The Perspectives of Patients and Health Professionals Regarding the Tuberculosis Control Programme in Recife, Brazil: A Contribution to Evaluation
The study objective is to describe patients and professionals' perspectives on the Tuberculosis Control Program (PCT) in Recife, Brazil, contributing to the program evaluation. A cross-sectional study was conducted in three purposively selected sites, representing the three levels of care in th...
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Published in: | Pharmacy Vol. 7; no. 2; p. 70 |
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Abstract | The study objective is to describe patients and professionals' perspectives on the Tuberculosis Control Program (PCT) in Recife, Brazil, contributing to the program evaluation. A cross-sectional study was conducted in three purposively selected sites, representing the three levels of care in the public health system. All eligible PCT patients in sites A, B and C were invited to participate (n = 123). Physicians, nurses, pharmacists and community health agents providing care to PCT patients in these sites, plus their managers, were purposively selected. Data were collected by means of interviews with 44 patients and a questionnaire to 24 professionals. Instruments encompassed previously published items to capture stakeholders' perspectives (16 and 12 closed-questions, respectively), grouped into categories. The overall evaluation by patients was unsatisfactory (median score 35%; third quartile below 50%; interquartile range 21.9%). Analysis of scores by categories showed that opinions about organizational accessibility were significantly worse than about economic and geographical accessibility, taken together. Overall the median score attributed by professionals was 52% (third quartile below 65%). Professionals had significantly worse opinions about diagnosis, clinical and laboratory assistance. Patients and professionals' perspectives highlight potential opportunities for improvement. Our findings can be used by managers as a starting point for shared decision-making, potentially contributing to a better performance of the PCT in Recife and, consequently, reducing the risk posed by tuberculosis. |
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AbstractList | The less positive scores attributed by patients (Table 1) included “home visits by health professionals related to TB treatment” (mean score 2.0, SD = 1.5) and “contact with advertising/campaign /educational work by health service professionals” (mean score 1.6, SD = 1.3) Analysis of scores by categories (Figure 2) showed that opinions about organizational accessibility (OA) are significantly worse than opinions about economic accessibility (EA) and geographical accessibility, taken together (signed rank test, V = 715.5, p-value = 0.005; Paired t-test, t = 2.9196, p-value = 0.003). Database research showed discontinuation rates urging attention, particularly in site B, as it exceeded the WHO 5% target [26,27]. [...]pharmacists delivering care to TB patients may be ideally positioned to implement more intensive interventions. The less positive score attributed by professionals to the category “Diagnosis, Clinical and Laboratory Assistance” corroborates known difficulties, such as shortage of qualified human resources, the centralized and fragmented organization of TB control actions, problems in the organization of the material for bacteriological examination, inadequate approach to the patient during sputum collection and inadequate professional training [30]. 3.0 (1.9) Categories Item Number Score Evaluation Criteria Mean Score (SD) Coverage and Reception (q1) Prs-01 1–5 Professional attention 3.6 (0.9) Prs-02 1–5 Integrated care 3.3 (1.0) Diagnosis, Clinical and Laboratory Assistance (q2) Prs-03 1–5 Registration and examination of contacts 1.8 (0.9) Prs-04 1–5 Contacts examination for case finding 1.8 (1.0) Prs-05 1–5 Provision of rapid results for Smear Test 2.3 (0.7) Prs-06 1–5 Performing a sputum culture and sensitivity test when indicated 2.3 (0.8) Prs-07 1–5 Provision of rapid HIV test for TB patients 2.4 (0.6) Treatment and Pharmaceutical Assistance (q3) Prs-08 1–5 Availability and accessibility to treatment 4.3 (0.9) Prs-09 1–5 Referral of patients with multidrug-resistant TB to the referral center when indicated 4.2 (0.9) Prs-10 1–5 Supervised treatment for smear positive patients with risk of neglect and coinfection 3.1 (1.6) Integrality of care (q4) Prs-11 1–5 Provision of comprehensive care for all TB-related or non-TB-related health problems 3.0 (1.3) Prs-12 1–5 Provision of comprehensive prevention guidance for health promotion 3.1 (1.2) Author Contributions Conceptualization, S.S.B. and J.L.S.S.; Methodology, S.S.B. and J.L.S.S.; Formal Analysis, J.J.F.G. and M.P.G.; Investigation, S.S.B., N.F.P., M.G.P.d.S., M.P.A. and M.G.d.B.; Data Curation, S.S.B.; Writing-Original Draft Preparation, S.S.B.; Writing-Review & Editing, M.P.G.; Supervision, M.P.G. and J.L.S.S.; Project Administration, J.L.S.S. Funding This research received no external funding. The study objective is to describe patients and professionals’ perspectives on the Tuberculosis Control Program (PCT) in Recife, Brazil, contributing to the program evaluation. A cross-sectional study was conducted in three purposively selected sites, representing the three levels of care in the public health system. All eligible PCT patients in sites A, B and C were invited to participate (n = 123). Physicians, nurses, pharmacists and community health agents providing care to PCT patients in these sites, plus their managers, were purposively selected. Data were collected by means of interviews with 44 patients and a questionnaire to 24 professionals. Instruments encompassed previously published items to capture stakeholders’ perspectives (16 and 12 closed-questions, respectively), grouped into categories. The overall evaluation by patients was unsatisfactory (median score 35%; third quartile below 50%; interquartile range 21.9%). Analysis