Medical residency: factors relating to ``difficulty in helping{''} in the resident physician-patient relationship

Autor(es)

De Marco, Mario Alfredo ^[1] ; Citero, Vanessa Albuquerque ^[1] ; Fantini Nogueira-Martins, Maria Cezira ^[2] ; Yazigi, Latife ^[1] ; Wissow, Lawrence Sagin ^[3] ; Nogueira-Martins, Luiz Antonio ^[1] ; Andreoli, Sergio Baxter ^[1]

Afiliação do(s) autor(es)

^[1] Univ Fed Sao Paulo, Dept Psychiat, Sao Paulo - Brazil

^[2] Hlth Inst, Hlth Dept State Sao Paulo, Sao Paulo - Brazil

^[3] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD - USA

• Tipo de documento: Artigo Científico
• Fonte: São Paulo Medical Journal; v. 129, n. 1, p. 5-10, JAN 6 2011.
• Citações Web of Science: 1

Resumo

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 Sao 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 (AU)

• Processo FAPESP: 02/12918-8 - Indicadores clínicos de efetividade de serviços de saúde mental em Hospital Geral: identificação de novos indicadores
• Beneficiário: Sérgio Baxter Andreoli
• Modalidade de apoio: Auxílio à Pesquisa - Regular