Cuidado centrado no paciente
um olhar sobre as práticas de cuidar e compartilhar no processo de educação em saúde
DOI:
https://doi.org/10.47519/risi.v1i00.7Palavras-chave:
Estudantes de Ciências da Saúde, Cuidado Centrado no Paciente, EnsinoResumo
Objetivo: Analisar as atitudes de centralidade no paciente entre estudantes de fonoaudiologia, enfermagem e odontologia em relação às práticas de cuidado e compartilhamento. Metodologia: Pesquisa transversal com 177 estudantes de cursos de enfermagem, fonoaudiologia e odontologia. Os dados foram coletados entre abril e setembro de 2021, utilizando a Escala de Orientação Paciente-Profissional como medida de desfecho. Resultados: Foi identificada uma maior tendência dos estudantes de fonoaudiologia em favorecer o cuidado centrado no paciente em comparação com os estudantes de enfermagem e odontologia. Nenhuma das variáveis independentes deste estudo foi um preditor do cuidado centrado no paciente. Conclusão: As médias dos escores da Escala de Orientação Paciente-Profissional dos estudantes indicaram atitudes de centralidade no paciente, mas sem significância estatística entre os grupos analisados. As atitudes de centralidade no paciente observadas durante o processo acadêmico da educação em saúde são um resultado importante da busca por estratégias que estimulem o diálogo acadêmico, a segurança e a qualidade do atendimento em saúde.
Referências
AHMAD, W; KRUPAT, E.; ASMA, Y.; FATIMA, N.; ATTIQUE, R.; MAHMOOD, U.; WAQAS, A. Attitudes of medical students in Lahore, Pakistan towards the doctor–patient relationship. PeerJ, v. 3, p. e1050, 30 jun. 2015. Disponível em: https://peerj.com/articles/1050. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.7717/peerj.1050
BALINT, M. The doctor, your patient and the patient. 2. ed. Editora Atheneu, 2005. 291 p.
BATENBURG, V.; SMAL, J. A.; LODDER, A.; MELKER, R. A. de. Are professional attitudes related to gender and medical specialty? Medical Education, v. 33, n. 7, p. 489–492, 4 jul. 1999. Disponível em: https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2923.1999.00333.x. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1046/j.1365-2923.1999.00333.x
BEATTIE, A.; DURHAM, J.; HARVEY, J.; STEELE, S. M.. Does empathy change in first-year dental students? European Journal of Dental Education, v. 16, n. 1, p. e111–116, fev. 2012. Disponível em: https://onlinelibrary.wiley.com/doi/10.1111/j.1600-0579.2011.00683.x. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1111/j.1600-0579.2011.00683.x
BENEDETTO, M. A. C. de; GALLIAN, D. M. C. Narrativas de estudantes de Medicina e Enfermagem: currículo oculto e desumanização em saúde. Interface - Comunicação, Saúde, Educação, v. 22, n. 67, p. 1197–1207, dez. 2018. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1414-32832018000401197&tlng=pt. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1590/1807-57622017.0218
BRANCH Jr, W. T. Teaching the Human Dimensions of Care in Clinical Settings. JAMA, v. 286, n. 9, p. 1067, 5 set. 2001. Disponível em: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.286.9.1067. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1001/jama.286.9.1067
BRASIL. Diretrizes Curriculares Nacionais para o Curso de Graduação em Fonoaudiologia. Diário Oficial da União. Brasil, 2002. Disponível em: http://portal.mec.gov.br/cne/arquivos/pdf/CES052002.pdf. Acesso em: 1 nov. 2024.
DE SILVA, D. Helping measure person-centred care. The Health Foundation. 2014. p. 80. Disponível em: https://www.health.org.uk/sites/default/files/HelpingMeasurePersonCentredCare.pdf. Acesso em: 1 nov. 2024.
