Espiritualidade/religiosidade como recurso terapêutico na prática clínica: concepção dos estudantes de graduação em medicina da Escola Paulista de Medicina – Universidade Federal de São Paulo
Data
2018
Autores
Abuchaim, Sílvia Cristina Borragini [UNIFESP]
Orientadores
Tarcia, Rita Maria Lino [UNIFESP]
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução - O envolvimento religioso/espiritual traz significado e propósito para a vida dos pacientes, principalmente quando se encontram fragilizados pela dor. Este envolvimento pode influenciar decisões médicas devendo ser identificado na anamnese. Existem relatos de dificuldades da tomada de história espiritual por parte dos médicos, predisposição dos pacientes em compartilhar suas crenças e comprovação científica da eficácia terapêutica da religiosidade/espiritualidade na saúde física e mental. Objetivo - Verificar a opinião dos estudantes de graduação em Medicina da Escola Paulista de Medicina – Universidade Federal de São Paulo, quanto à utilização da espiritualidade/religiosidade do paciente como recurso terapêutico na prática clínica. Método - Abordagem quantitativa do tipo analítica observacional transversal. Questionário padronizado em quatro blocos: perfil sociodemográfico; Índice de Religiosidade da Universidade de Duke; religiosidade/espiritualidade no contexto clínico; religiosidade/espiritualidade no contexto acadêmico, aplicado a acadêmicos do primeiro ao sexto ano. Resultados - A amostra consiste em 72% da população de estudantes matriculados, sendo que 62% possuem afiliação religiosa: 30% católicos, 13% evangélicos, 12% espíritas e 7% outras denominações. Dos 38% restantes, 26% declararam-se agnósticos e 12% ateus. Dos estudantes, 4,2% frequentam instituições religiosas mais do que uma vez por semana, 10% uma vez por semana, 6,4% duas a três vezes por mês, 27,6% algumas vezes por ano, 21,6% uma vez por ano ou menos e 30,2% nunca frequentam. Quanto ao tempo dedicado a atividades religiosas individuais, 4,5% dedicam-se mais do que uma vez ao dia; 17,5% diariamente; 8% duas ou mais vezes por semana; 6% uma vez por semana; 17% poucas vezes por mês; e 47% raramente ou nunca. A centralidade do transcendente na vida é muito forte em 13%; forte em 20,5%; moderada em 21,5%; fraca em 18,5%; e muito fraca em 26,5%. Das questões inseridas no bloco referente ao contexto clínico, “Independentemente de sua crença religiosa, o médico deve respeitar a crença do paciente” e “O médico deve considerar em sua prática clínica as necessidades emocionais, socioculturais e espirituais do paciente, além de suas necessidades físicas” tiveram os maiores escores de concordância, respectivamente 98,6% e 97,0%. Das que constituíram o contexto acadêmico, a que teve maior concordância (83,7%) foi “O cuidado com a dimensão espiritual faz parte do atendimento integral e humanizado ao paciente”. Por outro lado, o grau de discordância com a questão “Um bom médico deve se distanciar do sofrimento do paciente” foi de 90,5%. A assertiva “A proposição de ações didáticopedagógicas relacionadas à dimensão espiritual do paciente na educação médica é relevante” teve concordância média de 61,5% e 27,5% de indiferentes. Conclusões - Nossos resultados sugerem que: 1) os estudantes de Medicina atribuem importância à dimensão espiritual do paciente na prática clínica; 2) os acadêmicos consideram a abordagem da dimensão espiritual do paciente como recurso terapêutico para o exercício de uma prática clínica mais humanizada; 3) 61,7% dos participantes da pesquisa considera relevante, ou pelo menos não é contrária (27,3%), à proposição de ações didático-pedagógicas na educação médica relacionadas à dimensão espiritual do paciente.
