Author(s): Belchior, Aylana de Souza
Date: 2015
Origin: Oasisbr
Subject(s): Tuberculose; Conhecimento; Educa????o em Sa??de; Pacientes Desistentes do Tratamento; Tuberculosis; Knowledge; Health Education; Patient Dropouts; CI??NCIAS DA SA??DE: ENFERMAGEM
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FAPEAM - Funda????o de Amparo ?? Pesquisa do Estado do Amazonas
Background: Tuberculosis is an infectious disease to chronic disease, mainly caused by the Koch bacillus (Mycobacterium tuberculosis), is a disease in which ancient remains a significant public health problem. Objective: To assess the degree of patient information about tuberculosis is a factor associated with treatment noncompliance in Basic Health Units (BHU) and a Reference Center Pulmonology Clinic. Methods: A case-control study with 126 patients, 42 cases in re-treatment dropouts or concluded in 2011 retreatment seen at the Reference Center for Pulmonology Clinic of Manaus-Am, and 84 controls in the 6th first month of treatment attended in Basic Health Units For data collection, we performed a study of primary data through a structured interview instrument utulizando The survey and secondary data through Information Sheet for Notifiable Diseases (SINAN) . Data were analyzed using Epi Info 3.5.3 and Stata 9.2. Analysis of factors associated with dropout was performed with application of the test ?? ?? test or Fisher's exact test and logistic regression. Results: No significant differences between cases and controls in the following variables: gender, age, race / ethnicity, marital status, education, occupation and income. With respect to clinical and demographic characteristics, there was significant difference in the tuberculin skin test (P <0.05), sputum smear microscopy first sample (P <0.05), sputum smear microscopy second sample (P <0.05) the sputum culture (P <0.05) and HIV test (P <0.05). In Article 2, no significant difference between cases and controls for socioeconomic factors and sources of information on tuberculosis. In adjusted analysis, significant differences in terms of knowledge (OR = 3.6, CI = 2.2 to 5.98), home visits by professionals (OR = 3.3, CI = 1.8 to 6.09), lack the consultation (OR = 5.1, CI = 3.02 to 8.8), the return period of consultation (OR = 6.05, CI = 3.3 to 11.03), smoking (OR = 4.02 CI = 2.4 to 6.7) and HIV (OR = 3.2, CI = 1.9 to 5.5). Conclusion: There are significant differences pointing to an unfavorable profile cases retreatment compared to patients nearing completion of treatment. The study also showed that most cases have limited knowledge about their disease when compared with controls, and this may indicate those responsible for health education, monitoring of tuberculosis patients in order to invest more in activities that lead the patient to understand the disease and its treatment and thus obtain their membership.
Introdu????o: A Tuberculose ?? uma doen??a infectocontagiosa com evolu????o cr??nica, causada principalmente pelo bacilo de Koch (Mycobacterium tuberculosis), constitui-se em uma doen??a milenar que continua sendo um relevante problema de sa??de p??blica. Objetivo: Verificar se o grau de informa????o dos pacientes acerca da tuberculose ?? um fator associado ao abandono do tratamento em Unidades B??sicas de Sa??de (UBS) e em um Centro de Refer??ncia em Pneumologia Sanit??ria. M??todo: Estudo de caso-controle, realizado com 126 pacientes sendo 42 casos em re-tratamento por abandono de tratamento ou tendo conclu??do em 2011 o re-tratamento atendidos no Centro de Refer??ncia em Pneumologia Sanit??ria de Manaus-Am, e 84 controles no 6?? m??s do primeiro tratamento atendidos em Unidades B??sicas de Sa??de. Para coleta de dados, foi realizado o levantamento dos dados prim??rios por meio de entrevista estruturada utulizando o instrumento A e o levantamento dos dados secund??rios por meio da Ficha de Informa????o de Agravos de Notifica????o (SINAN). Os dados foram analisados no Epi Info 3.5.3 e Stata 9.2. A an??lise dos fatores associados ao abandono foi realizada com aplica????o do teste ???? de Pearson ou exato de Fisher e regress??o log??stica. Resultados: N??o houve diferen??a significativa entre casos e controles, nas seguintes vari??veis: sexo, faixa et??ria, ra??a/cor, estado civil, escolaridade, ocupa????o e renda. Com rela????o ao perfil cl??nico-epidemiol??gico, houve diferen??a significativa quanto ao teste tubercul??nico (P<0,05), a baciloscopia de escarro 1a amostra (P<0,05), a baciloscopia de escarro 2a amostra (P<0,05), a cultura de escarro (P<0,05) e o teste de HIV (P<0,05). No artigo 2, N??o houve diferen??a significativa entre casos e controles, para aspectos socioecon??micos e fontes de informa????o sobre tuberculose. Na an??lise ajustada houve diferen??a significativa quanto ao conhecimento (OR=3,6; IC=2,2-5,98), visita domicili??ria dos profissionais (OR=3,3; IC=1,8-6,09), falta na consulta (OR=5,1; IC=3,02-8,8), prazo de retorno ?? consulta (OR=6,05; IC=3,3-11,03), fumo (OR=4,02; IC=2,4-6,7) e HIV (OR=3,2; IC=1,9-5,5). Conclus??o: Existem diferen??as significativas apontando para um perfil desfavor??vel dos casos em retratamento em rela????o aos pacientes em vias de conclus??o do tratamento. O estudo tamb??m mostrou que os casos possuem conhecimento mais limitado sobre sua doen??a quando comparados com os controles, e isto pode ser um indicativo aos profissionais respons??veis pela educa????o em sa??de, no acompanhamento dos pacientes com tuberculose, no sentido de investir em mais atividades que levem o paciente a entender a doen??a e o seu tratamento e assim obter a sua ades??o.