DOCKENS, A. L.; BELLON-HARN, M. L.; MANCHAIAH, V. Preferences to Patient-Centeredness in Pre-Service Speech and Hearing Sciences Students: A Cross-Sectional Study. Journal of Audiology & Otology, v. 20, n. 2, p. 73–79, 20 set. 2016. Disponível em: http://ejao.org/journal/view.php?doi=10.7874/jao.2016.20.2.73. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.7874/jao.2016.20.2.73
DUCHAN, J. F. Impairment and Social Views of Speech-Language Pathology: Clinical Practices Re-Examined. Advances in Speech-Language Pathology, v. 3, n. 1, p. 37–45, 3 jan. 2001. Disponível em: http://www.tandfonline.com/doi/full/10.3109/14417040109003707. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.3109/14417040109003707
FOTHAN, A.; ESHAQ, A. M.; BAKATHER, A. M. Medical Students’ Perceptions of the Doctor-Patient Relationship: A Cross-Sectional Study from Saudi Arabia. Cureus, v. 11, n. 7, p. 1–8, 1 jul. 2019. Disponível em: https://www.cureus.com/articles/20190-medical-students-perceptions-of-the-doctor-patient-relationship-a-cross-sectional-study-from-saudi-arabia. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.7759/cureus.5053
GRILO, A. M. et al. Centração no paciente: Contributo para o estudo de adaptação da patient-practitioner orientation scale (PPOS). Psychology, Community & Health, v. 6, n. 1, p. 170–185, 8 jan. 2018. Disponível em: https://pch.psychopen.eu/article/view/148. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.5964/pch.v6i1.148
HAFFERTY, F. W. Beyond Curriculum Reform: Confronting Medicine’s Hidden Curriculum. Academic Medicine, v. 73, p. 403–407, 1998. DOI: https://doi.org/10.1097/00001888-199804000-00013
HAIDET, P.; DAINS, J. E.; PATERNITI, D. A.; HECHTEL, L.; CHANG, T.; TSENG, E.; ROGERS, J. C. Medical student attitudes toward the doctor-patient relationship. Medical Education, v. 36, n. 6, p. 568–574, jun. 2002. Disponível em: http://doi.wiley.com/10.1046/j.1365-2923.2002.01233.x. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1046/j.1365-2923.2002.01233.x
HAIDET, P.; KELLY, P. A.; BENTLEY, S.; BLATT, B.; CHOU, C. L.; FORTIN, A. H.; GORDON, G.; GRACEY, C.; HARRELL, H.; HATEM, D. S.; HELMER, D.; PATERNITI, D. A.; WAGNER, D.; INUI, T. S. Not the same everywhere. Journal of General Internal Medicine, v. 21, n. 5, p. 405–409, maio 2006. Disponível em: http://link.springer.com/10.1111/j.1525-1497.2006.00417.x. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1111/j.1525-1497.2006.00417.x
HENBEST, R. J.; STEWART, M. Patient-Centredness in the Consultation. 2: Does it Really Make a Difference? Family Practice, v. 7, n. 1, p. 28–33, 1990. Disponível em: https://academic.oup.com/fampra/article-lookup/doi/10.1093/fampra/7.1.28. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1093/fampra/7.1.28
INSTITUTE OF MEDICINE. Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academies Press (US), 2001.
ISHIKAWA, H.; SON, D.; ETO, M.; KITAMURA, K.; KIUCHI, T. Changes in patient-centered attitude and confidence in communicating with patients: a longitudinal study of resident physicians. BMC Medical Education, v. 18, n. 1, p. 20, 25 dez. 2018. Disponível em: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-018-1129-y. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1186/s12909-018-1129-y
JIANG, S. Pathway Linking Patient-Centered Communication to Emotional Well-Being: Taking into Account Patient Satisfaction and Emotion Management. Journal of Health Communication, v. 22, n. 3, p. 234–242, mar. 2017. Disponível em: http://dx.doi.org/10.1080/10810730.2016.1276986. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1080/10810730.2016.1276986
KRUPAT, E.; ROSENKRANZ, S. L.; YEAGER, C. M.; BARNARD, K.; PUTNAM, S. M.; INUI, T. S. The practice orientations of physicians and patients: the effect of doctor–patient congruence on satisfaction. Patient Education and Counseling, v. 39, n. 1, p. 49–59, jan. 2000. Disponível em: https://linkinghub.elsevier.com/retrieve/pii/S0738399199000907. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1016/S0738-3991(99)00090-7
LAPLANTE-LÉVESQUE, A.; HICKSON, L.; GRENNESS, C. An Australian survey of audiologists’ preferences for patient-centredness. International Journal of Audiology, v. 53, sup1, p. S76–S82, 21 fev. 2014. Disponível em: http://www.tandfonline.com/doi/full/10.3109/14992027.2013.832418. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.3109/14992027.2013.832418
