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      Rasgos de profesionalidad médica en el ámbito de la atención primaria: respeto por la autonomía Translated title: Traits of medical professionalism in the field of primary care: respect for autonomy

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          Abstract

          RESUMEN Fundamento: el respeto por la autonomía del paciente y una conducta respetuosa en general son rasgos centrales de la profesionalidad médica. Objetivo: indagar la presencia de los rasgos profesionales de respeto por la autonomía de los pacientes y de respeto en general en las expresiones verbales de profesionales del ámbito de atención primaria de la salud durante su interacción con pacientes y estudiantes del último año de la carrera de Medicina. Métodos: se efectuó una investigación cualitativa de carácter exploratorio en contextos de prácticas finales obligatorias en dos Centros de Atención Primaria de la Salud de la ciudad de Tandil, República de Argentina, durante el año 2019. Como métodos teóricos se emplearon: análisis-síntesis, inductivo-deductivo y método de revisión crítica de la literatura y empírico: se realizó el registro grabado de 28 encuentros entre expertos, estudiantes y pacientes. Las sesiones se analizaron mediante triangulación de investigadores. Resultados: las expresiones verbales de los expertos permitieron identificar enunciados relacionados con rasgos de respeto en general y respeto por la autonomía de los pacientes. Estos se evidenciaron en enunciados para construir un ambiente de confianza y confidencialidad, el esfuerzo por brindar explicaciones de forma clara y sencilla, la atención a las dudas de los pacientes y la formulación de explicaciones sobre cómo proceder, en un lenguaje accesible. Conclusiones: se identificó la presencia de los rasgos profesionales de respeto por la autonomía de los pacientes y de respeto en general, tanto en las interacciones con pacientes como con los estudiantes.

          Translated abstract

          ABSTRACT Background: respect for the autonomy of the patient and a respectful behavior in general are key features of medical professionalism. Objective: to investigate the presence of professional traits of respect for the autonomy of patients and of respect in general in the verbal expressions of professionals in the field of primary health care during their interaction with patients and students in the last year of the Medicine degree. Methods: a qualitative research of an exploratory nature was carried out in the context of mandatory final practices in two Primary Health Care Centers in the city of Tandil, Republic of Argentina, during the year 2019. The following theoretical methods were used: analysis-synthesis, inductive-deductive and method of critical review of the literature and empirical ones: the recorded record of 28 meetings between experts, students and patients was made. The sessions were analyzed by opposing sources of researchers. Results: the verbal expressions of the experts made it possible to identify statements related to traits of respect in general and respect for the autonomy of the patients. These were evidenced in statements to build an environment of trust and confidentiality, the effort to provide explanations in a clear and simple way, the attention to the patients' doubts and the formulation of explanations on how to proceed, in an accessible language. Conclusions: the presence of professional traits of respect for the autonomy of patients and respect in general was identified, both in interactions with patients and with students.

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          The New Era of Informed Consent: Getting to a Reasonable-Patient Standard Through Shared Decision Making.

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            Human Connections and Their Roles in the Occupational Well-being of Healthcare Professionals: A Study on Loneliness and Empathy

            Human connections are key to the promotion of health and prevention of illness; moreover, illness can cause deterioration of human connections. Healthcare professional–patient relationships are key to ensuring the preservation of adequate human connections. It is important for healthcare professionals to develop their ability to foster satisfactory human connections because: (i) they represent social support for patients; and (ii) they prevent work-related stress. In this study we assessed the relationship between absence (loneliness) and presence (empathy) of human connections with the occupational well-being of healthcare professionals. The Scale of Collateral Effects, which measures somatization, exhaustion, and work alienation; the Jefferson Scale of Empathy; and the Social and Emotional Loneliness Scale for Adults, were mailed to 628 healthcare professionals working in Spanish public healthcare institutions. The following explanatory variables were used to evaluate work well-being: (a) empathy, as a professional competence; (b) loneliness, age, and family burden, as psychological indicators; and (c) professional experience, work dedication, and salary, as work indicators. Comparison, correlation, and regression analyses were performed to measure the relationships among these variables and occupational well-being. Of 628 surveys mailed, 433 (69% response rate) were returned fully completed. Adequate reliability was confirmed for all instruments. The entire sample was divided into four groups, based on the combined variable, “occupation by sex.” Comparative analyses demonstrated differences among “occupation by sex” groups in collateral effects (p = 0.03) and empathy (p = 0.04), but not loneliness (p = 0.84). Inverse associations between empathy and collateral effects were confirmed for somatization (r = -0.16; p < 0.001), exhaustion (r = -0.14; p = 0.003), and work alienation (r = -0.16; p < 0.001). Furthermore, loneliness was positively associated with collateral effects (r = 0.22; p < 0.001). Neither family burden, nor work dedication to clinics or management activities were associated with the three collateral effects measured. These findings support an important role for empathy in the prevention of work stress in healthcare professionals. They also confirm that loneliness, as a multidimensional and domain specific experience, is detrimental to occupational well-being.
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              A vision for Primary Healthcare in the 21st Century: Towards universal health coverage and the Sustainable Development Goals

              (2018)
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                Author and article information

                Journal
                edu
                EDUMECENTRO
                EDUMECENTRO
                Editorial Ciencias Médicas (Santa Clara, , Cuba )
                2077-2874
                2023
                : 15
                : e2517
                Affiliations
                [1] Olavarría orgnameUniversidad Nacional del Centro de la Provincia de Buenos Aires orgdiv1Facultad de Ciencias de la Salud República Argentina
                Article
                S2077-28742023000100086 S2077-2874(23)01500000086
                2aec5b33-969c-43b3-81cf-62e9847bafc5

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 15 October 2022
                : 19 July 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 19, Pages: 0
                Product

                SciELO Cuba

                Categories
                ARTÍCULOS ORIGINALES

                medicina de la conducta,quality of health care,community medicine,internship and residency,behavioral medicine,education, medical,calidad de la atención de salud,medicina comunitaria,internado y residencia,educación médica

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