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

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

Alternative title Residência médica: fatores relacionados à dificuldade para ajudar na relação médico residente-paciente
Author De Marco, Mario Alfredo Autor UNIFESP Google Scholar
Citero, Vanessa de Albuquerque Autor UNIFESP Google Scholar
Nogueira-Martins, Maria Cezira Fantini Google Scholar
Yazigi, Latife Autor UNIFESP Google Scholar
Wissow, Lawrence Sagin Google Scholar
Nogueira-Martins, Luiz Antonio Autor UNIFESP Google Scholar
Andreoli, Sergio Baxter Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Health Department of the State of São Paulo Health Institute
Johns Hopkins Bloomberg School of Public Health Department of Health Policy and Management
Abstract CONTEXT 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 difficult

CONTEXTO 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 difíceis
Keywords Internship and residency
Physician-patient relations
Education, medical
Internato e residência
Relações médico-paciente
Educação médica
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Date 2011-01-06
Published in De 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
ISSN 1516-3180 (Sherpa/Romeo, impact factor)
Publisher Associação Paulista de Medicina - APM
Extent 5-10
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000288620300002
SciELO ID S1516-31802011000100002 (statistics in SciELO)

Show full item record


Name: S1516-31802011000100002.pdf
Size: 132.3Kb
Format: PDF
Open file

This item appears in the following Collection(s)




My Account