LEVINSON, W.; LESSER, C. S.; EPSTEIN, R. M. Developing Physician Communication Skills For Patient-Centered Care. Health Affairs, v. 29, n. 7, p. 1310–1318, jul. 2010. Disponível em: http://www.healthaffairs.org/doi/10.1377/hlthaff.2009.0450. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1377/hlthaff.2009.0450
LLOYD-WILLIAMS, M. Attitudes of preclinical medical students towards cuidado for chronically ill and dying patients: does palliative care teaching make a difference? Postgraduate Medical Journal, v. 80, n. 939, p. 31–34, 1 jan. 2004. Disponível em: https://pmj.bmj.com/lookup/doi/10.1136/pmj.2003.009571. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1136/pmj.2003.009571
MADHAN, B.; RAJPUROHIT, A. S.; GAYATHRI, H. Attitudes of Postgraduate Orthodontic Students in India Towards Patient-Centered Care. Journal of Dental Education, v. 75, n. 1, p. 107–114, jan. 2011. Disponível em: https://onlinelibrary.wiley.com/doi/10.1002/j.0022-0337.2011.75.1.tb05029.x. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1002/j.0022-0337.2011.75.1.tb05029.x
MALTA, M.; CARDOSO, L O.; BASTOS, F. I.; MAGNANINI, M. M. F.; DA SILVA, C. M. F. P. STROBE initiative: guidelines on reporting observational studies. Public Health Journal, v. 44, n. 3, p. 559–565, jun. 2010. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102010000300021&lng=pt&tlng=pt. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1590/S0034-89102010000300021
MANCHAIAH, V.; GOMERSALL, P. A.; TOMÉ, D.; AHMADI, T.; KRISHNA, R. Audiologists’ preferences for patient-centredness: a cross-sectional questionnaire study of cross-cultural differences and similarities among professionals in Portugal, India and Iran. BMJ Open, v. 4, n. 10, p. e005915, 14 out. 2014. Disponível em: https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2014-005915. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1136/bmjopen-2014-005915
ARTIMIANAKIS, M. A. (Tina); MICALEC, B.; LAM, J.; CARTMILL, C.; TAYLOR, J. S.; HAFFERTY, F. W. Humanism, the Hidden Curriculum, and Educational Reform. Academic Medicine, v. 90, n. 11, p. S5–S13, nov. 2015. Disponível em: http://journals.lww.com/00001888-201511001-00005. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1097/ACM.0000000000000894
MEHTA, A.; ADAMS, N.; FREDRICKSON, M.; KRASZKIEWICZ, W.; SIY, J.; HAMEL, L.; HENDEL-PATERSON, B. Craving Empathy: Studying the Sustained Impact of Empathy Training on Clinicians. Journal of Patient Experience, v. 8, p. 237437352110433, 27 jan. 2021. Disponível em: http://journals.sagepub.com/doi/10.1177/23743735211043383. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1177/23743735211043383
MUDIYANSE, R. M.; PALLEGAMA, R. W.; JAYALATH, T.; DHARMARATNE, S.; KRUPAT, E. Translation and validation of patient-practitioner orientation scale in Sri Lanka. Education for Health, [Internet], v. 28, n. 1, p. 35, 2015. Disponível em: http://www.educationforhealth.net/text.asp?2015/28/1/35/161847. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.4103/1357-6283.161847
NAZARIO, R. J. Medical humanities as tools for the teaching of patient-centered care. Journal of Hospital Medicine, v. 4, n. 8, p. 512–514, out. 2009. Disponível em: http://www.journalofhospitalmedicine.com/jhospmed/article/126891/teaching-patient-centered-care. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1002/jhm.480
NICHOLS, H. M.; DABABNAH, S.; BERGER, Z.; LONG, C.; SACCO, P. Can You Hear Me Now? Effects of Patient-Centered Communication With Young Adults Aged 26 to 39. Journal of Patient Experience, v. 8, p. 237437352110331, jan. 2021. Disponível em: http://journals.sagepub.com/doi/10.1177/23743735211033116. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1177/23743735211033116
PEIXOTO, J. M.; RIBEIRO, M. M. F.; AMARAL, C. F. S. Atitude do estudante de medicina a respeito da relação médico-paciente x modelo pedagógico. Revista Brasileira de Educação Médica, v. 35, n. 2, p. 229–236, jun. 2011. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-55022011000200012&lng=pt&tlng=pt. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1590/S0100-55022011000200012
PEREIRA, C. M. A. da S. Translation, cultural adaptation and validation of the Patient-Practitioner Orientation Scale (PPOS) for the Portuguese language of Brazil. Federal University of Uberlândia, Uberlândia, 2012. Disponível em: https://repositorio.ufu.br/bitstream/123456789/12731/1/d.pdf. Acesso em: 1 nov. 2024.
