THE SEARCH FOR TREATMENT BY PULMONARY TUBERCULOSIS PATIENTS: A QUALITATIVE STUDY BASED ON THE “ILLNESS BEHAVIOR” MODEL

Abstract

Objective: To evaluate how pulmonary tuberculosis patients report their illness experiences as well as to verify the different phases of “illness behavior” in the perspective of content analysis as proposed by Bardin. Material and Methods: This was a qualitative study using the discourse analysis of interviews with 16 pulmonary tuberculosis patients undergoing Directly Observed Treatment Short-course (DOTS) at the Clementino Fraga Hospital of Infectious Diseases in João Pessoa, Paraiba, Brazil. This study was based on the theory of “illness behavior” proposed by Mechanic. Results: It was observed a late seeking for medical attention, initial demand for general hospitals, with a delay in diagnosis, and limitation to work as a determinant factor for the acceptance of the sick role and of the need for medical assistance. Upon receiving the diagnosis, there was fear of contagion to family and stigma regarding the diagnosis. The causes for tuberculosis were attributed to lifestyle, weather, work and emotional problems. As to the dependent behavior phase, patients reported transferring the control to the doctor. Conclusion: Diverse phases of the “illness behavior” were observed, since denial of symptoms until adjustment to this sick role. As such, patients reported the need for legitimizing their illness through the medical diagnosis. This study indicates the need for healthcare professionals to go beyond the clinical framework in order to reach a more effective treatment. DESCRIPTORS: Tuberculosis. Sick Role. Qualitative Research.