Tuberculose na atenção primária à saúde: avaliação dos serviços na perspectiva dos enfermeiros

Abstract

Tuberculosis remains a major global health problem, the incidence of which remains high at global, national, regional and local levels. Because of this, the World Health Organization declared as a global emergency and developed strategies to contain it. Primary Health Care stands out in this context, since in Brazil it is the health network organizer and performs primary actions to control tuberculosis. This study aimed to evaluate the performance of Primary Health Care services in tuberculosis control in Manaus, from the nurses' perspective. Descriptive study of evaluative character with quantitative approach. The city of Manaus was elected due to its national prominence as the capital with the highest incidence of cases. The collection took place between December 2018 and May 2019, in the Primary Health Care services (Basic Health Units and Basic Family Health Units). The population consisted of 173 nurses who worked in these services. During the collection, the adapted and validated Primary Care Assessement Tool was used to assess tuberculosis care, which contains 96 specific questions to evaluate the performance of primary health care services from the perspective of health professionals and includes questions regarding the dimensions / attributes of Primary Health Care: Gateway, Access (subdivided into Diagnostic Access and Access to Treatment), Bonding (Longitunality), Service Casting (Integrality), Coordination, Family Focus, Guidance for Community and Vocational Training (Cultural Competence). Data analysis, interpretation and presentation were performed using descriptive statistics (measures of central tendency, dispersion and variance, absolute and relative frequencies, according to the orientations of the instrument used. Cronbach's α rate was used to verify the reliability and internal consistency of the instrument). (α = 0.86) The performance of the services in relation to the Bond, Coordination, Family Focus, Vocational Training dimensions was “Satisfactory”, Access, Casting of Services and Community Orientation presented “Regular” performance and no dimension was performed. “Unsatisfactory.” From these results we can conclude that from the nurses' perspective, most dimensions present “satisfactory” results, although there are weaknesses such as difficulties in access, service provision and integration with the community, which need to be addressed. designed to provide a better service than age to the tuberculosis user, and from that, consider a real change from the current local setting.