PERESTELO-PÉREZ, L.; RIVERO-SANTANA, A.; GONZÁLEZ-GONZÁLEZ, A. I.; BERMEJO-CAJA, C. J.; RAMOS-GARCÍA, V.; KOATZ, D.; TORRES-CASTAÑO, A.; BALLESTER, M.; MUÑOZ-BALSA, M.; DEL REY-GRANADO, Y.; PÉREZ-RIVAS, F. J.; CANELLAS-CRIADO, Y.; RAMÍREZ-PUERTA, A. B.; PACHECO-HUERGO, V.; ORREGO, C. Cross-cultural validation of the patient-practitioner orientation scale among primary care professionals in Spain. Health Expectations, v. 24, n. 1, p. 33–41, fev. 2021. Disponível em: https://onlinelibrary.wiley.com/doi/10.1111/hex.13135. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1111/hex.13135
RIBEIRO, M. M. F.; AMARAL, C. F. S. Medicina centrada no paciente e ensino médico: a importância do cuidado com a pessoa e o poder médico. Revista Brasileira de Educação Médica, v. 32, n. 1, p. 90–97, mar. 2008. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-55022008000100012&lng=pt&tlng=pt. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1590/S0100-55022008000100012
RIBEIRO, M. M. F.; KRUPAT, E.; AMARAL, C. F. S. Brazilian medical students’ attitudes towards patient-centered care. Medical Teacher, v. 29, n. 6, p. e204–e208, 3 jan. 2007. Disponível em: http://www.tandfonline.com/doi/full/10.1080/01421590701543133. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1080/01421590701543133
ROSEWILLIAM, S.; INDRAMOHAN, V.; BREAKWELL, R.; LIEW, B. X. W.; SKELTON, J. Patient-centred orientation of students from different healthcare disciplines, their understanding of the concept and factors influencing their development as patient-centred professionals: a mixed methods study. BMC Medical Education, v. 19, n. 1, p. 347, 11 dez. 2019. Disponível em: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-019-1787-4. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1186/s12909-019-1787-4
SCHMIDT, H. Integrating the Teaching of Basic Sciences, Clinical Sciences, and Biopsychosocial Issues. Academic Medicine, 1998. p. S24–S31. DOI: https://doi.org/10.1097/00001888-199809001-00006
SHANKAR, P. R.; DUBEY, A. K.; SUBISH, P.; DESHPANDE, V. Attitudes of first-year medical students towards the doctor-patient relationship. JNMA Journal of the Nepal Medical Association, v. 45, n. 161, p. 196–203, 2006. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/17160097. Acesso em: 1 nov. 2024.
SOBCZAK, K.; ZDUN-RYŻEWSKA, A.; RUDNIK, A. Intensity, dynamics, and deficiencies of empathy in medical and non-medical students. BMC Medical Education, v. 21, n. 1, p. 487, 10 dez. 2021. Disponível em: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-021-02927-x. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1186/s12909-021-02927-x
SURVEYMONKEY INC. SurveyMonkey Audience. San Mateo, Califórnia, EUA. Disponível em: pt.surveymonkey.com. Acesso em: 1 nov. 2024.
TOR, P. C. New Challenges Facing the Doctor-Patient. Singapore Medical Journal, v. 42, n. 12, p. 572–575, 2001.
TSIMTSIOU, Z.; KERASIDOU, O.; EFSTATHIOU, N.; PAPAHARITOU, S.; HATZIMOURATIDIS, K.; HATZICHRISTOU, D. Medical students’ attitudes toward patient-centred care: a longitudinal survey. Medical Education, v. 41, n. 2, p. 146–153, fev. 2007. Disponível em: https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2929.2006.02668.x. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1111/j.1365-2929.2006.02668.x
WANG, D.; LIU, C.; ZHANG, X. Do Physicians’ Attitudes towards Patient-Centered Communication Promote Physicians’ Intention and Behavior of Involving Patients in Medical Decisions? International Journal of Environmental Research and Public Health, v. 17, n. 17, p. 6393, 2 set. 2020. Disponível em: https://www.mdpi.com/1660-4601/17/17/6393. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.3390/ijerph17176393
WANG, J.; ZOU, R.; FU, H.; QIAN, H.; YAN, Y.; WANG, F. Measuring the preference towards patient-centred communication with the Chinese-revised Patient–Practitioner Orientation Scale: a cross-sectional study among physicians and patients in clinical settings in Shanghai, China. BMJ Open, v. 7, n. 9, p. e016902, 18 set. 2017. Disponível em: https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2017-016902. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.1136/bmjopen-2017-016902
WAQAS, A.; KHAN, S.; SHARIF, W.; KHALID, U.; ALI, A. Association of academic stress with sleeping difficulties in medical students of a Pakistani medical school: a cross-sectional survey. PeerJ, v. 3, p. e840, 12 mar. 2015. Disponível em: https://peerj.com/articles/840. Acesso em: 1 nov. 2024. DOI: https://doi.org/10.7717/peerj.840
ZHUMADILOVA, A.; CRAIG, B. J.; BOBAK, M. Patient-centered beliefs among patients and providers in Kazakhstan. Ochsner Journal, v. 18, n. 1, p. 46–52, 2018.
ZOLNIEREK, K. H.; DIMATTEO, R. Physician Communication and Patient Adherence to Treatment - A Meta-Analysis. Medical Care, v. 47, n. 8, 2009. DOI: https://doi.org/10.1097/MLR.0b013e31819a5acc
