0016/2023 - Afinal, quem é “difícil”? Revisão integrativa sobre pacientes, médicos e relações difíceis After all, who is “difficult”? Integrative review on patients, doctors and difficult relationships
O objetivo deste estudo foi sintetizar a literatura sobre as características de pacientes, médicos e relações médico-paciente considerados “difíceis”. Foi realizada revisão integrativa de estudos primários publicados entre janeiro de 2016 e setembro de 2021, em Português, Inglês e Espanhol. De 3.414 artigos identificados nas bases Embase, PubMed, Scopus e Lilacs, 19 foram analisados qualitativamente. Sete estudos foram realizados na Europa, oito na América do Norte, dois na América do Sul e dois na China, totalizando 1.694 pacientes, 1.903 médicos assistentes, 101 residentes e 160 acadêmicos de medicina. Médicos e/ou acadêmicos de medicina consideravam difíceis os pacientes com: condições clínicas como doenças psicossomáticas e crônicas; sintomas e queixas como dor; emoções fortes; problemas na obtenção e no compartilhamento das informações, nas tomadas de decisão, na adesão ao plano terapêutico e no seu autocuidado; e, certas características sociodemográficas e de vulnerabilidade. Pacientes ou seus familiares consideravam difíceis os médicos que não os escutavam, eram preconceituosos e pareciam não se importar com seus filhos, entre outros aspectos. Sugere-se o ensino de comunicação médica e intervenções sistêmicas para melhorar as relações médico-paciente.
Palavras-chave:
Relações médico-paciente; Educação Médica; Assistência Centrada no Paciente.
Abstract:
The objective of this study was to synthesize the literature about patients, physicians, and physician - patient relationships considered ‘difficult’. An integrative review was carried out, with primary studies published between January 1, 2016 and September 30, 2021 in Portuguese, English and Spanish. Of 3,414 papers identified in PubMed, Embase, Scopus and Lilacs databases, 19 were ed for qualitative analysis. Seven studies were carried out in Europe, eight in North America, two in South America and two in China, totaling 1,694 patients, 1,903 assistant physicians, 101 residents and 160 medical students. Physicians considered difficult: patients with: clinical conditions such as psychosomatic and chronic illnesses; symptoms and complaints such as pain; strong emotions; problems in obtaining and sharing information, in decision-making, in the adherence to the therapeutic plan and in their self-care; and, some sociodemographic and vulnerability characteristics. Patients or their relatives considered difficult doctors who did not listen to them, not to care about their children, among other aspects. Teaching medical communication and systemic interventions are suggested in order to avoid thoses difficulties and improve physician-patient relationships.
Keywords:
Physician-Patient Relations; Medical Education; Patient-Centered Care
After all, who is “difficult”? Integrative review on patients, doctors and difficult relationships
Resumo (abstract):
The objective of this study was to synthesize the literature about patients, physicians, and physician - patient relationships considered ‘difficult’. An integrative review was carried out, with primary studies published between January 1, 2016 and September 30, 2021 in Portuguese, English and Spanish. Of 3,414 papers identified in PubMed, Embase, Scopus and Lilacs databases, 19 were ed for qualitative analysis. Seven studies were carried out in Europe, eight in North America, two in South America and two in China, totaling 1,694 patients, 1,903 assistant physicians, 101 residents and 160 medical students. Physicians considered difficult: patients with: clinical conditions such as psychosomatic and chronic illnesses; symptoms and complaints such as pain; strong emotions; problems in obtaining and sharing information, in decision-making, in the adherence to the therapeutic plan and in their self-care; and, some sociodemographic and vulnerability characteristics. Patients or their relatives considered difficult doctors who did not listen to them, not to care about their children, among other aspects. Teaching medical communication and systemic interventions are suggested in order to avoid thoses difficulties and improve physician-patient relationships.
Palavras-chave (keywords):
Physician-Patient Relations; Medical Education; Patient-Centered Care
Cruvinel, P.V.Q, Grosseman, S.. Afinal, quem é “difícil”? Revisão integrativa sobre pacientes, médicos e relações difíceis. Cien Saude Colet [periódico na internet] (2023/Jan). [Citado em 07/07/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/afinal-quem-e-dificil-revisao-integrativa-sobre-pacientes-medicos-e-relacoes-dificeis/18642?id=18642
