Advisor(s)
Abstract(s)
No final da década de 70 do século XX, a redução progressiva das taxas de incidência de tuberculose levavam a crer que esta estivesse em erradicação. A partir da segunda metade da década de 80 do mesmo século, iniciou-se uma inversão deste panorama com o aumento das taxas de incidência na maioria dos países. De tal forma que a Organização Mundial de Saúde (OMS) em 1993 a considerou uma emergência global. Cerca de 98% dos 3 milhões de mortes por tuberculose em cada ano ocorre nos países subdesenvolvidos. Portugal tem uma das mais elevadas taxas de incidência entre os países da União Europeia. Em 2006 foram notificados 3333 casos, o que corresponde à taxa de notificação de 2,9 / 100 000 habitantes (Hab.).
Com base na existência de casos, o Módulo I e II do Estágio foram desenvolvidos no âmbito da temática da tuberculose. No primeiro foi realizado um diagnóstico de situação desaúde da tuberculose referente ao ano de 2008 na área de influência da Unidade de Saúde Pública do Centro de Saúde de Queluz, constatando-se nas suas 5 freguesias, 4 apresentam taxas de incidência elevadas (> 20 / 100 000 Hab.), destacando-se Monte Abraão. Desta forma, podemos concluir que a Tuberculose é sem dúvida um problema de saúde nesta comunidade justificando-se assim a pertinência da nossa intervenção nesta área.
O projecto de intervenção foi implementado na freguesia de Monte Abraão, no Módulo II, por ser a freguesia com taxa de incidência mais elevada. Foi elaborado de forma a abranger os três níveis de prevenção com: realização de uma acção de sensibilização sobre a tuberculose aberta á comunidade; identificação dos utentes com tuberculose pulmonar; realização de entrevista de acolhimento aos utentes em tratamento de tuberculose pulmonar, sustentado no Modelo de avaliação familiar de Calgary e tendo também como base o cuidado cultural definido por Madeleine Leininger; realizado inquérito epidemiológico a esta mesma população.
No Módulo III foi desenvolvido e implementado projecto com o intuito de estabelecer articulação de cuidados entre o hospital e os centros de saúde. Os utentes em programa de Diálise Peritoneal do serviço de Nefrologia do Hospital Curry Cabral, de uma forma geral, são apenas utilizadores em exclusivo dos Cuidados de Saúde Hospitalares. Com o objectivo de os referenciar também aos Cuidados de Saúde Primários e de fomentar a continuidade dos cuidados, foram criadas estratégias que facilitam a troca de informação e de saberes entre os enfermeiros das diferentes unidades tendo como base a parceria dos cuidados.
At the end of the 70th decade in the XXth century, based on the reducing of rates of incidence, tuberculosis seemed to be in eradication. Since the second half of the 80th decade in the same century, a reversal of this scenery was started once the rates increased in the most of countries. Because of this, in 1993, World Health Oraganization (WHO) considered it a global emergency. About 98% of 3 million of deaths caused by tuberculosis in each year happens in the underdeveloped countries. Portugal has one of the highest rates of incidence between the countries of European Union. In 2006, 3333 cases were notified, wich corresponds to a rate of 2,9 / 100 000 inhabitants (inhab.). Based on the existing number of cases, the Module I and II were developed under the theme of tuberculosis. The first module was to diagnose the tuberculosis situation concerning the year of 2008 in the area of influence of Public Health Unit Center of Queluz, revealing that in the 5 civil parishes, 4 had very high rates of incidence (> 20 / 100 000 inhab.), highlighting Monte Abraão. Thus, we conclude that Tuberculosis is, without a doubt, an health problem in this community, justifying the appropriateness of intervention in this area. The intervention project was implemented in the civil parish of Monte Abraão, in Module II, because of being the civil parish with the higher incidence. It has been prepared to cover the three levels of prevention: was aimed at creating awareness about tuberculosis opened to the community; individuals with pulmonary tuberculosis have been identified; It was done an interview reception for users in treatment of pulmonary tuberculosis, which was supported on the Calgary´s Model for family evaluation, and also based on Madeleine Leininger´s definition for cultural care; it was also conducted an epidemiological survey to this same population. Finally, in Module III, it was developed and implemented a project with the aim of establishing joint care between the hospital and health centers. Users in Peritoneal Dialysis at the Nephrology Service of Curry Cabral´s Hospital, in general, are exclusive Hospital´s Care users. In order to refer them to the Primary Health Care and promote continuity of care, strategies were created to facilitate the exchange of information and knowledge among nurses from different units based on the partnership of care.
At the end of the 70th decade in the XXth century, based on the reducing of rates of incidence, tuberculosis seemed to be in eradication. Since the second half of the 80th decade in the same century, a reversal of this scenery was started once the rates increased in the most of countries. Because of this, in 1993, World Health Oraganization (WHO) considered it a global emergency. About 98% of 3 million of deaths caused by tuberculosis in each year happens in the underdeveloped countries. Portugal has one of the highest rates of incidence between the countries of European Union. In 2006, 3333 cases were notified, wich corresponds to a rate of 2,9 / 100 000 inhabitants (inhab.). Based on the existing number of cases, the Module I and II were developed under the theme of tuberculosis. The first module was to diagnose the tuberculosis situation concerning the year of 2008 in the area of influence of Public Health Unit Center of Queluz, revealing that in the 5 civil parishes, 4 had very high rates of incidence (> 20 / 100 000 inhab.), highlighting Monte Abraão. Thus, we conclude that Tuberculosis is, without a doubt, an health problem in this community, justifying the appropriateness of intervention in this area. The intervention project was implemented in the civil parish of Monte Abraão, in Module II, because of being the civil parish with the higher incidence. It has been prepared to cover the three levels of prevention: was aimed at creating awareness about tuberculosis opened to the community; individuals with pulmonary tuberculosis have been identified; It was done an interview reception for users in treatment of pulmonary tuberculosis, which was supported on the Calgary´s Model for family evaluation, and also based on Madeleine Leininger´s definition for cultural care; it was also conducted an epidemiological survey to this same population. Finally, in Module III, it was developed and implemented a project with the aim of establishing joint care between the hospital and health centers. Users in Peritoneal Dialysis at the Nephrology Service of Curry Cabral´s Hospital, in general, are exclusive Hospital´s Care users. In order to refer them to the Primary Health Care and promote continuity of care, strategies were created to facilitate the exchange of information and knowledge among nurses from different units based on the partnership of care.
Description
Keywords
Projecto Intervenção Tuberculose Saúde Articulação de cuidados Diálise peritoneal Project Intervention Tuberculosis Health Establishing care Peritoneal dialysis