Atención centrada en el paciente
una mirada a las prácticas de cuidar y compartir en el proceso de educación para la salud
DOI:
https://doi.org/10.47519/risi.v1i00.7Palabras clave:
Estudiantes de Ciencias de la Salud, Atención centrada en el paciente, EnseñanzaResumen
Objetivo: Analizar las actitudes de centralidad del paciente entre estudiantes de logopedia, enfermería y odontología en relación a la práctica del cuidado y el compartir. Metodología: Estudio transversal con 177 estudiantes de cursos de enfermería, logopedia y odontología. Los datos se recolectaron entre abril y septiembre de 2021, utilizando la Escala de orientación paciente-profesional como medida de resultado. Resultados: Se identificó una mayor tendencia de los estudiantes de logopedia a favorecer la atención centrada en el paciente en comparación con los estudiantes de enfermería y odontología. Ninguna de las variables independientes en este estudio fue un predictor de la atención centrada en el paciente. Conclusión: Los puntajes promedio de Escala de orientación paciente-profesional de los estudiantes indicaron actitudes de centralidad en el paciente, pero sin significación estadística entre los grupos analizados. Las actitudes de centralidad del paciente observadas durante el proceso académico de educación en salud son un resultado importante de la búsqueda de estrategias que estimulen el diálogo académico, la seguridad y la calidad de la atención a la salud.
Citas
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
