Patient-doctor relationships: an alliance in health care
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) |
Texto Completo: | https://doi.org/10.32385/rpmgf.v29i5.11165 |
Resumo: | Introduction: The reasons that lead patients to seek health care, the value of symptoms, and their perception of problems depend on the personal history, cultural, socioeconomic and family context of the patient. Illness (the disease experience of the patient) and disease (the medical disease) are terms used to describe what the patient feels when he goes to the doctor and what he has when he returns home after the consultation. This case aims to highlight the importance of the presenting complaint and its exploration by the Family Physician. Case Description: A 56 year-old unemployed man came to his first consultation in four years because of a lesion on his forearm, which has been present for five years. He was not receiving medication, did not smoke, and had moderate alcohol consumption. There was one visit recorded in 2007 with a diagnosis of hypertension. The blood pressure at the current visit was found to be elevated. In addition, a vegetative tumor was noted on his forearm. The patient agreed to renew follow-up, to perform the necessary tests, and accepted a referral to the dermatology clinic. A squamous cell carcinoma was diagnosed. The patient returned to clinic to obtain the results of his tests. A diagnosis of diabetes mellitus was suspected and confirmed. His blood pressure remained elevated and medication was prescribed. Comment: The family physician must try to understand why patients choose to consult or delay consultation. Is there a fear of being labeled as a sick person? Is the social network weak? This patient, who considered himself healthy, was labeled with a different disease at each visit. The family physician should manage expectations, explore them, discuss them and negotiate with the patient so that care is more effective and better accepted by patients. This can have implications for adherence to treatment and patient satisfaction with the consultation. |
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Patient-doctor relationships: an alliance in health careRelação médico-doente: uma aliança nos cuidados de saúdePatient-Doctor RelationshipReason for ConsultationDiseaseIllness.Relação Médico-DoenteMotivo de ConsultaDoençaDolênciaIntroduction: The reasons that lead patients to seek health care, the value of symptoms, and their perception of problems depend on the personal history, cultural, socioeconomic and family context of the patient. Illness (the disease experience of the patient) and disease (the medical disease) are terms used to describe what the patient feels when he goes to the doctor and what he has when he returns home after the consultation. This case aims to highlight the importance of the presenting complaint and its exploration by the Family Physician. Case Description: A 56 year-old unemployed man came to his first consultation in four years because of a lesion on his forearm, which has been present for five years. He was not receiving medication, did not smoke, and had moderate alcohol consumption. There was one visit recorded in 2007 with a diagnosis of hypertension. The blood pressure at the current visit was found to be elevated. In addition, a vegetative tumor was noted on his forearm. The patient agreed to renew follow-up, to perform the necessary tests, and accepted a referral to the dermatology clinic. A squamous cell carcinoma was diagnosed. The patient returned to clinic to obtain the results of his tests. A diagnosis of diabetes mellitus was suspected and confirmed. His blood pressure remained elevated and medication was prescribed. Comment: The family physician must try to understand why patients choose to consult or delay consultation. Is there a fear of being labeled as a sick person? Is the social network weak? This patient, who considered himself healthy, was labeled with a different disease at each visit. The family physician should manage expectations, explore them, discuss them and negotiate with the patient so that care is more effective and better accepted by patients. This can have implications for adherence to treatment and patient satisfaction with the consultation.Introdução: Os motivos que levam um utente a recorrer aos cuidados de saúde e a forma como valoriza os sintomas e os perceciona como problema vão depender da história pessoal e do contexto familiar, cultural e socioeconómico. A «doença do doente» (illness) e a «doença do médico» (disease) são termos usados para descrever o que «o doente sente quando vai ao médico» e «o que ele tem quando volta para casa após a consulta». Este caso pretende realçar a importância do motivo de consulta e da sua exploração pelo Médico de Família (MF). Descrição do Caso: Homem, 56 anos, desempregado. Separado, família unitária. Recorreu à consulta, pela primeira vez nos últimos quatro anos, por lesão no antebraço com cinco anos de evolução. Registo de consulta em 2007 com diagnóstico de hipertensão arterial mas negava antecedentes relevantes. Fumador, consumo moderado de álcool, não fazia medicação. Verificou-se tensão arterial (TA) elevada e lesão tumoral vegetativa, do tipo couve-flor, no antebraço. Aceitou reiniciar cuidados de saúde, pediu-se estudo analítico e referenciou-se para dermatologia. Diagnóstico posterior de carcinoma espinocelular. Voltou à consulta para mostrar resultados. Perante a possibilidade de ser diabético o doente desvalorizou. Confirmou-se o diagnóstico e mantendo TA elevada propôs-se anti-hipertensor, anti-diabético oral e anti-dislipidémico, a que o utente aderiu. Comentário: O MF deve tentar perceber o porquê do doente ter recorrido apenas agora aos cuidados de saúde. Medo de ser rotulado de doente? Pela rede social ser escassa? Este paciente, que até então se considerava saudável, foi rotulado com um problema/doença diferente em cada consulta. Compete ao MF fazer a gestão das suas expectativas, que devem ser exploradas, discutidas e negociadas, para que os cuidados prestados sejam mais efetivos e melhor aceites pelo paciente, o que terá implicações na adesão terapêutica e satisfação com este encontro.Associação Portuguesa de Medicina Geral e Familiar2013-09-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.32385/rpmgf.v29i5.11165https://doi.org/10.32385/rpmgf.v29i5.11165Portuguese Journal of Family Medicine and General Practice; Vol. 29 No. 5 (2013): Revista Portuguesa de Medicina Geral e Familiar; 316-21Revista Portuguesa de Medicina Geral e Familiar; Vol. 29 Núm. 5 (2013): Revista Portuguesa de Medicina Geral e Familiar; 316-21Revista Portuguesa de Medicina Geral e Familiar; Vol. 29 N.