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RESUMO Na atualidade, não há mais dúvidas sobre a importância das ciências humanas e humanidades no currículo médico, isto já é consenso. É necessário retomar, pelo menos parcialmente, a capacidade de empatia e comunicação dos futuros médicos, a exemplo do que se tinha outrora, além do olhar sistêmico para que os pacientes possam se sentir mais bem acolhidos, o que é muito bem ilustrado no texto da médica Tatiana Bruscky, produzido pela Ria Slides: "Onde andará o meu doutor"4. No entanto, ainda não foi encontrada uma forma sistematizada de trabalhar esses conceitos, apesar das iniciativas que vêm ocorrendo no Brasil, principalmente após 2014, visto que as Diretrizes Curriculares para os cursos de graduação em Medicina inseriram ainda mais aspectos relacionados à comunicação médico-paciente. Introduzir esses assuntos e discussões no ensino dos cursos de Medicina é uma tarefa difícil, pois, quase sempre, dosar teoria e prática e tornar as disciplinas que as compõem atrativas e valorizadas pelos alunos são um grande desafio. Não existem parâmetros claros e nem descrições pormenorizadas das metodologias utilizadas, apenas breves relatos. Este artigo aborda, detalhadamente, uma das formas de ensinar humanidades no curso de Medicina do Centro Universitário Lusíada (Unilus), descrevendo a metodologia passo a passo, a experiência e alguns resultados desde a sua implantação em 2010, com uma estação denominada Comunicação, pertencente à disciplina de Habilidades Práticas. Ela é desenvolvida nos três primeiros anos, sendo que no primeiro o foco é a comunicação entre médico, paciente e familiares em situações diversas de consulta; no segundo ano, é a comunicação de más notícias, enquanto no terceiro o enfoque são os cuidados na comunicação do pré e pós-operatório. Por meio de simulações, os alunos conseguem treinar e refletir sobre uma vasta gama de casos e contextos, dos mais simples aos mais complexos. O intuito é compartilhar a didática aplicada e estimular a discussão e a troca de experiências entre profissionais interessados e comprometidos com a excelência na formação médica.
ABSTRACT At the present there is no longer any doubt about the importance of human sciences and humanities in the medical curriculum. This is already a consensus. It is necessary to resume at least partially the ability of future doctors to empathize and communicate as in the past in addition to the systemic view so that patients can feel better welcomed which is very well illustrated in the text of the doctor Tatiana Bruscky produced by Ria Slides: "Onde andará o meu doutor"4. However, finding a systematized way of working on these concepts still does not exist despite the initiatives that have been taking place in Brazil, especially after 2014, since the Curriculum Guidelines for undergraduate courses in Medicine have inserted even more aspects related to this medical / patient communication. Introducing these subjects and discussions in the teaching of medical courses is a difficult task since almost always dosing theory and practice and making the disciplines attractive and valued by the students is a great challenge. There are no clear parameters or detailed descriptions of the methodologies used only brief reports. This article seeks to address in detail one of the ways of teaching humanities in the Centro Universitário Lusíada (Unilus) medical course, describing the step-by-step methodology, experience and some results since its implementation in 2010 with a Station called Communication belonging to the discipline of Practical Skills. It is developed in the first three years. In the first year the focus is the communication between doctor and patient/family in different consultation situations. The second year is the communication of bad news while in the third the focus is the communication of pre and postoperative. In that way students can train and reflect through simulations a wide range of cases and contexts from the simplest to the most complex. The purpose is to share applied didactics and stimulate the discussion and exchange of experience among interested professionals committed to excellence in medical education.
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CONTEXT: Recent population-based surveys suggest that the prevalence of erectile dysfunction is between 30 percent and 56 percent among men over the age of 40. Most of these studies, however, are from the United States or Europe. We need estimates of erectile dysfunction from samples of Brazilian populations, as societies that differ ethnically, culturally, and economically may also differ with respect to potential risk factors for erectile dysfunction. OBJECTIVE: To determine the prevalence of erectile dysfunction and its potential correlates. SETTING: Santos, State of Säo Paulo. DESIGN: Cross-sectional study. PARTICIPANTS: A population-based sample of men aged 40-70 years. Out of 718 men invited, 342 (47.6 percent) returned a completed questionnaire. MAIN MEASUREMENTS: Data on demographic variables, medical history, lifestyle habits and degree of erectile dysfunction. RESULTS: The prevalence of any degree of erectile dysfunction was 45.9 percent (minimal, 33.9 percent; moderate, 8.5 percent; complete, 3.5 percent) and increased with age. In bivariate age-adjusted analyses comparing men with no erectile dysfunction or minimal erectile dysfunction with those with moderate or complete erectile dysfunction, histories of diabetes or hypertension, depressive symptoms, heavy smoking and obesity were significantly associated with increased prevalence of erectile dysfunction, whereas moderate alcohol consumption was inversely associated with erectile dysfunction. In the multivariate model, age was a strong predictor of erectile dysfunction, while history of diabetes or hypertension and heavy smoking remained significantly associated with increased prevalence of erectile dysfunction. CONCLUSION: We found higher prevalence of erectile dysfunction (45.9 percent) among men older than 40 years old in Brazil. The variables associated with erectile dysfunction may alert physicians to patients who are at risk of erectile dysfunction as well as offer clues to the etiology of erectile dysfunction. Physicians should routinely ask their patients about sexual health and erectile dysfunction