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Abstract(s)
Introdução: A depressão atinge em Portugal 9% da população em geral. As consequências são graves, prejudicando a funcionalidade familiar, social e ocupacional, piorando o prognóstico da multimorbilidade e aumentando o risco de mortalidade. As queixas de perturbações depressivas são muito frequentes em Medicina Geral e Familiar. Os clínicos de Medicina Geral e Familiar têm um papel importante no diagnóstico e no acompanhamento destes doentes utilizando corretamente todas as suas armas terapêuticas, farmacológicas e não farmacológicas, dentre as quais a empatia.
Objetivos: Analisar a empatia sentida na consulta comparando-a entre pacientes com motivo de consulta psicológica versus os restantes e sabendo, nas consultas por motivos psicológicos, se o médico conseguiu responder às expectativas do consulente.
Material e métodos: Estudo observacional analítico por entrevista a doentes á saída das consultas de Medicina Geral e Familiar no Centro de Saúde da Covilhã com um questionário permitindo avaliar o motivo de consulta pela Classificação Internacional de Cuidados de Saúde Primários (ICPC2) e a empatia. No caso dos doentes com motivo de consulta no capítulo Psicológico, caracterizaram-se as atitudes médicas na consulta. Foi obtido parecer da Comissão de Ética, respeitada a privacidade dos consulentes, produzido um relatório para os médicos do Centro de Saúde e obtido consentimento informado de todos os questionados.
Resultados: A prevalência da depressão na amostra foi de 39,3%. O sexo feminino apresentou maior taxa de depressão com 45,9% contra 24,2% no caso do sexo masculino (p=0,027). Nos doentes com motivo de depressão, o indicador global de empatia está significativamente mais baixo (p<0,001) com uma média de 5,0 em relação aos doentes que não apresentam depressão em que a média é de 6,1 (p<0,001). Em 4 das 5 questões da Jefferson Scale of Patient Perceptions of Physicians Empathy, a média de respostas quando o motivo de consulta é depressão está mais baixo significativamente. A afirmação “Pergunta acerca do que está a acontecer na minha vida diária.”, obteve uma média na depressão de 3,7 vs 5,1 (p=0,002). A pergunta “O meu médico parece preocupado comigo e com a minha família”, a média na depressão foi de 4,5 vs 6,0 (p<0,001). A pergunta “Compreende as minhas emoções, sentimentos e preocupações”, a média na depressão foi de 5,2vs6,2 (p=0,005). Na pergunta “É um médico que me compreende”, a média na depressão foi de 5,8vs6,5 (p= 0,013).
Discussão e Conclusão: O nosso estudo mostrou que a prevalência de depressão, como motivo de consulta, é muito elevada no Centro de Saúde da Covilhã, especialmente no sexo feminino. Concluímos que a empatia sentida pelo consulente cujo motivo da consulta foi depressão está significativamente mais baixa comparando com doentes que foram a consulta por outros motivos. Estes dados são alarmantes dado que o envolvimento empático nos cuidados ao doente permite fazer diagnósticos mais assertivos, aumenta o grau de satisfação, aumenta as adesão e manutenção em tratamento da pessoa com doença, diminui as queixas de má-prática e dá ao doente estratégias de coping mais efetivas para enfrentar o stress e a doença. O tratamento, na maioria, passou por farmacoterapia isolada, o que não será a prática mais correta dado que existem outras terapias complementares não farmacológicas que mostraram serem eficazes. Em relação às expectativas dos doentes, muitas vezes não foram alcançadas. Este estudo constitui um incentivo para investigações futuras, na medida em que se considera importante alertar os profissionais de saúde para esta temática.
