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Relação médico-doente na depressão : a perspetiva dos cuidados de saúde primários
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A depressão é uma doença muito prevalente na sociedade atual, especialmente em países ocidentais. Tem um grande impacto na qualidade de vida dos doentes com um elevado número de anos de vida perdidos. Os Cuidados de Saúde Primários assumem um papel fundamental na prevenção da doença e promoção da saúde e a elevada prevalência de depressão leva a que a maioria dos diagnósticos ocorra nos CSP. Neste contexto, a relação médico-doente adquire particular importância, podendo funcionar como uma barreira ou um notável facilitador no diagnóstico e tratamento de doentes com perturbação depressiva.
Neste trabalho original realizaram-se entrevistas semi-estruturadas a 25 médicos de MGF em funções na região de Lisboa e foi posteriormente aplicado o método de análise temática aos dados obtidos. O objetivo principal do estudo foi avaliar a perceção dos médicos dos CSP quanto à importância da relação médico-doente no diagnóstico da depressão e o envolvimento do doente na tomada de decisão terapêutica. Avaliou-se ainda a capacidade de gestão destes doentes pelos médicos de MGF, a necessidade de formação para este tema e de que forma surge a cooperação e colaboração com a Psiquiatria e Psicologia.
O nosso estudo permitiu concluir que a relação médico-doente é essencial para o sucesso do diagnóstico destes doentes e que a inclusão do doente na elaboração da terapêutica deve ser privilegiada, pois uma comunicação eficaz aliada à confiança da RMD contribuem para o sucesso terapêutico. Os médicos de MGF assumem ter facilidade ao efetuar um diagnóstico de depressão, sendo que as principais dificuldades recaem no tratamento e mudança comportamental. Ações formativas com vista à formação dos médicos de MGF para a temática da depressão são pertinentes e podem melhorar as taxas de tratamento nos CSP, diminuindo as necessidades de referenciação e a sobrecarga dos serviços de Psiquiatria.
Depression is a very prevalent disease in today's society, especially in Western countries. It has a major impact on the quality of life of patients, being responsable for a high number of years of life lost. Primary Health Care plays a fundamental role in disease prevention and health promotion and the high prevalence of depression results in most diagnoses occurring in PHC. In this context, the doctor-patient relationship acquires particular importance, being able to act as a barrier or a remarkable facilitator in the diagnosis and treatment of patients with depressive disorder. In this original work, semi-structured interviews were carried out with 25 general practitioners working in Lisboa and later the thematic analysis method was applied to the data obtained. The main objective of the study was to assess the perception of GP physicians regarding the importance of the doctor-patient relationship in the diagnosis of depression and the patient's involvement in therapeutic decision-making. It was also evaluated the ability of GP doctors to manage these patients, the need for training on this topic and how cooperation and collaboration with Psychiatry arises. Our study concluded that the doctor-patient relationship is essential for the success of the diagnosis of these patients and that the inclusion of the patient in the elaboration of the therapy should be privileged, since an effective communication combined with the trust of the doctor-patient relationship contribute to the therapeutic success. GPs assume it is easy to make a diagnosis of depression, and the main difficulties lie in treatment and behavioral change. Training actions aimed at training GP doctors on the subject of depression are relevant and can improve treatment rates in PHC, reducing the need for referrals and the overload of Psychiatric services.
Depression is a very prevalent disease in today's society, especially in Western countries. It has a major impact on the quality of life of patients, being responsable for a high number of years of life lost. Primary Health Care plays a fundamental role in disease prevention and health promotion and the high prevalence of depression results in most diagnoses occurring in PHC. In this context, the doctor-patient relationship acquires particular importance, being able to act as a barrier or a remarkable facilitator in the diagnosis and treatment of patients with depressive disorder. In this original work, semi-structured interviews were carried out with 25 general practitioners working in Lisboa and later the thematic analysis method was applied to the data obtained. The main objective of the study was to assess the perception of GP physicians regarding the importance of the doctor-patient relationship in the diagnosis of depression and the patient's involvement in therapeutic decision-making. It was also evaluated the ability of GP doctors to manage these patients, the need for training on this topic and how cooperation and collaboration with Psychiatry arises. Our study concluded that the doctor-patient relationship is essential for the success of the diagnosis of these patients and that the inclusion of the patient in the elaboration of the therapy should be privileged, since an effective communication combined with the trust of the doctor-patient relationship contribute to the therapeutic success. GPs assume it is easy to make a diagnosis of depression, and the main difficulties lie in treatment and behavioral change. Training actions aimed at training GP doctors on the subject of depression are relevant and can improve treatment rates in PHC, reducing the need for referrals and the overload of Psychiatric services.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022
Palavras-chave
Depressão Saúde mental Relação médico-doente Cuidados de saúde primários Medicina geral e familiar