Elementos que interferem na continuidade do tratamento da tuberculose de usuários de álcool em situação de rua

Abstract

BARBOSA, Alice Duarte. Elements that interfere with the continuity of tuberculosis treatment in street alcohol users. 2023. 114f. Dissertation (Master in Nursing) – School of Nursing, Federal University of Minas Gerais, Belo Horizonte, 2023. The study aimed to analyze the elements that interfere with the (dis)continuity of tuberculosis (TB) treatment in homeless alcohol users treated at a Health Center in Belo Horizonte, Minas Gerais, Brazil. This is a descriptive-exploratory study based on a qualitative approach, developed at the Carlos Chagas Primary Health Center, in Belo Horizonte/Minas Gerais, Brazil. The participants were 09 homeless alcohol addicts who concluded cured or abandoned, a TB treatment between the period of October 2015 to July 2021 in the aforementioned Primary Health Center. Data were collected through document analysis and face-to-face interviews guided by a semi-structured script and observation records in a field diary. The 09 interviews were conducted in a single face-to-face meeting with each participant. The transcripts of the interviews and field diary were analyzed using Bardin's Thematic Content Analysis technique. Based on the analysis, 05 categories emerged: "The Primary Health care recognized as a powerful device for a care trajectory", "Social, spiritual and health needs: looking beyond the symptoms of tuberculosis", "Referral in the care network for a homeless person and his dependence on psychoactive substances"; "The duality of choosing between treatment or maintenance of psychoactive substance use"; Have tuberculosis and living on the streets: overcoming the double prejudice and achieving the cure". The first category showed the potential for care in Primary Health Care and the difficulties the homeless population (PSR) found to navigate in the healthcare network. In the second category, the social and emotional impacts of TB were identified as important as the disease's physical symptoms. Additionally, social support proved to be an essential tool to help with TB treatment. In the third category, it was verified the importance of the street office for singular care of this population as well as the need to offer care for drug addiction and treatment of alcohol abuse. The fourth category clarified the paradoxical choice between continuing a TB treatment or alcohol abuse, and the importance of professional support. The stigma of TB and being homeless were addressed in the fifth category, as well as the need to implement strategies to mitigate it. It is concluded that the homeless affected by TB and alcohol abuse faces several challenges for the continuity of treatment and the Primary Health Care plays a crucial role in providing this type of singular care.