º 5 (2013): Revista Portuguesa de Medicina Geral e Familiar; 316-212182-51812182-517310.32385/rpmgf.v29i5reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAPporhttps://rpmgf.pt/ojs/index.php/rpmgf/article/view/11165https://rpmgf.pt/ojs/index.php/rpmgf/article/view/11165/10891Pereira, Ana CristinaRocha, Filipa Alvesinfo:eu-repo/semantics/openAccess2024-09-17T11:59:41Zoai:ojs.rpmgf.pt:article/11165Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T18:51:50.030732Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse |
dc.title.none.fl_str_mv |
Patient-doctor relationships: an alliance in health care Relação médico-doente: uma aliança nos cuidados de saúde |
title |
Patient-doctor relationships: an alliance in health care |
spellingShingle |
Patient-doctor relationships: an alliance in health care Pereira, Ana Cristina Patient-Doctor Relationship Reason for Consultation Disease Illness. Relação Médico-Doente Motivo de Consulta Doença Dolência |
title_short |
Patient-doctor relationships: an alliance in health care |
title_full |
Patient-doctor relationships: an alliance in health care |
title_fullStr |
Patient-doctor relationships: an alliance in health care |
title_full_unstemmed |
Patient-doctor relationships: an alliance in health care |
title_sort |
Patient-doctor relationships: an alliance in health care |
author |
Pereira, Ana Cristina |
author_facet |
Pereira, Ana Cristina Rocha, Filipa Alves |
author_role |
author |
author2 |
Rocha, Filipa Alves |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Pereira, Ana Cristina Rocha, Filipa Alves |
dc.subject.por.fl_str_mv |
Patient-Doctor Relationship Reason for Consultation Disease Illness. Relação Médico-Doente Motivo de Consulta Doença Dolência |
topic |
Patient-Doctor Relationship Reason for Consultation Disease Illness. Relação Médico-Doente Motivo de Consulta Doença Dolência |
description |
Introduction: The reasons that lead patients to seek health care, the value of symptoms, and their perception of problems depend on the personal history, cultural, socioeconomic and family context of the patient. Illness (the disease experience of the patient) and disease (the medical disease) are terms used to describe what the patient feels when he goes to the doctor and what he has when he returns home after the consultation. This case aims to highlight the importance of the presenting complaint and its exploration by the Family Physician. Case Description: A 56 year-old unemployed man came to his first consultation in four years because of a lesion on his forearm, which has been present for five years. He was not receiving medication, did not smoke, and had moderate alcohol consumption. There was one visit recorded in 2007 with a diagnosis of hypertension. The blood pressure at the current visit was found to be elevated. In addition, a vegetative tumor was noted on his forearm. The patient agreed to renew follow-up, to perform the necessary tests, and accepted a referral to the dermatology clinic. A squamous cell carcinoma was diagnosed. The patient returned to clinic to obtain the results of his tests. A diagnosis of diabetes mellitus was suspected and confirmed. His blood pressure remained elevated and medication was prescribed. Comment: The family physician must try to understand why patients choose to consult or delay consultation. Is there a fear of being labeled as a sick person? Is the social network weak? This patient, who considered himself healthy, was labeled with a different disease at each visit. The family physician should manage expectations, explore them, discuss them and negotiate with the patient so that care is more effective and better accepted by patients. This can have implications for adherence to treatment and patient satisfaction with the consultation. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-09-01 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.32385/rpmgf.v29i5.11165 https://doi.org/10.32385/rpmgf.v29i5.11165 |
url |
https://doi.org/10.32385/rpmgf.v29i5.11165 |
dc.language.iso.fl_str_mv |
por |
language |
por |
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https://rpmgf.pt/ojs/index.php/rpmgf/article/view/11165 https://rpmgf.pt/ojs/index.php/rpmgf/article/view/11165/10891 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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Associação Portuguesa de Medicina Geral e Familiar |
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Associação Portuguesa de Medicina Geral e Familiar |
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Portuguese Journal of Family Medicine and General Practice; Vol. 29 No. 5 (2013): Revista Portuguesa de Medicina Geral e Familiar; 316-21 Revista Portuguesa de Medicina Geral e Familiar; Vol. 29 Núm. 5 (2013): Revista Portuguesa de Medicina Geral e Familiar; 316-21 Revista Portuguesa de Medicina Geral e Familiar; Vol. 29 N.º 5 (2013): Revista Portuguesa de Medicina Geral e Familiar; 316-21 2182-5181 2182-5173 10.32385/rpmgf.v29i5 reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia instacron:RCAAP |
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