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      Educational intervention for collecting sputum for tuberculosis: a quasi-experimental study 1

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          Abstract

          Objective:

          to evaluate the quality of the sputum sample before and after the Nursing guidance to patients.

          Methods:

          this is a quasi-experimental research design, single group type, before and after, non-randomized study. The study enrolled patients with suspected pulmonary tuberculosis, respiratory symptomatic patients for over three weeks, aged over 18 years, of both genders and without tuberculosis history in the last two years. The educational intervention consisted of individualized guidance on the collection of sputum sample, which was based on the guidelines of the Ministry of Health of Brazil and on the explanatory folder delivery.

          Results:

          in this study participated 138 patients with suspected pulmonary tuberculosis. The results showed significant increase of the samples with purulent particles, volume greater than 5 mL and increased rate of patients diagnosed with tuberculosis, after the educational intervention.

          Conclusion:

          it was shown that after the educational intervention, it was observed sputum samples with better quality, with satisfactory aspect and volume for the effectiveness of the bacilloscopic examination.

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          Most cited references64

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          Global tuberculosis report 2014

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            Improvement of tuberculosis case detection and reduction of discrepancies between men and women by simple sputum-submission instructions: a pragmatic randomised controlled trial.

            In several settings, women with suspected tuberculosis are less likely to test smear positive than are men. Submission of poor-quality sputum specimens by women might be one reason for the difference between the sexes. We did a pragmatic randomised controlled trial to assess the effect of sputum-submission instructions on female patients. 1494 women and 1561 men with suspected tuberculosis attending the Federal Tuberculosis Centre in Rawalpindi, Pakistan, were randomly assigned between May and July, 2005 either to receive sputum-submission guidance before specimen submission or to submit specimens without specific guidance, according to prevailing practice. Of enrolled patients, 133 (4%) declined to participate. The primary outcome measure was the proportion of instructed and non-instructed women testing smear positive. Intention-to-treat analysis was undertaken on the basis of treatment allocation. This study is registered with the International Standard Randomised Controlled Trial number 34123170. Instructed women were more likely to test smear positive than were controls (Risk ratio 1.63 [95% CI 1.19-2.22]). Instructions were associated with a higher rate of smear-positive case detection (58 [8%] in controls vs 95 [13%] in the intervention group; p=0.002), a decrease in spot-saliva submission (p=0.003), and an increase in the number of women returning with an early-morning specimen (p=0.02). In men, instructions did not have a significant effect on the proportion testing smear positive or specimen quality. In the Federal Tuberculosis Centre in Rawalpindi, lower smear positivity in women than in men was mainly a function of poor-quality specimen submission. Smear positivity in women was increased substantially by provision of brief instructions. Sputum-submission guidance might be a highly cost-effective intervention to improve smear-positive case detection and reduce the disparity between the sexes in tuberculosis control in low-income countries.
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              Manual Nacional de Vigilância Laboratórial da Tuberculose e outras Micobacterias

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                Author and article information

                Journal
                Rev Lat Am Enfermagem
                Rev Lat Am Enfermagem
                rlae
                Revista Latino-Americana de Enfermagem
                Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo
                0104-1169
                1518-8345
                07 June 2016
                2016
                : 24
                : e2703
                Affiliations
                [2 ]Doctoral student, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil. Assistant Professor, Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, AM, Brasil. Scholarship holder from Fundação de Amparo à Pesquisa do Estado do Amazonas (FAPEAM), Brazil.
                [3 ]Researcher, Instituto Nacional de Pesquisa da Amazônia, Manaus, AM, Brazil.
                [4 ]Adjuntct Professor, Faculdade de Medicina, Universidade Federal do Amazonas, Manaus, AM, Brazil.
                [5 ]Adjunct Professor, Faculdade de Enfermagem e Obstetrícia, Universidade Federal de Pelotas, Pelotas, RS, Brazil.
                [6 ]Associate Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo,
                Author notes
                Corresponding Author: Amélia Nunes Sicsú Universidade do Estado do Amazonas. Escola Superior de Ciências da Saúde Av. Carvalho Leal, 1777 Bairro: Cachoeirinha CEP: 69065-001, Manaus, AM, Brasil E-mail: asicsu@ 123456uea.edu.br
                Article
                00333
                10.1590/1518-8345.0363.2703
                4915801
                27276015
                6e5f1441-30e6-4b34-9033-e26819db0a31

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 05 August 2014
                : 05 July 2015
                Page count
                Figures: 0, Tables: 9, Equations: 0, References: 19, Pages: 1
                Categories
                Original Articles

                tuberculosis,health education,specimen handling,intervention studies

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