Introduction: Depression attain in Portugal 9 percent of the general population. Consequences are serious, damaging the social and occupational function, worsening the prognosis of multimorbidity and increasing the risk of mortality. Complaints of depressive disorders are very common in family medicine. Clinicians of family medicine have an important role in the diagnosis and monitoring of these patients correctly using all their therapeutic, pharmacological and non-pharmacological weapons, among which empathy. Aim: Analyze the empathy felt in consultation comparing it between patients with psychological counseling reason versus the other and knowing, in consultations for psychological reasons, if the doctor could respond to the inquirer 's expectations. Methodology: This is an observational analytical study interview to patients at the output of general practice consultations in the Covilhã Health Centre with a questionnaire allowing to evaluate the query why the International Primary Care Classification (ICPC2) and empathy. For patients with query subject in the chapter Psychological characterize medical attitudes in the query. It is obtained the opinion of the Ethics Committee, respecting the privacy of the consultants produced a report for the doctors of the Health Centre and always obtained informed consent from all participants. Results: The prevalence of depression in the sample n = 107 was 39.3%. Females have a higher rate of depression with 45.9% against 24.2% for males (p = 0.027). In patients with depression reason, the overall indicator of empathy is significantly lower (p <0.001) with an average of 5.0 for those patients who do not have depression where the average is 6.1. In 4 of the 5 questions of the Jefferson Scale of Patient Perceptions of Physicians Empathy, the average responses when the query is why depression is lower significantly. The statement "question about what is happening in my daily life." Scores a depression of 3.7 vs. 5.1 (p = 0.002). The question "My doctor seems preoccupied with me and my family", the average depression was 4.5 vs 6.0 (p <0.001). The question "understands my emotions, feelings and concerns," the average depression was 5.2 vs 6.2 (p = 0.005). To the question "Is a doctor who understands me", the average depression was 5.8 vs 6.5 (p = 0.013). Discussion and Conclusion: The aim of this study was achieved. Our study showed that the prevalence of depression is very high at the Health Centre of Covilhã, especially in females. We conclude that the empathy felt by the inquirer whose reason for consultation was depression is significantly lower compared to patients who were consulted for other reasons. These figures are alarming as the empathic involvement in patient care allows more assertive diagnosis, increases the level of satisfaction, increases the user's compliance, reduces malpractice complaints and gives the patient more effective coping strategies to face the stress and disease. Treatment mostly passed pharmacotherapy alone, which is not the most correct practice given that there are other non-pharmacological complementary therapies that have shown to be effective. Regarding expectations of patients often were not met. This study provides an incentive for further investigation, as it is considered important to alert healthcare professionals to this issue.
Introduction: Depression attain in Portugal 9 percent of the general population. Consequences are serious, damaging the social and occupational function, worsening the prognosis of multimorbidity and increasing the risk of mortality. Complaints of depressive disorders are very common in family medicine. Clinicians of family medicine have an important role in the diagnosis and monitoring of these patients correctly using all their therapeutic, pharmacological and non-pharmacological weapons, among which empathy. Aim: Analyze the empathy felt in consultation comparing it between patients with psychological counseling reason versus the other and knowing, in consultations for psychological reasons, if the doctor could respond to the inquirer 's expectations. Methodology: This is an observational analytical study interview to patients at the output of general practice consultations in the Covilhã Health Centre with a questionnaire allowing to evaluate the query why the International Primary Care Classification (ICPC2) and empathy. For patients with query subject in the chapter Psychological characterize medical attitudes in the query. It is obtained the opinion of the Ethics Committee, respecting the privacy of the consultants produced a report for the doctors of the Health Centre and always obtained informed consent from all participants. Results: The prevalence of depression in the sample n = 107 was 39.3%. Females have a higher rate of depression with 45.9% against 24.2% for males (p = 0.027). In patients with depression reason, the overall indicator of empathy is significantly lower (p <0.001) with an average of 5.0 for those patients who do not have depression where the average is 6.1. In 4 of the 5 questions of the Jefferson Scale of Patient Perceptions of Physicians Empathy, the average responses when the query is why depression is lower significantly. The statement "question about what is happening in my daily life." Scores a depression of 3.7 vs. 5.1 (p = 0.002). The question "My doctor seems preoccupied with me and my family", the average depression was 4.5 vs 6.0 (p <0.001). The question "understands my emotions, feelings and concerns," the average depression was 5.2 vs 6.2 (p = 0.005). To the question "Is a doctor who understands me", the average depression was 5.8 vs 6.5 (p = 0.013). Discussion and Conclusion: The aim of this study was achieved. Our study showed that the prevalence of depression is very high at the Health Centre of Covilhã, especially in females. We conclude that the empathy felt by the inquirer whose reason for consultation was depression is significantly lower compared to patients who were consulted for other reasons. These figures are alarming as the empathic involvement in patient care allows more assertive diagnosis, increases the level of satisfaction, increases the user's compliance, reduces malpractice complaints and gives the patient more effective coping strategies to face the stress and disease. Treatment mostly passed pharmacotherapy alone, which is not the most correct practice given that there are other non-pharmacological complementary therapies that have shown to be effective. Regarding expectations of patients often were not met. This study provides an incentive for further investigation, as it is considered important to alert healthcare professionals to this issue.
Description
Keywords
Cuidados de Saúde Primários Depressão Empatia. Medicina Geral e Familiar