Evidências do cuidado centrado no paciente no contexto da prática profissional de saúde brasileira

Ferla, Josiane Bernart da Silva; Araujo, Cristiano Miranda de; Oliveira, Marcos Herrerias de; Carnevale, Luciana Branco; Berberian, Ana Paula

Josiane Bernart da Silva Ferla Corresponding author: Josiane Bernart da Silva Ferla, E-mail: josiane.ferla@ifpr.edu.br

conception or design of the study/research

analysis and/or interpretation of data

final review with critical and intellectual participation in the manuscript

Universidade Tuiuti do Paraná. Curitiba, Paraná, Brazil

Instituto Federal de Educação Ciência e Tecnologia do Paraná. Curitiba, Paraná, Brazil

https://orcid.org/0000-0003-4267-2553

Cristiano Miranda de Araujo

analysis and/or interpretation of data

final review with critical and intellectual participation in the manuscript

Universidade Tuiuti do Paraná. Curitiba, Paraná, Brazil

https://orcid.org/0000-0003-1325-4248

Marcos Herrerias de Oliveira

analysis and/or interpretation of data

final review with critical and intellectual participation in the manuscript

Instituto Federal de Educação Ciência e Tecnologia do Paraná. Curitiba, Paraná, Brazil

https://orcid.org/0000-0002-1148-8844

Luciana Branco Carnevale

analysis and/or interpretation of data

final review with critical and intellectual participation in the manuscript

Universidade Estadual do Centro-Oeste. Irati, Paraná, Brazil

https://orcid.org/0000-0003-3414-3002

Ana Paula Berberian

conception or design of the study/research

analysis and/or interpretation of data

final review with critical and intellectual participation in the manuscript

Universidade Tuiuti do Paraná. Curitiba, Paraná, Brazil

https://orcid.org/0000-0001-7176-7610

Corresponding author: Josiane Bernart da Silva Ferla, E-mail: josiane.ferla@ifpr.edu.br

EDITOR IN CHIEF: Antonio José de Almeida Filho

ASSOCIATE EDITOR: Maria Itayra Padilha

Sociodemographic characteristics	n^* * Number of participants; †SD - standard deviation. (%)
Gender
Male	56 (13.7)
Female	352 (86.3)
Area of expertise
Nursing	229 (55.8)
Speech therapy	84 (20.5)
Medicine	37 (9.0)
Dentistry	60 (14.1)
Academic level
Undergraduate degree	42 (10.2)
Specialization	226 (55.1)
Master’s degree	75 (18.3)
Doctoral degree	54 (13.2)
Postdoctoral studies	13 (3.2)
Assisted subjects
Children	251 (61.4)
Adolescents	234 (57.1)
Adults	337 (82.2)
Older adults	268 (65.4)
Level of care
Primary	162 (39.5)
Secondary	185 (45.1)
Tertiary	186 (45.4)
Teaching	133 (32.6)
Hospitalization experience
Staff	214 (52.7)
Family	377 (92.4)
Age in years - Mean (SD†)	42 (10.4)

PPOS^* * Patient-Practitioner Orientation Scale; Item [Mean (SD^† † SD - standard deviation. )]	Nursing	Speech therapy	Dentistry	Medicine
1. Is it the healthcare professional who should decide what will be talked about in the consultation?	4.27 (1.7)	4.57 (1.77)	3.46 (1.63)	4.70 (1.43)
2. Although professional healthcare is more impersonal today, is this a small loss in exchange for advances in medicine?	3.97 (1.72)	4.17 (1.86)	3.47 (1.65)	4.72 (1.38)
3. Is physical examination the most important part of the consultation?	3.1 (1.63)	4.33 (1.80)	3.39 (1.69)	4.76 (1.32)
4. Is it generally best for patients that they do not have a complete explanation of their medical (health) condition?	5.51 (1.15)	5.28 (1.44)	5.69 (0.74)	5.59 (0.88)
5. Patients should rely on the knowledge of their health professionals and not try to find out about their condition for themselves.	3.44 (1.74)	3.95 (1.77)	3.33 (1.88)	4.19 (1.64)
6. When health professionals ask many questions about the patient’s history, are they intruding too much on personal issues?	5.79 (0.58)	5.92 (0.27)	5.94 (0.23)	5.78 (0.69)
7. If healthcare professionals are really good at diagnosis and treatment, the way they relate to patients is not that important.	5.72 (0.83)	5.83 (0.71)	5.72 (0.65)	5.87 (0.33)
8. Do many patients keep asking questions, even when they no longer have anything to learn in the consultation?	4.06 (1.65)	4.54 (1.52)	3.94 (1.58)	4.28 (1.46)
9. Should patients be treated as if they were partners of the health professional, with similar power, rights, and duties?	4.34 (1.71)	4.08 (1.81)	4.11 (1.82)	4.41 (1.72)
10. Do patients generally want to be reassured instead of having information about their health?	3.45 (1.47)	3.82 (1.70)	3.58 (1.42)	3.7 (1.24)
11. If the main characteristics of a health professional are to be sincere and friendly, will they not have much success?	5.14 (1.40)	5.2 (1.44)	5.28 (1.26)	5.46 (1.04)
12. When patients disagree with their healthcare professional, is it a sign that this professional does not have the respect and trust of their patient?	4.28 (1.48)	5.08 (1.20)	4.11 (1.65)	4.54 (1.31)
13. Can a treatment not succeed if it conflicts with the patient’s lifestyle or values?	5.28 (1.08)	5.15 (1.35)	5.17 (1.25)	5.24 (1.15)
14. Do most patients want to enter and leave the health professional’s office as soon as possible?	4.51 (1.37)	4.75 (1.39)	4.25 (1.48)	5.19 (0.99)
15. Should the patient always be aware that the healthcare professional is in charge?	4.53 (1.61)	4.53 (1.58)	3.11 (1.67)	4.72 (1.55)
16. Isn’t it so important to know the patient’s culture and history to treat their disease?	5.89 (0.58)	5.75 (0.79)	5.86 (0.42)	5.85 (0.35)
17. Is humor a major ingredient of the health professional in the treatment of the patient?	4.59 (1.47)	4.13 (1.53)	4.08 (1.56)	4.07 (1.49)
18. When the patient searches for information about their health status on their own, does this usually confuse more than help?	3.21 (1.62)	3.85 (1.55)	3.14 (1.64)	3.78 (1.64)
Full scale	4.49 (0.58)	4.66 (0.60)	4.30 (0.52)	4.77(0.56)

