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Comunicação de um diagnóstico oncológico : um estudo qualitativo sobre as experiências e necessidades dos doentes
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Introdução: O diagnóstico oncológico e a comunicação médico/a-doente é um processo complexo na prestação de cuidados de saúde, e difícil na relação eficaz e satisfatória de ambas as partes. A pouca preparação dos/as médicos/as poderá contribuir para esta maior dificuldade, afectando a relação terapêutica com o/a médico/a, causando sentimentos de ansiedade nos/as doentes, e na sua qualidade de vida. Objectivos: Avaliar a experiência e necessidades sentidas pelo/a doente na comunicação do seu diagnóstico oncológico. Métodos: Estudo qualitativo interpretativo com recurso a entrevistas semiestruturadas e um conjunto de questões sobre o impacto dos antecedentes oncológicos na vida dos/as doentes e a qualidade da comunicação médico/a-doente avaliadas em escalas de Likert. Participaram 14 voluntários/as e deontes do IPO de Lisboa. O conteúdo das entrevistas foi analisado pelo método da Análise Temática. Resultados: A comunicação médico/a-doente foi caracterizada como adequada sendo que a maioria dos/as participantes referiu como essenciais as qualidades humanas do/a médico/a. Da análise temática emergiram cinco temas principais: (1) as expectativas dos doentes relativamente ao diagnóstico oncológico; (2) a experiência do/a doente no momento do diagnóstico; (3) gestão do/a doente e da doença durante o tratamento e follow-up; (4) barreiras na gestão da experiência da doença e (5) microagressões durante o processo clínico. Conclusão: 64,3% dos/as participantes caracterizou de forma positiva a comunicação de más notícias pelo/a seu/sua médico/a, e 57% refere como excelente a disponibilidade dos/as médicos/as para esclarecer dúvidas e preocupações. Foram reconhecidas como importantes a formação dos/as médicos/as nas competências humanas e socioculturais para melhor corresponderem às necessidades dos/as seus/suas doentes.
Introduction: The oncological diagnosis and respective doctor-patient communication is a complex process in healthcare and hard to achieve in an effective and pleasing way for both parties. The doctor’s lack of preparation may contribute to this increased difficulty, causing feelings of anxiety and distress in their patients, affecting the therapeutical relationship with the doctor, as well as patient’s quality of life. Objectives: Evaluate the experience and needs felt by the patients during the diagnostic appointment. Methods: Interpretative qualitative study using semi-structured interviews and a range of questions to evaluate the impact of the oncological history in the patient’s life as well as the quality of the doctor-patient communication were analysed using Likert-like scales. 14 volunteers and current patients at IPO Lisboa participated in this study. The content was analysed using Thematic Analysis. Results: Doctor-patient communication has been characterized as adequate, with the majority of the participants referring as essential the human qualities of their doctors. From the thematic analysis five themes emerged: (1) patient’s expectations regarding their oncological diagnosis; (2) patient’s experience while he/she receives the diagnosis, (3) management of the patient and the disease during treatment and follow-up, (4) barriers in the management of this experience, (5) microaggressions throughout the clinical process. Conclusion: 64,3% of the participants has positively characterized their doctor’s way of breaking bad news, and 57% considered excellent the availability of their doctors to address patient’s doubts and concerns. Medical training in humane and sociocultural dimensions to better correspond to their patients’ needs were regarded as important.
Introduction: The oncological diagnosis and respective doctor-patient communication is a complex process in healthcare and hard to achieve in an effective and pleasing way for both parties. The doctor’s lack of preparation may contribute to this increased difficulty, causing feelings of anxiety and distress in their patients, affecting the therapeutical relationship with the doctor, as well as patient’s quality of life. Objectives: Evaluate the experience and needs felt by the patients during the diagnostic appointment. Methods: Interpretative qualitative study using semi-structured interviews and a range of questions to evaluate the impact of the oncological history in the patient’s life as well as the quality of the doctor-patient communication were analysed using Likert-like scales. 14 volunteers and current patients at IPO Lisboa participated in this study. The content was analysed using Thematic Analysis. Results: Doctor-patient communication has been characterized as adequate, with the majority of the participants referring as essential the human qualities of their doctors. From the thematic analysis five themes emerged: (1) patient’s expectations regarding their oncological diagnosis; (2) patient’s experience while he/she receives the diagnosis, (3) management of the patient and the disease during treatment and follow-up, (4) barriers in the management of this experience, (5) microaggressions throughout the clinical process. Conclusion: 64,3% of the participants has positively characterized their doctor’s way of breaking bad news, and 57% considered excellent the availability of their doctors to address patient’s doubts and concerns. Medical training in humane and sociocultural dimensions to better correspond to their patients’ needs were regarded as important.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2023
Palavras-chave
Comunicação de más notícias Diagnóstico oncológico Barreiras de comunicação Microagressões