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A Empatia e a Capacitação do Consulente em Medicina Geral e Familiar

Authors: Lourenço, Joana Alexandra Fernandes;

A Empatia e a Capacitação do Consulente em Medicina Geral e Familiar

Abstract

Introdução: A Medicina Centrada na Pessoa assume um papel muito importante na Medicina Geral e Familiar, sendo a relação Médico-Paciente um dos pilares fundamentais a investir, em prol da melhoria da prática clínica. A Empatia como atributo cognitivo que envolve a compreensão do consulente e a capacidade para comunicar a intenção de o ajudar e a Capacitação que expressa a melhor gestão de problemas de saúde pelo consulente são dois conceitos imprescindíveis a ter em conta na arte de comunicação médica com o paciente. Objetivos: O objetivo deste estudo foi avaliar a evolução dos resultados da empatia médica e capacitação dos consulentes após a consulta com o seu(a) Médico(a) de família e verificar se existe correlação entre dois instrumentos, em ciclo de garantia de qualidade. Material e Métodos: Estudo observacional, com a aplicação de dois questionários Jefferson Scale of Patient Perceptions of Physician Empathy - (mede a empatia) e Patient Enablement Instrument/Instrumento de Capacitação do Consulente (mede a capacitação), ambos validados para o efeito, a 284 utentes do ACeS Gaia-USF Gaya. Obtidas informações relativas à idade, género, toma diária de medicação, grau de formação, atividade profissional dos consulentes e do consentimento informado. Posteriormente, verificámos se havia correlação entre os dois instrumentos. Resultados: A resposta mais dada no questionário da Empatia foi a máxima (7) e a média das respostas foi 6,2 (desvio padrão 1,8). As afirmações com melhores pontuações foram “capaz de compreender as coisas na minha perspetiva” e “É um médico que me compreende”. Na Capacitação o valor médio foi de 1,8 (desvio padrão 0,5). As opções predominantemente escolhidas foram as respostas intermédias “Melhor/Mais” e “Igual ou pior/menos”. As menos escolhidas foram “Muito Melhor/Mais”. A correlação entre os dois instrumentos, apesar de significativa (p=0.008), foi positiva e fraca (0.232). Discussão e Conclusão: Os resultados indicam que a maioria dos consulentes têm scores elevados de Empatia. A Capacitação após consulta com o Medico de Família de um modo geral as consultas foram benéficas, contudo foram poucos os que sentiram suficientemente capacitados para responder “Muito melhor “, resposta mais pretendida. É necessário que o medico averigue se os consulentes realmente percebem o que é discutido na consulta, estimulando a sua participação no processo de decisão, mantendo os saudáveis e incentivando--os a sentirem-se confiantes com o seu estado de saúde. Mais estudos devem ser realizados, com amostras significativas, com outros indicadores, ou utilizar outras abordagens, em mais regiões do País.

Introduction: Person-Centered Medicine plays a very important role in General and Family Medicine, and the Doctor-Patient relationship is one of the fundamental pillars to be invested in order to improve clinical practice. Empathy as a cognitive attribute which involves the comprehension of the consultant and the ability to communicate the intention to help him or her, and Enablement qualification that expresses the best management of health problems by the consultant are two essential concepts to be taken into account in the art of medical communication with the patient. Objectives: The objective of this study is to evaluate the evolution of the results of medical empathy and enablement of the consultants after consultation with their family’s doctor and to verify if there is a correlation between two instruments in a quality assurance cycle. Material and Methods: Observational study, with the application of two validated Jefferson Scale of Patient Perceptions of Physician Empathy - and Patient Enablement Instrument (Measure Enablement) questionnaires, both validated for this purpose 284 users of ACeS Gaia-USF Gaya. We also obtained the age, gender, daily medication, degree of training and professional activity of the consultants. Subsequently, we verified whether there was a correlation between the two instruments. Results: The most common response in Empathy questionnaire was maximal (7) and the mean response was 6.2 (standard deviation 1.8). The statements with the best scores were "Able to understand things in my perspective" and "It is a doctor who understands me". In Enablement the mean value was 1.8 (standard deviation 0.5). The predominantly chosen options were the intermediate responses "Best / More" and "Equal or worse / less". The least chosen were "Much Better / More". The correlation between the two instruments, although significant (p = 0.008), was positive and weak (0.232). Discussion and Conclusion: The results indicate that most consultants have high scores on Empathy. Training after consultation with the Family Physician, in general, the consultations were beneficial, however few were sufficiently qualified to respond "Much better", a more desired answer. It is necessary for the doctor to inquire if the consultants really perceive what is discussed in the consultation, stimulating their participation in the decision making process, keeping them healthy and encouraging them to feel confident about their state of health. More studies should be carried out, with significant samples, with other indicators, or use other approaches, in more regions of the country.

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Portugal
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Keywords

Empatia, Medicina Geral e Familiar, Domínio/Área Científica::Ciências Médicas::Ciências da Saúde::Medicina, Capacitação, Relação Médico-Paciente

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selected citations
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This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
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influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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