medigraphic.com
ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2013, Number 1

<< Back Next >>

An Med Asoc Med Hosp ABC 2013; 58 (1)

Companions experience during multiple hospitalizations: Qualitative approach

Hamui SA, Ramírez ROF, Aguirre HR, Fuentes GRS, Díaz VA, Gómez LDS

Language: Spanish
References: 30
Page: 26-36
PDF size: 101.42 Kb.


ABSTRACT

Background: The dynamics of hospitals, treatment and care, affect expectations and experiences of patients and companions in their trajectory through medical units during a health care event. Objective: Describe the experience of the companions in their trajectory during a health care event and their function inside and outside the medical units. Material and methods: Qualitative study based on 57 audio-recorded interviews conducted in November 2010 in three areas of the medical units: hospitalization, emergency room and outpatient in 19 hospitals of the Ministry of Health. Transcripts were coded, categorized and analyzed based on the grounded theory using Atlas Ti.6. Results: 73% of patients attended accompanied. They arrived with high expectations for the medical specialists’ prestige of the medical units. We identified social functions of the companion as: development of strategies for the appropriation of the social space, alliances and conflicts with other actors of the medical units, family support to physical and emotional changes of the patient, as well as financial support. The triadic communication (doctor-patient-companion) led to greater commitment and attachment to the treatment by the patient. Conclusions: Companions facilitated the exchange of information and subjec-tive well-being of the patient, their intermediation favored the agency inside and outside the medical units. Social functions exercised by companions were an articulator element in the fragmented process of medical care.


REFERENCES

  1. Institute, TM. The Care Model: Expanded Chronic Care Model. Seattle, WA. IOM 2008. Retooling for an aging America: Building the health care workforce. Washington, DC: The National Academies Press. Integrative Medicine and the Health of the Public: A summary of the February 2009 Summit. IOM, 2009. Available in: http://www.nap.edu/catalog.php?record_id=12668 [Consultado el 16 de febrero de 2011].

  2. Wolff JL, Roter DL. Family presence in routine medical visits: a meta-analytical review. Soc Sci Med 2011; 72 (6): 823-831.

  3. Gerteis M, Edgman-Levitan S, Daley J. Through the patient’s eyes. Understanding and promoting patient-centered care. San Francisco, CA: Jossey-Bass Publishers. 1993: 27-34.

  4. Institute T M. The Care Model: Expanded Chronic Care Model. Seattle, WA. IOM, 2008.

  5. Clayman M, Roter D, Wissow L, Bandeen-Roche K. Autonomy-related behaviors of patient companions and their effect on decision-making activity in geriatric primary care visits. Soc Sci Med 2005; 60 (7): 1583-1591.

  6. Wolff J, Roter D. Hidden in plain sight: medical visit companions as a quality of care resource for vulnerable older adults. Arch Intern Med 2008; 168 (13): 1409-1415.

  7. DiMatteo M. Social support and patient adherence to medical treatment: a meta-analysis. Health Psychol 2004; 23 (2): 207-218.

  8. Glynn S, Cohen A, Dixon L, Niv N. The potential impact of the recovery movement on family interventions for schizophrenia: opportunities and obstacles. Schizophr Bull 2003; 32 (3): 451-463.

  9. Vickrey B, Mittman B, Connor K, Pearson M, Della Penna R, Ganiats T et al. The effect of a disease management intervention on quality and outcomes of dementia care: a randomized, controlled trial. Ann Intern Med 2006; 145 (10): 713-726.

  10. Seeman T. Health promoting effects of friends and family on health outcomes in older adults. Am J Health Promot 2000; 14 (6): 362-370.

  11. Christakis N, Allison P. Mortality after the hospitalization of a spouse. N Engl J Med 2006; 354 (7): 719-730.

  12. Staruss AL. Qualitative Analysis for Social Research. Cambridge, Mass: Cambridge University Press, 1987: 43.

  13. Cisterna CF. Categorización y triangulación como procesos de validación del conocimiento en investigación cualitativa. Theoria 2005; 14 (1): 61-71.

  14. Hamui SA, Fuentes GR, Aguirre HR, Ramírez ROF. Expectativas y experiencias de los usuarios del Sistema de Salud en México: un estudio de satisfacción con la atención médica. Facultad de Medicina, UNAM. CCINSHRAE. México, 2012: 45.

  15. Gutiérrez RC, Mulén LD, Pozo FD, Vega PC. Influencia de las normas en las interacciones sociales entre visitas y personal en el Hospital de Enfermedades Infecciosas Dr. Lucio Córdova. Revista de Humanidades Médicas y Estudios Sociales. 2010; 2(2). Disponible en: http://www.ea-journal.com/es/numero-actual [Consultado el 23 de febrero de 2011].

  16. Bodenheimer T, Berry-Millett R. Follow the money--controlling expenditures by improving care for patients needing costly services. N Engl J Med 2009; 361 (16): 1521-1523.

  17. Peikes D, Chen A, Schore J, Brown R. Effects of care coordination on hospitalization, quality of care, and health care expenditures among Medicare beneficiaries: 15 randomized trials. JAMA 2009; 301 (6): 603-618.

  18. Rocha GA, Hernández PP, Ruiz VS, Ávila BL, Marin PT, Lazcano PE. Gasto en hogares durante la hospitalización de menores derechohabientes, con diagnóstico de leucemia, en dos hospitales de México. Sal Pub Mex 2003; 45 (4): 285-292.

  19. Aberasturi A. Las prioridades del enfermo y su familia. Educ Med 2005; s36-s37.

  20. Seeman T. Health promoting effects of friends and family on health outcomes in older adults. Am J Health Promot 2000; 14 (6): 362-370.

  21. DiMatteo M. Social support and patient adherence to medical treatment: a meta-analysis. Health Psychol 2004; 23 (2): 207-218.

  22. Borges IJ. El enfermo y su situación vital. Gac Med Caracas 2003; 111 (2): 112-116.

  23. Parsons T. Illness and the role of the physician. En: Kluckhohn C. y Murray H, (eds.) Personality in nature, society and culture. New York: Alfred A Knopf; 1948: 132-138. Confrontar también con: Parsons T: The Social System. England: Routledge & Kegan Paul Ltd; 1951: 231-246.

  24. Hamui SL. Trastornos genéticos, narrativas y entorno social: los judíos en la Ciudad de México. México: Universidad Nacional Autónoma de México; 2011.

  25. Wolff JL, Roter DL. Family Presence in Routine Medical Visits: A Meta- Analytical Review, Soc Sci Med 2011. doi: 10.1016/j.socscimed.2011.01.015

  26. Emanuel JE, Emanuel LL MD. Four models of the physician patient relationship. JAMA 1992; 267 (16): 2221-2226.

  27. Rao JK, Anderson LA, Inui TS, Frankel RM. Communication interventions make a difference in conversations between physicians and patients: a systematic review of the evidence. Med Care 2007; 45 (4): 340-349.

  28. Wolff J, Roter D. Hidden in plain sight: Medical visit companions as a quality of care resource for vulnerable older adults. Arch Intern Med 2008; 168 (13): 1409-1415.

  29. La Prensa [Sede web]. Panamá: Ricart M; 2007 [Consultado el 19 de febrero de 2011]. La medicina deshumanizada: una soledad nada hospitalaria. Disponible en: http://www.prensa.com/actualidad/salud/2007/07/17/index.htm

  30. Rosenberg AE, Lussier MT, Beaudin C. Lessons for clinicians from physician–patient communication literature. Arch Fam Med 1997; 6: 279-283.




2020     |     www.medigraphic.com