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Nursing care experiences with Hansen’s disease patients: contributions from hermeneutics

Abstract

Objective

To analyze the experience of caring for Hansen’s disease patients in the practice of nurses in the city of Rio de Janeiro.

Methods

Qualitative study based on philosophical hermeneutics conducted in the programmatic areas of health in the city of Rio de Janeiro, which presented high or medium rates of Hansen’s disease detection in 2014. Services with the following profiles were selected: exclusively Family Health Strategy (FHS), services with specialized clinics, and hybrid units in which the FHS and the traditional care model coexist. Nineteen nurses working in the primary and secondary health services of these areas participated in the research. The inclusion criteria were having at least five years of experience in following up Hansen’s disease patients, and technical ability acquired from specific training. Exclusion criterion was being absent from work during the whole data collection stage, which happened between February 2015 and March 2016. Interviews were scheduled in agreement with participants and recorded with their authorization.

Results

Two categories were established: For nurses, care for Hansen’s disease patients lost its quality, and nurses recognize stigma as a problem that compromises Hansen’s disease treatment and cure.

Conclusion

Treatment of Hansen’s disease patients was limited to eventual actions, where the professional-user relationship has a fragile link. The stigma and discrimination that harm treatment are still present in attitudes and behaviors of health professionals, and represent an obstacle for reestablishing health.

Keywords
Leprosy; Health services, Nursing care; Health care

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