La relacion medico-paciente, la medicina cientifica y las terapias alternativas / Physician-patient relationship, scientific medicine and alternative therapies

RESUMO

The objective of this paper is to describe the magnitude and characteristics of the use of complementary therapies in clinical practice. A consecutive sample of 540 outpatients who had sought medical care for the first time at the General Internal Medicine Program of a University Hospital were interviewed. A questionnaire was completed, collecting socio-demographic informations, data on physical and psychological health, perception of physician-patient relationship, self-medication, and beliefs associated with the disease and its treatment. Lifetime prevalence use of alternative therapies was near 55%. The most used were homeopathy and herbal medicines (40.8% and 37.6%, respectively). The evaluation of these practices was considered "excellent/very good/and good" 84.5% of the time. Significant associations were females (p < 0.00001), high level of education (p < 0.001), dissatisfaction with the way in which the cause of the disease had been investigated and how the diagnosis and treatment had been communicated (p < 0.03), psychological and psychiatric treatment (p < 0.00001), self-medication (p < 0.0002), pain and concern during over 6 months due to disease or disability (p < 0.00001), lack of confidence in scientific medicine (p < 0.00001), the belief that "spiritual problems" (p < 0.00001), "mental conditions" (p < 0.003), and "emotional conditions" (p < 0.00001), popular beliefs, particularly dano & envidia (p < 0.00001), and mal de ojo (p < 0.001) have triggered the disease. One third of the patients attended the hospital while undergoing an alternative therapy that may pose an interference or interaction hazard. Emphasis is placed on the importance of medical education to assess physician-patient relationship and the ability to convey trust in medical procedures and treatments, and scientific consulting for other practices