Thesis (M.S.)--University of Michigan, 1988.

Thesis (M.S.)--University of Michigan, 1986.

Thesis (M.S.)--University of Michigan, 1988.

Thesis (M.S.)--University of Wisconsin--Madison, 1984. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 66-67).

Thesis (M.S.)--University of Wisconsin-Madison. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 43-46).

Thesis--University of Oklahoma. / Bibliography: leaves 85-88.

Thesis (Ph.D. in Nursing) -- University of Colorado, 2006. / Typescript. Includes bibliographical references (leaves 177-185). Free to UCDHSC affiliates. Online version available via ProQuest Digital Dissertations;

As características biológicas e comportamentais relacionadas aos doentes de tuberculose (TB) são importantes aspectos a serem considerados quando se almeja a precocidade da detecção dos casos, uma vez que determinam a procura e utilização dos serviços de saúde. Este estudo teve como objetivo descrever os aspectos relacionados aos doentes de TB que interferem no tempo de procura por um serviço de saúde após a percepção do início dos sintomas da doença na cidade de São José do Rio Preto - SP. Trata-se de um estudo epidemiológico descritivo e exploratório, do tipo inquérito. Participaram do estudo 100 doentes de TB entrevistados por meio de um instrumento que contemplou questões sócio-demográficas, clínicas, econômicas e comportamentais dos doentes. A partir da questão relacionada ao tempo para proceder a procura por um serviço de saúde realizou-se o cálculo da mediana e, por meio do valor obtido, definiu-se o ponto de corte a partir do qual se considerou atraso na procura por atendimento. O tempo mediano decorrido entre a percepção do início dos sintomas da TB e a primeira procura por um serviço de saúde foi de 15 dias, sendo a Unidade de Pronto Atendimento (UPA) o principal serviço de saúde procurado. Houve predominância de doentes do sexo masculino. Encontrou-se atraso (>15 dias) entre homens e indivíduos com idade entre 50 a 59 anos que procuraram pelas UPA e entre mulheres e indivíduos cuja faixa etária estava entre 18 a 29 e maiores de 60 anos que optaram pelas Unidades de Atenção Básica (UAB). No que se refere ao estado civil, somente tiveram atraso doentes que se declararam divorciados/separados. Doentes sem escolaridade ou com EF incompleto, sem remuneração e que possuíam a forma pulmonar da TB atrasaram ao buscar UPA. Doentes com forma extrapulmonar da TB e em recidiva/retratamento atrasaram quando a busca por atendimento ocorreu nas UAB. Co-infectados foram mais rápidos ao buscar por atendimento nos serviços especializados. Demoraram para buscar pelo primeiro atendimento aqueles que relataram os sintomas ao início da doença como sendo de fracos a moderados. Houve atraso entre doentes que não fumavam e procuraram por UAB e UPA. Houve demora superior a 15 dias somente quando a procura por assistência entre os doentes consumidores de bebidas alcoólicas ocorreu nas UAB. Tiveram retardo doentes com conhecimento precário que procuraram as UAB e aqueles com conhecimento satisfatório que optaram pelas UPA. A maioria dos doentes deste estudo tinham o hábito de procurar pelos serviços mais próximos do domicílio antes do diagnóstico da TB e não atrasaram ao buscar por atendimento em UAB e serviços especializados. Levanta-se a necessidade de maior atenção por parte da equipe dos serviços de saúde quanto às caracteristicas do perfil dos usuários que tiveram atraso na busca por atendimento. O reconhecimento dessas características e do padrão de utilização dos serviços de saúde é primordial para o planejamento em saúde e definição de estratégias que favoreçam a busca por atendimento entre os usuários em menor tempo, de modo a possibilitar o diagnóstico precoce da TB pelos serviços de saúde. / The biological and behavioral characteristics related to patients with tuberculosis (TB) are important aspects to be considered when the early detection of cases of the disease is aimed, since they seem to play an important role in demand and utilization of health services patterns. This study aimed to describe the aspects related to TB patients that affect time to search for a health facility after the perception of the onset of disease symptoms in Sao Jose do Rio Preto - SP. An epidemiological study, descriptive and exploratory type of investigation were conducted including 100 TB patients, who were interviewed by an instrument that included socio-demographic, clinical, economic and behavioral characteristics. From the issue related to time to search for a health service the median was calculated, and half the value obtained, we defined the cutoff point from which delay in seeking treatment was considered. The median time between the perception of TB symptoms\' onset and the first demand for a health service was 15 days, being the Emergency Unit (EU) the main health service sought. There was a predominance of male patients. A delay was found (> 15 days) among men and those with age from 50 to 59 years who sought first a EU and among women and those with age between 18 to 29, as well as seniors over 60, who opted for searching first a Primary Care Unit (PHU). Regarding to marital status, in general, only patients who declared themselves as divorced/separated had shown delay. Patients without education or with incomplete level of formation, without remuneration and who presented the TB pulmonary form seek the EU with delay. Patients with extrapulmonary TB and relapse/retreatment delayed when searching for treatment occurred in the PHU. Co-infection patients seek faster care at specialized services. Those who reported the symptoms of the disease as being low to moderate showed longer time to search. Patients who didn´t smoke and looked for PHU and EU also present delayed. Among patients who consumed alcohol, delay was greater than 15 days when demand for care occurred at UAB. Those who present poor knowledge and sought PHU and those with satisfactory knowledge that opted for the EU also showed longer delays. Most patients in this study were used to seek services closer to their homes before the diagnosis of TB and did not delay in seeking care at PHU and specialized services. Need for greater focus by the team of health services regarding the characteristics of the profile of users who have had to seek delays for care is raised. Recognition of patient\'s characteristics and health services\' utilization patterns, in their different ways of organizing and delivering assistance is central to health planning and developing strategies to promote the search for treatment among users in less time, in order to enable early diagnosis of TB at health services.

Even though a plethora of research is devoted to explicating caregivers' experiences, comparatively there is a dearth of information about care recipients. The purpose of this study was to further theoretical and empirical understanding of care recipients' experiences within care relationships. Specifically, this study was concerned with identifying the strategies elders use to seek care and how the processes and characteristics of individual, interpersonal, and structural levels interact to affect elders' care seeking. A synthesized symbolic interactionist and life span developmental framework informed the research. Multiple qualitative field work methods (semi-structured interviews, participant observation, focus group) were utilized to collect information about care recipients who were representative of the variety of care relationships within a life care retirement community. The care seeking process emerged as a sequence of activities engaged in as elders elicited care from others and negotiated care with others. Of most conceptual interest, however, was elders' dependency work: The work elders engaged in as they not only sought care for a specific need but also situated each care occasion within past experiences of care and future possibilities for care. Dependency work was agency in action, serving to define the everyday lives of elders involved in care relationships. The findings of this study suggest the need for viewing care recipients as agents, actively being with others in their delicate dance of dependency.

Source: Masters Abstracts International, Volume: 46-05, page: 2674. Adviser: Carl Hacker. Includes bibliographical references.