para a procura pelos serviços de saúde; aos serviços de saúde, observou-se a excessiva demanda das funções administrativas do gerente; aos profissionais, atribuem-se a falta de práticas educativas com a comunidade, a não realização da busca de sintomáticos respiratórios, a baixa qualificação dos mesmos para o trabalho em equipe nas ações para o diagnóstico da TB, a baixa suspeição diagnóstica da doença, e a valorização de métodos de elevada densidade tecnológica, em detrimento de outros métodos de fácil acesso. Compreende-se que a TB é negligenciada nos microprocessos de trabalho dos gerentes e equipes da AB, o que discursivamente relaciona-se com os sentidos circulantes na sociedade acerca da doença. A relação do atraso no diagnóstico da TB com a baixa capacidade de enfrentamento da doença na AB pelos gerentes, como um acontecimento discursivo, traz sentidos divergentes à proposta de controle da TB pela AB, na perspectiva da vigilância em saúde. Recomenda-se investimento em capacitação dos profissionais para o desenvolvimento de uma gestão pró-ativa que incorpore o controle da TB na AB.
Title in English
Delay in diagnosis of tuberculosis in the perception of managers of Primary Health, Ribeirao Preto - São Paulo state
Keywords in English
Health services
Management
Primary Health Care
Tuberculosis
Abstract in English
The present study aimed to analyze the factors related to the delay in the diagnosis of tuberculosis (TB) based on the managers of Primary Health Care services perceptions. The scenario was the city of Ribeirão Preto, which is a priority city to the tuberculosis control at the state of São Paulo. The research project which gave rise to this work was approved by the Research ethics committee of the School of Nursing at Ribeirão Preto at University of São Paulo (CEP/EERP/USP - 012/2009). Participated in the study 17 subjects, that represented 43.6% of the managers at the five health districts. To produce the empirical issue it was realized semi structured interviews, which were digitally recorded in the period between July to August 2009. All the interviews were guided by a thematic script and occur after the free and informed consent signature. After the transcriptions of the interviews, the information was organized with the resource of Atlas Software 6.0 version. The interpretation was supported by the methodological and theoretical approach of the Discourse Analysis focusing on the Pêcheux pattern. The delay in the TB diagnosis, on the manager's perceptions, has factors associated to the disease, the unhealthy (ill), the services and the health professional. To the disease were mentioned characteristics of the bacillus; to the ill person were indentified the TB stigmatization and the delay to look for health services; and to the health services it was observed the excessive amount manager administrative functions. To the professional, were assigned the absence of educative practices with the community, not completion of the search for respiratory symptomatic, the low qualification of them to diagnosis the TB within a staff working, the low diagnosis suspicion of the disease, and the recovery of high technology methods instead of the access to other easy methods. It was comprehended that the TB is neglected in the micro process of the managers and PHC staff work, which discursively are related to the surrounding meanings of the society related to the disease. The relation of the delay in the TB diagnosis between the low capacity of coping with the disease by the PHC managers, as a discursive event, bring divergent meanings to the TB control proposal by the PHC, on the perspective of the health surveillance. It was recommended an investment in the professional training to the development of a proactive management which incorporates the TB control at the Primary Health Care.
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
MONALISELEMOS.pdf (633.87 Kbytes)
Publishing Date
2011-01-27
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
CeTI-SC/STI
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2024. All rights reserved.