O acesso do usuário ao diagnóstico da tuberculose no município de Vitória/ES
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Data
2011-03-22
Autores
Fávero, Juliana Lopes
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Universidade Federal do Espírito Santo
Resumo
The patient's access to health services is a key strategy for tuberculosis control. The purpose of this study is to assess access to tuberculosis diagnosis professionals' view on health in Vitória/ES. Cross-sectional study. We interviewed 61 doctors, 45 nurses and 70 nurse technicians working in the Family Health Unit (FHU), Basic Health Unit (BHU), Emergency Health Care (EHC) and Tuberculosis Control Program (TCP), Vitoria/ES, from August to November 2009. Was performed chi-square test. Results: 76% of the sample consisted of women. With regard to training, 83% of physicians have residence, 55% of nurses have expertise and 11% of nurses have master's degree. 64% have up to 5 years experience in function, 22% of professionals have never done a training related to TB (p = 0.004), 79% reported difficulty filling in forms for ordering tests (p = 0.001). 65% considered good professional service time for each user (p = 0.052). 53% of nurses often do not request examinations (p = 0.001). 72% of doctors often deal with social problems (p = 0.019). At FHU, 64% carry out an active search for symptoms frequently (p = 0.005). Home visits to deliver pot of sputum collection (54%, p = 0.016), and educational programs about TB during the year (67%, p = 0.047) are infrequent. 47% of health professionals consider themselves the main responsible for delayed diagnosis of tuberculosis (p = 0.001).The hours of operation of the service was considered good for most professionals (89%), but at the FHU 72% (p = 0.001) considered the bad times. 42% report being frequent users lose the shift to be serviced, which is more frequent in EHC (43%, p = 0.001). 43% of BHU practitioners do not respect the user's difficulties in shifting to the health service, but at the FHU 45% sometimes there is this difficulty (p = 0.001). FHU at BHU and 89% are infrequent use of motorized transport for travel to the health service, being common to the EHC and TCP (70%, p = 0.001). 44% evaluate how bad the place for sputum collection (p = 0.001). At FHU/BHU, often (90%) users seeking the service closer to home, as for the professionals of EHC and TCP, there is sometimes (77%, p = 0.001). The health service provides a basic framework for the care, but responds in part to population expectations. Inputs for the service and human resources are the main barriers in access to tuberculosis diagnosis.
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Access , Tuberculosis , Diagnosis delay , Responsiveness , Acesso , Tuberculose , Atraso no diagnóstico , Responsividade