Integrating the client's perspective in planning a XXXX education and treatment program in Honduras.

@entity1 @entity378 @entity3147
The @entity378 Control Program began its reorganization in 1979, when the Honduran Ministry of Public Health designated @entity378 as one of its priority problems. Administrative and logisitical problems faced by the program were exacerbated by the public's negative image of the disease and the consequent rejection of anything related to it, including medical diagnosis and treatment. A baseline investigation was carried out to determine the knowledge, attitudes and behaviors of the public, @entity1 and @entity1 ' relatives regarding @entity378 ( @entity378 ). Sampled were 361 healthy adults, 75 @entity378 @entity1 , 55 relatives of @entity1 , 20 health personnel, 12 nurses in 12 health centers, and 3 epidemiologists. Data was gathered using surveys (healthy population), focus groups (healthy population, @entity1 ) unstructured interviews (relatives, health personnel, nurses and epidemiologists) and focused interviews (relatives). The investigation confirmed the existence of social rejection toward @entity378 . The disease is considered quite contagious, and is associated with extreme poverty, filth and @entity3147 . The @entity1 stated that this rejection is 1 of the greatest burdens of their disease; they considered themselves a danger to others and expressed feelings of guilt. The most recognized symptom was coughing and expectoration. A @entity1 with a persistent cough does not however, want to think of @entity378 , except as a very remote possibility. Health personnel also fail to perceive a persistent cough as a respiratory symptom and possible indicator of @entity378 . Cough syrups and bronchial decongestants are the most widely distributed medicines in rural health centers. Both the @entity1 and the general population queried knew that @entity378 is curable, although they doubted that the @entity1 could recover his/her full health. @entity1 ' fear was that the long period of treatment would inevitably lead to their neighbors discovering that they had the disease and rejecting them. The health system's capacity to diagnose and treat @entity378 was also analyzed. Several problems were detected in the diagnosis of respiratory cases, e.g., difficulties leading to long delays in the collection and analysis of sputum samples and in the subsequent reporting of the findings. Moreover, instructions given to the @entity1 are quite vague as to exactly what quality sputum is needed and how best to obtain it. These problems affect the number of @entity1 who are diagnosed and treated, but seem to have little bearing on those already being treated. An education campaign was prepared based on these findings. Its goals were toinform the population at large that @entity378 @entity1 no longer transmit the disease, that they can be completely cured if treatment is begun promptly, and that a persistent cough lasting for more than 15 days may be a symptom. A pamphlet has been developed to better educate the @entity1 and their relatives. It is concluded that an understanding of and familiarity with the client's perspective can help educational programmers identify exactly which facts or opinions must be reinforced or modified so that beneficial health services are utilized.
