Competências comunicacionais na relação médico-doente em medicina geral e familiar

: um estudo empírico em contexto de consultas privadas

Abstract

The process of communication is a central aspect in building the doctor-patient relationship, which is at the crux of the therapeutic path. As such, this investigation examines the communication process between doctor and patient within a general practice and family medicine consultation, as well as to what extent communication skills are used and perceived. Are communication skills valued and practiced by doctors? Are doctor’s communication skills valued and appreciated by patients? The investigation project that embodied the final document of this Doctoral Thesis materialised as an empirical study built upon documental and bibliographical research that sought roots, concepts, as well as material and mental tools that led the research activity and the observation and analysis that allows for setting in action the dialogue between the phenomena that we proposed to study: doctor-patient communication within a general practice and family medicine consultation in the private healthcare sector in Portugal.This topic became of particular interest to us given the growing awareness and debate that has been garnering both in the media and within Academia. The doctor-patient relationship in clinical practice involves particular features that derive from each subject’sown goals, becoming the construct of a helping relationship. Relationships are based from inception upon an affective experience that forms their very sense. Therefore, effective communication between doctor and patient is an essential clinical skill.Grounded upon an interpretivist approach, this investigation is carried out within a context of theoretical references that allow for the setting of arguments and hypothesis to be empirically tested so as to provide answers to the initial question: To what extent are(...) Knowledge is not something pure, separate from its instruments, its material tools or even its mental tools, such as concepts; scientific theory is an organizing activity of the mind, which puts observations into action and which, of course, also puts into action this dialogue with the world of phenomena. (Morin, 1990, p. 42).interpersonal communication skills applied by doctors within a general practice and family medicine consultation?The proposed theoretical framework relies on a sociocultural approach within Communication Sciences, with contributions from other traditions in the same scientific field.The systemic, micro-analytical, proxemic and kinesics approaches were dimensional references in the interpretation of the communication process between doctor and patient. The selection of tools to be incorporated in the empirical research favored the spheres which are linked to variables and elective dimensions within a relational communication process.The empirical research was developed by applying two online surveys, using mixed sampling methods – the first, directed at doctors, which gathered 33 completed questionnaires; another was directed at patients, with a total number of 481 responses.Both surveys featured the same questions, grouped around the effective communication,verbal communication, non-verbal communication and affective communication dimensions. Analysis of the results confirms a positive outcome in what concerns doctors’performance in the different dimensions within the communication component. However,some more specific deficits have been identified in the proposed questions, namely preparation for the consultation, message summarization, focus on the patient’s socioeconomic and cultural background, and vocal and body expression.With the data we obtained, we have sought wherever possible to establish a bridge that will raise awareness to the importance of humanizing the relational process, an essential cornerstone in Human interaction, where Doctor and Patient are both protagonists.

Date of Award	18 Jul 2022
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Cristina Salgado (Supervisor)