Predictor variable	Category	Caring		Sharing		Total
Predictor variable	Category	Mean (SD^† † SD - standard deviation; )	p value^‡ ‡ p-value ANOVA test, Post-hoc - Tukey test; For variables with multiple correlations - different letters in the same column indicate statistical significance;	Mean (SD^† † SD - standard deviation; )	p value^‡ ‡ p-value ANOVA test, Post-hoc - Tukey test; For variables with multiple correlations - different letters in the same column indicate statistical significance;	Mean (SD^† † SD - standard deviation; )	p value^‡ ‡ p-value ANOVA test, Post-hoc - Tukey test; For variables with multiple correlations - different letters in the same column indicate statistical significance;
Gender	Male	4.89(0.55)^a	0.429	4.02(0.90)^a	0.239	4.45(0.60)^a	0.240
Gender	Female	4.95(0.52)^a		4.17(0.84)^a		4.56(0.58)^a
Area of expertise	Nursing	4.89(0.54)^a	0.001^§ § Significance level - p < 0.05	4.09(0.83)^a	<.001^§ § Significance level - p < 0.05	4.49(0.58)^a	<.001^§ § Significance level - p < 0.05
	Speech therapy	5.00(0.53)^abc		4.33(0.84)^ac		4.66(0.60)^ac
	Dentistry	4.83(0.47)^ac		3.76(0.84)^b		4.30(0.52)^b
	Medicine	5.16(0.43)^b		4.38(0.84)^c		4.77(0.56)^c
Academic level	Undergraduate degree	4.89(0.54)^a	0.343	4.12(0.85)^ab	0.001^§ § Significance level - p < 0.05	4.51(0.62)^ab	0.009^§ § Significance level - p < 0.05
	Specialization	4.91(0.49)^a		3.99(0.77)^b		4.45(0.53)^b
	Master’s degree	5.05(0.49)^a		4.34(0.89)^a		4.69(0.58)^a
	Doctoral degree	4.99(0.58)^a		4.38(0.86)^a		4.69(0.63)^a
	Postdoctoral degree	4.88(0.83)^a		4.69(1.11)^ab		4.79(0.94)^ab
Assisted subjects (Y/N)	Children	4.99(0.52)	0.115	4.18(0.85)	0.431	4.59(0.59)	0.167
	Teens	4.97(0.54)	0.791	4.16(0.85)	0.437	4.56(0.60)	0.439
	Adults	4.94(0.54)	0.612	4.15(0.85)	0.620	4.54(0.59)	0.593
	Elderly	4.96(0.52)	0.297	4.20(0.80)	0.060	4.58(0.56)	0.071
Level of care (Y/N)	Primary	4.97(0.53)	0.324	4.18(0.86)	0.350	4.58(0.59)	0.254
	Secondary	4.91(0.49)	0.437	4.06(0.84)	0.141	4.48(0.56)	0.172
	Tertiary	4.96(0.52)	0.369	4.21(0.83)	0.184	4.59(0.58)	0.186
Hospitalization experience (Y/N)	Teaching	4.99(0.59)	0.260	4.22(0.95)	0.222	4.60(0.68)	0.193
	Staff	4.92(0.46)	0.264	4.12(0.85)	0.450	4.52(0.61)	0.277
	Family	4.96(0.52)	0.102	4.16(0.86)	0.576	4.55(0.59)	0.261

Domain	Predictor variable	β		Standard error	p value^†
Domain	Predictor variable	Non-standardized	Standardized	Standard error	p value^†
Score Total of the PPOS^* * Patient-Practitioner Orientation Scale; †p-value obtained by the multivariate linear regression model; ‡Significance level - p < 0.05	Constant	4.34		0.062	0.001
	Area of expertise	0.061	0.117	0.032	0.002^‡
	Academic level	0.100	0.164	0.027	0.028^‡

[1] Corresponding author: Josiane Bernart da Silva Ferla, E-mail: josiane.ferla@ifpr.edu.br

Brasil

Brasil

Evidências do cuidado centrado no paciente no contexto da prática profissional de saúde brasileira

RESUMO

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