Relação médico-paciente: a atitude de estudantes e professores de medicina em uma universidade brasileira

Abstract

The patient-centered care has actually been associated with positive outcomes . This was an analytical cross-sectional study with students and teachers of an undergraduate degree in medicine, using PPOS "Patient-Practitioner Orientation Scale" as well as a questionnaire with sociodemographic information. The subjects were students and medical school professors of the institution in question, in the second half of 2015. We used SPSS and Windows 10 to examine the data. Mann-Whitney and Kruskal-Wallis tests were used to examine the effect of the variables of socio-demographic questionnaires and interaction with the scores found for students and teachers. A total of 212 students were surveyed, corresponding to 57.1% of the enrolled students. The value of the total score PPOS found for the students was 4.35 (± 0.5 SD), and the mean total score of PPOS among female students (4.43) was significantly higher than male ( 4.23) (p = 0.00), indicating more patient focused attitudes in this group. There was also a statistically significant difference in both the power dimension scores (4.30 for female students and 4.01 for males) (p = 0.01) and in the care dimension (4.59 for female sex students and 4.43 for the male) (p = 0.01). It was noticed still statistically significant difference in the desired specialty after graduation, with attitudes less centered on the person of students who wanted to pursue surgical specialties (4.08) compared to those pre intended non-surgical specialties (4.43) (p = 0.00 ). There was no difference in the values of the total score PPOS according to the period of the course. With regard to medical teachers, 77 (56%) participated. The total score of PPOS out 4.52 (± 0.5 SD), with more focused attitude in the patient among teachers compared to students (4.35) (p = 0.001), but there is clear need for progress for both groups. The difference in scores regarding sex and surgical specialty exercise was not observed among teachers. However, the average subscale of power between teachers of basic areas (internal medicine, pediatrics and general practitioner) was significantly higher (4.49) compared to the average of teachers from other areas (4,12 ) (p = 0.04), which reflects greater willingness to share decisions with patients, among these teachers. The total scores of PPOS in both students and teachers, showed no statistical differences in relation to other variables of sociodemographic questionnaire.The analysis of the attitudes of students and teachers about the doctor-patient relationship allowed unravel an unknown scenario, more centered attitudes on patient found between teachers, despite the need for improvements to both. It is imperative studies to evaluate not only the attitude but the behavior of these subjects. More importantly, we see the need for structural changes and or curriculum that can positively impact the attitude of both students and medical faculty, regarding the relationship with the one who should be at the center, ie the patient.