Representações sociais da tuberculose por pessoas com tuberculose e suas implicações para o seguimento do tratamento

Abstract

Introduction: Tuberculosis remains recognized worldwide as an important problem that involves public health policies, requiring the development of actions aimed at its control, considering humanitarian, economic and public health aspects. For every case of tuberculosis, the directly observed treatment must be carried out, as it is not possible to predict the cases that will adhere to the treatment, and it is necessary to build a bond between the patient and the health professional. This is because another important aspect that permeates the pathophysiological understanding of the disease is related to the psychological and social issues that tuberculosis presents, as it is associated with stigmas and representations anchored in interpersonal relationships. It is in this context that the Theory of Social Representations is applied, as it is understood that understanding the representations built about tuberculosis and its implications for the follow-up of treatment is fundamental for promoting health and combating this disease. Objective: To understand the social representations of people with tuberculosis about the disease and its implications for treatment follow-up. Method: This is a descriptive study, with a qualitative approach, using the Theory of Social Representations as a theoretical basis. The study setting was the municipal health unit of Guamá, District DAGUA, in the city of Belém. People with a positive diagnosis of tuberculosis and undergoing treatment directly observed in the study unit for a period of one month or more participated in the research. quantitative was defined by applying the data saturation technique. Data collection was performed using two techniques: free word association and semi-structured interview. For data analysis, thematic content analysis was used. Results: from the analysis of the data obtained, the registration units converged into three categories, namely: Representations of tuberculosis and its impacts on the diagnosis; the faces of treatment: challenges in terms of follow-up and hope; and Constructions of living with the disease in the family and society. The ways of living with the disease in the daily work, family and social relationships were marked by concerns and practices related to direct contacts or through objects. Suffering is strongly linked to the treatment routine, which implies a radical change in lifestyle, but also figures as a hope for a cure. The family emerges as a welcoming place; however, there is still strong social discrimination and prejudice marking the social representations of tuberculosis. Final Considerations: The impact of the diagnosis, representation and living with the disease can transform daily life, work, family relationships and society. Discrimination and prejudice have an impact on social life, and denote the need to disseminate qualitative information with a view to reconfiguring such representations so that the patient can be better welcomed and included. Nursing as an active team in this care process must remain present and sensitive to the understanding of these various aspects, contexts and representations that surround them, being also active in public health policies, educational actions and scientific research that contribute to quality of assistance and in the reduction of prejudice.