The Adherence for the Tuberculosis Treatment: the Mark of Stigma in the Discourse of Nurses

  • Séfora Luana Evangelista de Andrade Master in Nursing. professor of nursing program in college Mauricio de Nassau. Technical Control of Tuberculosis and Leprosy Municipal Health. João Pessoa, PB, Brazil.
  • Patrícia Geórgia Oliveira Diniz Pinheiro Doctoral Student of Nursing at the Federal University of Paraiba. João Pessoa, Paraíba, Brazil.
  • Rita de Cassia Cordeiro de Oliveira Ph.D. in Nursing. Nurse at the National Foundation of Health. João Pessoa, PB, Brazil
  • Lilia de Medeiros Alcântara Master's degree in Nursing by the Graduação Program in Nursing by UFPB. Technical Control of Tuberculosis and Leprosy Municipal Health. João Pessoa, PB, Brazil.
  • Tereza Cristina Scatena Villa Ph.D. in Nursing. Tenured professor in the Faculty of Public Health, School of Nursing, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Jordana de Almeida Nogueira Ph.D. in Nursing. Professor of Nursing at the Federal University of Paraiba. João Pessoa, Paraiba, Brazil.
  • Lenilde Duarte de Sá Ph.D. in Nursing. Professor of Nursing at the Federal University of Paraiba. João Pessoa, Paraiba, Brazil.

Abstract

Introduction: One of the issues considered today as an obstacle for the control of tuberculosis in the world scenario, regards the non-adherence of the patient for the treatment of the disease, resulting in complications to the health of the individual and negative implications for public health.

Objective: To analyze the speeches of nurses working in the Family Health Strategy, about the difficulties in adherence to Directly Observed Treatment (DOT) of tuberculosis in the city of João Pessoa, state of Paraiba, Brazil.

Method: Qualitative study and discursive approach, developed in August and October 2012. Through the technique of interview guided by a semi driven script, thirteen nurses working in the Family Health Strategy were interviewed in the city of João Pessoa, state of Paraiba, Brazil. The empirical material produced was analyzed according to the theoretical and methodological device of Discourse Analysis of pecheutiana French line.

Results: The discursive analysis made from the textual marks present in the speeches of enunciators indicates that the difficulties in joining the directly observed treatment of tuberculosis in the city of João Pessoa, bind to patients, health professionals and treatment. In relation to the patient, the analysis points to discursive formations linked to the stigma, commitment in the treatment and low level of education. As for healthcare professionals, fear of contagion of the disease - reinforced by the stigma - and the transfer of responsibility in caring to other professionals were observed.  Notably, the spoken relapse, in addition to the fear of health professionals themselves in treating the TB patient, reveals the prejudice that runs through the speeches of the subjects in relation to the exposure of the patient and the duration of treatment made in the Directly Observed Treatment modality.

Discussion: The effects of produced senses show that nurses relate the difficulties of adherence to directly observed treatment, among other factors, to the fear of acquiring the disease, which affects not only the patients but also the health professionals themselves, provoking discrimination and contributing to justifying the non-adherence to therapy. It is observed that this fear is affiliated to the historical and social memory of the disease, marked by stigma, prejudice, segregation and exclusion.

Conclusion: It is not only enough for the medication to be available. Innovative measures should be designed and implemented not only in relation to the qualification of health professionals to run the DOT. The coordination of tuberculosis control in all health management spheres, must be concerned in fighting the stigma, in a way in which it will demystify the prejudices of professionals and enlighten them about the meaning of this treatment modality to control the disease in the current days.

Published
Jun 2, 2016
How to Cite
ANDRADE, Séfora Luana Evangelista de et al. The Adherence for the Tuberculosis Treatment: the Mark of Stigma in the Discourse of Nurses. International Archives of Medicine, [S.l.], v. 9, june 2016. ISSN 1755-7682. Available at: <http://imed.pub/ojs/index.php/iam/article/view/1585>. Date accessed: 20 nov. 2017.
Section
Infectious Diseases

Keywords

Tuberculosis; Nursing; Directly Observed Treatment