Abstract
ABSTRACT Objective: identifying social representations of health professionals and patients with tuberculosis in an initial interview for diagnostic disclosure and analyzing discursive content regarding the relation of this mode of communication during the interview for adherence of these patients to tuberculosis treatment. Method: a descriptive and qualitative study. A semi-structured interview was conducted with 39 health professionals involved in the initial tuberculosis diagnosis disclosure interview and 34 adult patients undergoing treatment in 22 health units in the southern region of São Paulo (Brazil). Discourse analysis was based on the discussions about “Awareness”, developed by Paulo Freire. Results: a lack of explanations resulted in patients not understanding the diagnosis, abrasiveness by health professionals, the need for health education and how to approach the patient have emerged as conditions that influence patient adherence to treatment. Conclusion: regarding communication, we have identified a professional exercise that is contrary to promoting patient adherence to treatment, since it does not allow them to critically reflect on their current situation, and consequently does not modify their reality (in choosing adhesion and cure), thus characterizing incompetent communication.
Highlights
The work of the health professional is based in human relations, and it is not possible to not consider the communicative process that is inserted in these relations
After all the work organizing the speeches of all the participants to the three questions, in central ideas into categories, and into Discourses of the Collective Subject (DCS), all the material was analyzed regarding the diagnosis communication mode, as based on the six key ideas presented by the Brazilian educator Paulo Freire which were adapted for this research.[26]
Few professionals believe that the best way to disclose the diagnosis so that patients will adhere to treatment is by making them accountable for their outcome, provoking fear into them or offering material incentives as a bargain for them to adhere
Summary
The work of the health professional is based in human relations, and it is not possible to not consider the communicative process that is inserted in these relations. Adequate communication is one that attempts to reduce conflicts, misunderstandings, and above all, achieves defined goals in interacting with the patient. It is bi-directional, and needs to respond and to validate messages, both verbally and physically (proximity, posture, eye contact); it can be a communication that negatively influences the situation when it does not occur in this way.[1]. For communication to be considered appropriate, it must be suitable to the situation, the person, the time/moment, and it must reach a definite goal. It implies an earlier preparation considering what will be transmitted, who will transmit it and who will receive it, as well as the technique that will be employed.[1]
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