of scores by categories showed that opinions about organizational accessibility were significantly worse than about economic and geographical accessibility, taken together. Overall the median score attributed by professionals was 52% (third quartile below 65%). Professionals had significantly worse opinions about diagnosis, clinical and laboratory assistance. Patients and professionals’ perspectives highlight potential opportunities for improvement. Our findings can be used by managers as a starting point for shared decision-making, potentially contributing to a better performance of the PCT in Recife and, consequently, reducing the risk posed by tuberculosis. The study objective is to describe patients and professionals' perspectives on the Tuberculosis Control Program (PCT) in Recife, Brazil, contributing to the program evaluation. A cross-sectional study was conducted in three purposively selected sites, representing the three levels of care in the public health system. All eligible PCT patients in sites A, B and C were invited to participate (n = 123). Physicians, nurses, pharmacists and community health agents providing care to PCT patients in these sites, plus their managers, were purposively selected. Data were collected by means of interviews with 44 patients and a questionnaire to 24 professionals. Instruments encompassed previously published items to capture stakeholders' perspectives (16 and 12 closed-questions, respectively), grouped into categories. The overall evaluation by patients was unsatisfactory (median score 35%; third quartile below 50%; interquartile range 21.9%). Analysis of scores by categories showed that opinions about organizational accessibility were significantly worse than about economic and geographical accessibility, taken together. Overall the median score attributed by professionals was 52% (third quartile below 65%). Professionals had significantly worse opinions about diagnosis, clinical and laboratory assistance. Patients and professionals' perspectives highlight potential opportunities for improvement. Our findings can be used by managers as a starting point for shared decision-making, potentially contributing to a better performance of the PCT in Recife and, consequently, reducing the risk posed by tuberculosis.The study objective is to describe patients and professionals' perspectives on the Tuberculosis Control Program (PCT) in Recife, Brazil, contributing to the program evaluation. A cross-sectional study was conducted in three purposively selected sites, representing the three levels of care in the public health system. All eligible PCT patients in sites A, B and C were invited to participate (n = 123). Physicians, nurses, pharmacists and community health agents providing care to PCT patients in these sites, plus their managers, were purposively selected. Data were collected by means of interviews with 44 patients and a questionnaire to 24 professionals. Instruments encompassed previously published items to capture stakeholders' perspectives (16 and 12 closed-questions, respectively), grouped into categories. The overall evaluation by patients was unsatisfactory (median score 35%; third quartile below 50%; interquartile range 21.9%). Analysis of scores by categories showed that opinions about organizational accessibility were significantly worse than about economic and geographical accessibility, taken together. Overall the median score attributed by professionals was 52% (third quartile below 65%). Professionals had significantly worse opinions about diagnosis, clinical and laboratory assistance. Patients and professionals' perspectives highlight potential opportunities for improvement. Our findings can be used by managers as a starting point for shared decision-making, potentially contributing to a better performance of the PCT in Recife and, consequently, reducing the risk posed by tuberculosis. |
Author | Silva, Maria Gabriela Pereira da Athayde, Maria Paula Guerreiro, Mara Pereira Gomes, João José Ferreira Soares Sobrinho, José Lamartine Auad, Rodrigo Zeymer Barros, Mirela Galvão de Bezerra, Simone Santos Pessoa, Nathany França |
AuthorAffiliation | 4 Faculty of Sciences, Universidade de Lisboa, 1749-016 Lisboa, Portugal; jjgomes@campus.ul.pt 1 Pharmaceutical Science Department, Federal University of Pernambuco-Recife, Pernambuco 50740-52, Brazil; t-hany18@hotmail.com (N.F.P.); maria_gabrielapsa@hotmail.com (M.G.P.d.S.); mirelagalvao@gmail.com (M.G.d.B.); joselamartinesoares@gmail.com (J.L.S.S.) 5 Otávio de Freitas Hospital-Recife, Pernambuco 50920-460, Brazil; paulathayde@uol.com.br 6 State Technical School Professor Agamenon Magalhães, Recife 52050-385, Pernambuco, Brazil; rodzeymer@yahoo.com.br 2 Escola Superior de Enfermagem de Lisboa, Unidade de Investigação e Desenvolvimento em Enfermagem (UI&DE), 1990-096 Lisboa, Portugal; mara.guerreiro@sapo.pt 3 Portugal & Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Monte de Caparica, Portugal |
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Snippet | The study objective is to describe patients and professionals' perspectives on the Tuberculosis Control Program (PCT) in Recife, Brazil, contributing to the... The study objective is to describe patients and professionals’ perspectives on the Tuberculosis Control Program (PCT) in Recife, Brazil, contributing to the... The less positive scores attributed by patients (Table 1) included “home visits by health professionals related to TB treatment” (mean score 2.0, SD = 1.5) and... |
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SubjectTerms | Hospitals Medical personnel Patients patients’ perspectives Pharmacists Primary care Professionals professionals’ perspectives program and health projects evaluation Studies Systematic review Tuberculosis |
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Title | The Perspectives of Patients and Health Professionals Regarding the Tuberculosis Control Programme in Recife, Brazil: A Contribution to Evaluation |
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