A clientela e os profissionais de saude diante da tuberculose

AUTOR(ES)
DATA DE PUBLICAÇÃO

1998

RESUMO

This work is the result of a qualitative survey condutec on health professionals (medical professors, resident doctors and nurses) dealing with outpatiente care in a teaching hospital located in the State of São Paulo, Brazil on the one hand and on the other on a group of adult patients with a tuberculosis of the lung diagnosis discharged either as cured or for abandono (administrative discharge of patients who stopped coming to hospital, on the thirtieth day after they missed their last monthly consultation). The analysis of the interviews with the health professionals highlights the prevalence of their egalitarian attitude toward patients in their outpatient practice, the emphasis placed on their curative and clinical activities, as well as their conception of controling the disease through the cure of cases and preventive measures. What particularly comes to attention is the sort of mixture of a microbic conception and a clinical perspective focused on the medicine of pathology: lesions, bodily dysfunction, signs and symptoms. The way such professionals represent their patients derives from a set of socioeconomic and educational attributes, which are the result of both their daily experience and the ideological precepts through which individuais classify the population. Divergence emerges with regard to how well patients assimilate and incorporate rules and prescriptions, and to ho~ proper the chemotherapeutic treatment scheme is, although everyone agrees on its efficiency. As for the interviews of patients cared of in that very outpatient ward, the analysis shows of the disease conception is included in their representations of tuberculosis, which is painted as curable, contagious and surrounded with stigma. The representations are built upon concepts derived from medical history, and their own traditions, life experiences and general representation of the disease, the latter being mainly centered on their conception of instrumental and social usage of thê body. Their representation of health (absence of symptoms and/or capability to work) is derived from such body conceptions and thus regarded as the parameter for cure. On their way to cure, doctors stand as the most valued and sought for agents, being both divine influence and personal effort coadjutant factors in this processo The analysis revealed that such patients were able to assimilate the medical orientations directly related to treatment, as well as some recommended conducts. This, however does not mean ali of them incorporated or put them into practice: medical prescriptions and orientations have in fact only been followed by those who either where discharged as cured or underwent exams. Among those who did not effectively incorporate the medical orientations and prescriptions are the and abandonos , who made the decision to interrupt their treatment. The conclusion to the present work is that the abandono of tuberculosis treatment. far exceeds the lack of information and orientations, as suggested by medical professionals. Such abandono derives from a set of factors composed of socioeconomic, cultural causes as well as representations ofhealth (cure), disease and body

ASSUNTO(S)

pulmão - tuberculose doenças estigmatização comportamento humano

ACESSO AO ARTIGO

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