Managing care for older adults with tuberculosis in Primary Care: an integrative review

Abstract Objective: to analyze the available knowledge on the management of care for older adults with tuberculosis in primary care. Method: an integrative literature review was performed in the following databases, based on articles from 2008 to 2017: the Latin American and Caribbean Health Sciences (LILACS), International Health Sciences Literature (MEDLINE) and the Cumulative Index to Nursing and Allied Health Literature (CINALH). The sample consisted of six scientific articles, considering the established inclusion and exclusion criteria. Data collection took place in June 2018, using an instrument with information relevant to the proposed objective. Results: the selected studies identified weaknesses and challenges in primary health care health services regarding professional skills and knowledge, the entry point to the diagnosis of tuberculosis, the link between professionals and patients, and the logistics of health services. Conclusion: a health policy that expands the response of the government and health professionals to the needs of older adults with tuberculosis is recommended, in line with the principles of the Brazilian National Health Service. This health policy would support improving the skills and knowledge of professionals at the entry point to the diagnosis of the disease and enhancing the link between professionals and patients, and the logistics of health services. Health technology could be used to accompany the nursing team in the management of care in geriatric and gerontological research and practice.

摘要：本研究旨在分析基层医疗（primary care）老年结核病患者照护管理领域的现有知识。研究方法：本研究采用整合性文献综述设计，检索2008年至2017年发表于拉丁美洲和加勒比卫生科学数据库（LILACS）、国际医学文献数据库（MEDLINE）以及护理及相关健康文献累积索引（CINALH）的相关学术文献。根据既定纳入与排除标准，最终纳入6篇科学论文作为研究样本。数据采集工作于2018年6月完成，采用针对本研究目标设计的专用信息采集工具。研究结果：入选研究均指出，基层医疗卫生服务在专业人员技能与知识储备、结核病诊断首诊环节、医患衔接机制以及医疗服务后勤保障等方面存在明显短板与挑战。研究结论：建议出台契合巴西国家卫生服务体系原则的卫生政策，强化政府与医疗专业人员对老年结核病患者需求的响应能力。该卫生政策可助力提升诊断环节专业人员的技能与知识水平，优化医患衔接与医疗服务后勤保障。此外，可引入健康技术辅助护理团队开展老年病学与老年学领域的照护管理研究及实践。