Estratégias de engajamento para o paciente com hanseníase: uma revisão de escopo
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Data
2025-03-11
Autores
Soza, Letícia Guedes Morais Gonzaga de
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Universidade Federal do Espírito Santo
Resumo
Leprosy is an infectious disease that, if left untreated, can cause irreversible deformities and physical disabilities. Additionally, individuals with leprosy are prone to stigmatization, which can lead to treatment abandonment, worsened quality of life, and social exclusion. In this context, the engagement of the individual and their family in managing their health issues can promote greater understanding of the disease and its treatment, leading to positive health outcomes. Therefore, the aim of this study was to map strategies for engaging individuals with leprosy. A scoping review was conducted considering articles published up to January 2024 in the databases EMBASE, Scopus, BVS/Lilacs, Medline/PubMed, and Web of Science. The review protocol was registered in the Open Science Framework and can be accessed at https://osf.io/nxm6h/ (DOI 10.17605/OSF.IO/NXM6H). The search strategy used terms related to "leprosy" and "health behavior". Original studies were included if they described engagement strategies for individuals with leprosy, their families, and the community. The selection stages were carried out independently and in duplicate. Data were extracted, and the strategies were synthesized with the aid of the adapted 6W3H tool, considering the following variables: "what" (strategy identification), "why" (strategy objective), "where" (execution location), "when" (execution time), "who" (responsible parties), "for whom" (target recipients), "how many" (number of participants), "how" (execution method), "how much" (cost), and "how to measure" (evaluation). The strategies were then categorized into five levels based on the Person and Family Engagement Scale: Inform about health, Inform about engagement, Empower, Partner, and Integrate. In total, 854 studies were identified and 18 met the eligibility criteria and were included in this review. The identified strategies consisted of interventions for disability prevention (n = 3; 16.67%), mobile applications for health education and leprosy case detection (n = 2; 11.11%), self-help groups (n = 2; 11.11%), self-care group (n = 1; 5.76%), community project to improve community attitudes towards leprosy (n = 1; 5.76%), lesson plans for health education on leprosy (n = 1; 5.76%), community project to reduce stigma related to leprosy (n = 1; 5.76%), face-to-face meetings between people with leprosy and the general public (n = 1; 5.76%), text messages for monitoring the pharmacological treatment of leprosy patients (n = 1; 5.76%), self-care education program (n = 1; 5.76%), educational podcast (n = 1; 5.76%), training for healthcare professionals and community health agents (n = 2; 11.11%), and education on self-examination and fictional television works (n = 1; 5.76%). The most frequent objectives of the strategies were health education (n = 5; 27.78%) and prevention of deformities derived from leprosy (n = 6; 33.33%). Most strategies were implemented by health professionals and/or workers, such as community health agents (n = 10; 55.56%). The main target audience of the strategies was people diagnosed with leprosy (n = 12; 66.67%); however, some strategies involved health professionals (n = 3; 16.67%) and the community (n = 4; 22.22%). Regarding the cost of the strategies, four studies (22.22%) reported this information. In the “How to measure” category, 12 studies (66.67%) described ways of evaluating the proposed strategy. Regarding engagement levels, Empower was the level with the highest number of strategies (n = 8, 44.44%). Furthermore, no strategy achieved the highest levels of engagement, namely: Partner and Integrate. Based on the findings, it is observed that despite the diversity of engagement strategies aimed at people with leprosy, their families and the community, there are still gaps in strategies that promote higher levels of engagement. In this sense, it is necessary to develop new strategies, as well as to expand the application of existing strategies. Furthermore, the effectiveness of the strategies in the long term and their impact on achieving higher levels of engagement need to be further explored
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Hanseníase , Comportamentos relacionados com a saúde , Participação do paciente , Engajamento do paciente , Leprosy , Health behavior , Patient participation , Patient engagement