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Updated: Jul 14, 2026
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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
La relación paciente-médico. Comunicación paciente-médico durante las visitas de tratamiento paliativo ambulatorio:
S B Detmar1, M J Muller, L D Wever
1Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands.
JAMA
|March 20, 2001
Resumen
La comunicación del médico sobre la calidad de vida del paciente (QVQ) durante el tratamiento paliativo del cáncer es limitada. La CQHR reportada por los pacientes influye significativamente en las discusiones, sin embargo, muchos problemas graves, especialmente el bienestar emocional y la fatiga, permanecen sin abordar.
Área de la Ciencia:
- Oncología Oncología.
- Los cuidados paliativos son cuidados paliativos.
- Servicios de salud Servicios de salud Investigación Investigación.
- Comunicación en el cuidado de la salud.
Sus antecedentes:
- Mejorar la calidad de vida relacionada con la salud (HRQL) es un objetivo clave en la atención paliativa del cáncer.
- La comprensión actual de la comunicación paciente-médico con respecto a la HRQL durante el tratamiento paliativo es limitada.
Objetivo del estudio:
- Para analizar el contenido de la comunicación rutinaria paciente-oncólogo en relación con cuatro cuestiones específicas de HRQL.
- Para identificar los factores relacionados con el paciente, el médico y las visitas asociados con las discusiones de HRQL.
Principales métodos:
- Se realizó un estudio observacional en una clínica de quimioterapia paliativa ambulatoria.
- Se recopilaron datos de 10 oncólogos y 240 pacientes con cáncer incurable utilizando cuestionarios y análisis de cintas de audio.
- El Sistema de Análisis de Interacción de Roter se utilizó para analizar la comunicación con respecto a las actividades diarias, el funcionamiento emocional, el dolor y la fatiga.
Principales resultados:
- Los médicos dedicaron el 64% del tiempo de consulta a cuestiones médicas/técnicas frente al 23% a cuestiones relacionadas con la calidad de vida humana.
- Los pacientes discutieron temas médicos / técnicos (41%) y temas de HRQL (48%) de manera más equitativa.
- La CQH informada por el paciente fue el predictor más fuerte para discutir la CQH, sin embargo, entre el 20 y el 54 por ciento de los problemas graves de CQH, particularmente el funcionamiento emocional y la fatiga, no fueron abordados.
Conclusiones:
- La comunicación paciente-médico con respecto a la HRQL en la atención paliativa del cáncer es limitada.
- La comunicación explícita sobre HRQL hace una modesta contribución a la evaluación de la eficacia del tratamiento en la práctica.
- Se necesita más investigación para mejorar las estrategias de comunicación para mejorar la calidad de vida de los pacientes.
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