Introduction - Religious / spiritual involvement brings meaning and purpose to the patient life, especially when they are fragilized by pain. This involvement may influence medical decisions and should be identified in the anamnesis. There are reports of difficulties in achieving spiritual history by physicians, the predisposing of patients to share their beliefs and scientific proofs of the therapeutic efficacy of religiosity / spirituality in physical and mental health. Objective - To verify the opinion of undergraduate students in Medicine of the Escola Paulista de Medicina – Universidade Federal de São Paulo, regarding the use of the spirituality / religiosity of the patient as a therapeutic resource in clinical practice. Method - Quantitative approach of the transversal analytical observational type. Standardized questionnaire was applied to academics from the first to the sixth year and it is divided in four blocks: sociodemographic profile; Duke University Religious Index; religiosity / spirituality in the clinical context; religiosity / spirituality in the academic context. Results - The sample consists of 72% of the enrolled students, of which 62% have religious affiliation: 30% Catholic, 13% Evangelical, 12% Spiritist and 7% other denominations. Of the remaining 38%, 26% declared themselves agnostic and 12% atheists. Of the students, 4.2% attended religious institutions more than once a week, 10% once a week, 6.4% twice a month or more, 27.6% a few times a year, 21.6% one per year or less and 30.2% never attend. As for the time devoted to individual religious activities, 4.5% dedicate themselves more than once a day; 17.5% daily; 8% twice a week or more; 6% once a week; 17% a few times a month; and 47% rarely or never. The centrality of the transcendent in life is very strong in 13%; strong in 20.5%; moderate in 21.5%; weak in 18.5%; and very weak in 26.5%. Regardless of his or her religious belief, the physician should respect the patient's belief, and "The physician should consider in his clinical practice the emotional, sociocultural and spiritual needs of the patient, as well as his / her needs physical "had the highest concordance scores, respectively 98.6% and 97.0%. Of those that constituted the academic context, the one that had the highest agreement (83.7%) was "Care with the spiritual dimension is part of the integral and humanized care to the patient". On the other hand, the degree of disagreement with the question "A good doctor should distance himself from the patient's suffering" was 90.5%. The assertion "The proposition of didactic-pedagogical actions related to the spiritual dimension of the patient in medical education is relevant" had average agreement of 61.5% and 27.5% of indifferent. Conclusions - Our results suggest that: 1) medical students attach importance to the spiritual dimension of the patient in clinical practice; 2) scholars consider the approach of the spiritual dimension of the patient as a therapeutic resource for the practice of a more humanized clinical practice; 3) 61.7% of the participants considered relevant, or at least not contrary (27.3%), to the proposition of didactic-pedagogical actions in medical education related to the spiritual dimension of the patient.
Introduction - Religious / spiritual involvement brings meaning and purpose to the patient life, especially when they are fragilized by pain. This involvement may influence medical decisions and should be identified in the anamnesis. There are reports of difficulties in achieving spiritual history by physicians, the predisposing of patients to share their beliefs and scientific proofs of the therapeutic efficacy of religiosity / spirituality in physical and mental health. Objective - To verify the opinion of undergraduate students in Medicine of the Escola Paulista de Medicina – Universidade Federal de São Paulo, regarding the use of the spirituality / religiosity of the patient as a therapeutic resource in clinical practice. Method - Quantitative approach of the transversal analytical observational type. Standardized questionnaire was applied to academics from the first to the sixth year and it is divided in four blocks: sociodemographic profile; Duke University Religious Index; religiosity / spirituality in the clinical context; religiosity / spirituality in the academic context. Results - The sample consists of 72% of the enrolled students, of which 62% have religious affiliation: 30% Catholic, 13% Evangelical, 12% Spiritist and 7% other denominations. Of the remaining 38%, 26% declared themselves agnostic and 12% atheists. Of the students, 4.2% attended religious institutions more than once a week, 10% once a week, 6.4% twice a month or more, 27.6% a few times a year, 21.6% one per year or less and 30.2% never attend. As for the time devoted to individual religious activities, 4.5% dedicate themselves more than once a day; 17.5% daily; 8% twice a week or more; 6% once a week; 17% a few times a month; and 47% rarely or never. The centrality of the transcendent in life is very strong in 13%; strong in 20.5%; moderate in 21.5%; weak in 18.5%; and very weak in 26.5%. Regardless of his or her religious belief, the physician should respect the patient's belief, and "The physician should consider in his clinical practice the emotional, sociocultural and spiritual needs of the patient, as well as his / her needs physical "had the highest concordance scores, respectively 98.6% and 97.0%. Of those that constituted the academic context, the one that had the highest agreement (83.7%) was "Care with the spiritual dimension is part of the integral and humanized care to the patient". On the other hand, the degree of disagreement with the question "A good doctor should distance himself from the patient's suffering" was 90.5%. The assertion "The proposition of didactic-pedagogical actions related to the spiritual dimension of the patient in medical education is relevant" had average agreement of 61.5% and 27.5% of indifferent. Conclusions - Our results suggest that: 1) medical students attach importance to the spiritual dimension of the patient in clinical practice; 2) scholars consider the approach of the spiritual dimension of the patient as a therapeutic resource for the practice of a more humanized clinical practice; 3) 61.7% of the participants considered relevant, or at least not contrary (27.3%), to the proposition of didactic-pedagogical actions in medical education related to the spiritual dimension of the patient.
Descrição
Citação
ABUCHAIM, Sílvia Cristina Borragini. Espiritualidade/religiosidade como recurso terapêutico na prática clínica: concepção dos estudantes de graduação em medicina da Escola Paulista de Medicina – Universidade Federal de São Paulo. 2018. 174f. Dissertação (Mestrado Profissional) – Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, 2018.