The process of adherence to treatment by tuberculosis: contributions from social work

Abstract

The article is the product of the work carried out in the Sanitary Commission of Tuberculosis Control of the Province of Córdoba, Republic of Argentina. Its objective is to problematize the concept of adherence to treatment in order to overcome the positivist view, to identify social determinants that intervene in the health-disease-attention process that influence during treatment and to describe the contributions of Social Work in this process. It is considered that an integral treatment must incorporate interventions that mitigate the determinants that hinder the culmination of the treatment or that prevent seeing the real causes of the failures. In Córdoba, Law 9185/04 provides economic support as part of comprehensive health treatment; strategies are designed to promote adherence of patients whose access to the health system is hindered. Through the qualitative analysis of the interviews of admission to the 2017 Program, obtained in the hospitals and primary care centers of the capital and interior of Cordoba, it is concluded that adherence is more than compliance with the indication, it implies a process by which subjects aware of their health situation, empower themselves of their right to access to it and make use of it, through the use of devices provided for that purpose, from their own particularities. In the process of adherence to treatment for tuberculosis, it is important to highlight the patient-health team relationship, which will be decisive in the culmination of the treatment. For the analysis of the data we used the information that comes from the interviews of admission to the Program. In 2017, 84 formal transfer requests were received, and qualitative analysis was carried out from these semi-structured interviews. Throughout the trial, the term "patient" is used as a synonym for people under treatment, service users, or citizens.