ABSTRACT
Background: There are suggestions that, despite training efforts for Primary Health Care physicians, difficulties in making accurate diagnoses and timely treatments persist. Aim: To evaluate the impact of a new training model in Depressive disorders integrated with Mindful Practice, on the diagnostic and therapeutic skills of primary care general physicians. Material and Methods: A voluntary sample of 56 general physicians was studied. The design of this study was experimental and randomized, with two groups attending theoretical sessions followed by differing workshops that were carried out in a parallel fashion. The Quantitative phase of this study considered measuring the impact of training in physician s skills. The Qualitative phase included nine semi-structured interviews and Qualitative Content Analysis. This paper reports the results of the interviews. Results: As a consequence of training sessions, physicians learned that above the mental health problems, other issues such as self-efficacy and self-confidence are important for the management of depressive patients. Conclusions: This qualitative study shows that physicians are obtaining significant benefits from their training sessions.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Clinical Competence , Depressive Disorder , Physicians, Primary Care/education , Qualitative Research , Attitude of Health Personnel , Depressive Disorder/diagnosis , Depressive Disorder/therapy , Interviews as TopicABSTRACT
Background: The relationship between patients and health professionals emphasizes deliberation and joint decision making, that derives in the informed consent. Aim: To evaluate decision making of patients in health care and to identify the notion of capacity for decision making, according to lawyers and physicians. Material and methods: A semi-structured interview about procedures to assess decision making capacity was applied to 27 selected physicians and lawyers, considering their experience in this area. A qualitative analysis of answers was performed. Results: Several differences were observed between physicians and lawyers, probably originated in their respective disciplines as well as the context of their professional practice. For physicians the notion of capacity is associated to comprehension of the information, it is not absolute, and it must consider the intellectual maturity of the teenager and the autonomy of the elderly. This evaluation is frequently performed in the clinical interview and standardized protocols do not exist. For lawyers, capacity is established by age and is associated to rights and obligations, as determined by law. When it is assessed by experts, including physicians, it becomes evidence. These professionals assume that experts will use standardized assessment instruments. Capacity has significance in the legal system. Conclusions: Since there are substantial consequences when a person is deemed incompetent, it is necessary to distinguish between health capacity and legal capacity, and to ¡ink the informed consent with the fundamental rights of citizens, such as taking decisions about our own health.