Medical residency: factors relating to difficulty in helping in the resident physician-patient relationship

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dc.contributor.authorDe Marco, Mario Alfredo [UNIFESP]
dc.contributor.authorCitero, Vanessa de Albuquerque [UNIFESP]
dc.contributor.authorNogueira-Martins, Maria Cezira Fantini
dc.contributor.authorYazigi, Latife [UNIFESP]
dc.contributor.authorWissow, Lawrence Sagin
dc.contributor.authorNogueira-Martins, Luiz Antonio [UNIFESP]
dc.contributor.authorAndreoli, Sergio Baxter [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionHealth Department of the State of São Paulo Health Institute
dc.contributor.institutionJohns Hopkins Bloomberg School of Public Health Department of Health Policy and Management
dc.date.accessioned2015-06-14T13:42:53Z
dc.date.available2015-06-14T13:42:53Z
dc.date.issued2011-01-06
dc.description.abstractCONTEXT AND OBJECTIVE: Previous studies have attempted to understand what leads physicians to label patients as 'difficult'. Understanding this process is particularly important for resident physicians, who are developing attitudes that may have long-term impact on their interactions with patients. The aim of this study was to distinguish between patients' self-rated emotional state (anxiety and depression) and residents' perceptions of that state as a predictor of patients being considered difficult. DESIGN AND SETTING: Cross-sectional survey conducted in the hospital of Universidade Federal de São Paulo (UNIFESP). METHODS: The residents completed a sociodemographic questionnaire and rated their patients using the Hospital Anxiety and Depression Scale (HADS) and Difficulty in Helping the Patient Questionnaire (DTH). The patients completed HADS independently and were rated using the Karnofsky Performance Status scale. RESULTS: On average, the residents rated the patients as presenting little difficulty. The residents' ratings of difficulty presented an association with their ratings for patient depression (r = 0.35, P = 0.03) and anxiety (r = 0.46, P = 0.02), but not with patients' self-ratings for depression and anxiety. Residents from distant cities were more likely to rate patients as difficult to help than were residents from the city of the hospital (mean score of 1.93 versus 1.07; P = 0.04). CONCLUSIONS: Understanding what leads residents to label patients as having depression and anxiety problems may be a productive approach towards reducing perceived difficulty. Residents from distant cities may be more likely to find their patients difficulten
dc.description.abstractCONTEXTO E OBJETIVO: Estudos têm tentado compreender o que leva os médicos a rotularem pacientes como difíceis. Entender este processo é particularmente importante para os médicos residentes, que estão desenvolvendo atitudes que podem ter impacto a longo prazo em suas interaç ões com pacientes. O objetivo deste estudo foi de distinguir entre o estado emocional (ansiedade e depressão) auto-avaliado pelos pacientes e a percepção dos residentes desse estado, como preditor de pacientes serem considerados difíceis. TIPO DE ESTUDO E LOCAL: Estudo transversal realizado no hospital da Universidade Federal de São Paulo (UNIFESP). MÉTODOS: Os residentes responderam a um questionário sociodemográfico e pontuaram seus pacientes com a Hospital Anxiety and Depression Scale (HADS) e o Difficulty in Helping the Patient Questionnaire (DTH). Os pacientes completaram a HADS de forma independente e foram avaliados usando o Karnofsky Performance Status Scale. RESULTADOS: Em média, os residentes avaliaram seus pacientes como mobilizadores de pouca dificuldade. Os escores de dificuldade dos residentes apresentaram associação com os escores de depressão (r = 0.35, P = 0,03) e ansiedade (r = 0,46, P = 0,02) que atribuíram aos pacientes, mas não com os escores de ansiedade e depressão na auto-avaliação dos pacientes. Residentes provenientes de cidades distantes mostraram-se mais propensos a classificar os pacientes como difíceis de ajudar do que os residentes provenientes da mesma cidade do hospital (pontuação média de 1.93 versus 1.07, P = 0,04). CONCLUSÕES: Compreender o que leva os residentes a classificar pacientes como tendo problemas de ansiedade e depressão pode ser uma abordagem produtiva para reduzir a dificuldade percebida. Residentes de cidades distantes do local do hospital podem ser mais propensos a considerar seus pacientes como difíceispt
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Department of Psychiatry
dc.description.affiliationHealth Department of the State of São Paulo Health Institute
dc.description.affiliationJohns Hopkins Bloomberg School of Public Health Department of Health Policy and Management
dc.description.affiliationUnifespUNIFESP, Department of Psychiatry
dc.description.sourceSciELO
dc.description.sponsorshipFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.format.extent5-10
dc.identifierhttp://dx.doi.org/10.1590/S1516-31802011000100002
dc.identifier.citationDe MARCO, Mario Alfredo et al . Medical residency: factors relating to "difficulty in helping" in the resident physician-patient relationship. Sao Paulo Med. J., São Paulo , v. 129, n. 1, p. 5-10, jan. 2011
dc.identifier.doi10.1590/S1516-31802011000100002
dc.identifier.fileS1516-31802011000100002.pdf
dc.identifier.issn1516-3180
dc.identifier.scieloS1516-31802011000100002
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/6265
dc.identifier.wosWOS:000288620300002
dc.language.isoeng
dc.publisherAssociação Paulista de Medicina - APM
dc.relation.ispartofSão Paulo Medical Journal
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectInternship and residencyen
dc.subjectPhysician-patient relationsen
dc.subjectAnxietyen
dc.subjectDepressionen
dc.subjectEducation, medicalen
dc.subjectInternato e residênciapt
dc.subjectRelações médico-pacientept
dc.subjectAnsiedadept
dc.subjectDepressãopt
dc.subjectEducação médicapt
dc.titleMedical residency: factors relating to difficulty in helping in the resident physician-patient relationshipen
dc.title.alternativeResidência médica: fatores relacionados à dificuldade para ajudar na relação médico residente-pacientept
dc.typeinfo:eu-repo/semantics/article
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