Representações sociais de enfermeiros da estratégia saúde da família sobre o tratamento diretamente observado e de curta duração em tuberculose

Abstract

This study aimed to analyze the social representations of nurses of the Family Health Strategy (ESF) about the Directly Observed Treatment, Short-sourse (DOTS) strategy in tuberculosis (TB). We chose a descriptive study with a qualitative approach using as theoretical-methodological reference the Theory of Social Representations. The research was developed in Primary Health Care Units that work on the ESF model in the city of Juiz de Fora – Minas Gerais. For the apprehension of the information, semi-structured interviews were used. 18 nurses participated in the study, in this sense the interviews were transcribed and analyzed according to Bardin‟s perspective. The social representations of the nurses were grouped according to the units of inferences that were most frequently repeated, in addition, a category was constructed with the purpose of characterizing the participants. They are: Characterization of the Participants, Weaving knowledge about the daily routine for the care of people with TB and Weaving representations about DOTS. Of the 18 nurses interviewed, 16 were female, with training time between seven and 35 years. Of these professionals 66.7% have specialization in family health, with work time in the FHT between four months and 23 years. The findings demonstrate that nurses do not incorporate DOTS into activities related to TB control and treatment, but recognize the importance of nurses as primary in controlling the disease. DOTS is associated by these professionals simply by supervising the medication intake and associating it to users in situations of social vulnerability. Regarding the early detection of cases, we can observe that the active search is sometimes limited to the ESF space and is related to several difficulties for its effectiveness, such as lack of human resources and deficiency in the training of professionals. Other issues cited by nurses as those that compromise the effectiveness of this strategy were the lack of standard medication for the treatment and the difficulty to see the political commitment on the part of the management. In addition, it is possible to notice the lack of knowledge on the part of some professionals regarding the sources of information and registry of the cases, thus hindering, the quality and continuity of the care. In this sense, this study points out the need for a new look from management and professionals regarding TB control in order to organize and plan these health actions, integrating DOTS into these activities through training in a health care network.