2011, Number 6
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Rev Invest Clin 2011; 63 (6)
Physician-patient with AIDS-relationship, as a model of clinical relation within the framework of the social security institutions in Mexico
Valdez-Martínez E, Bedolla M, Rico R
Language: Spanish
References: 14
Page: 574-589
PDF size: 182.82 Kb.
ABSTRACT
Objective. To examine the nature and level of physician involvement during a clinical encounter with a patient with a chronic condition, such as AIDS, and to explore how it is understood and constructed by them.
Material and methods. Qualitative design with participant observation and semi-structured interviews, with physicians and patients, conducted in hospitals of Social Security Institutions in Mexico City. Data were analyzed using the constant comparative method developed in the grounded theory tradition. The emergent themes studied were the dynamics of the encounters, levels of participation of the physician, and attitudes of both participants.
Results. Irrespective of whether patients were seen for the first time, or subsequently, in outpatient consultation or in hospital, the physician focused on the solution of the biological problem and on the performance of a work commitment with the Institution.
Conclusion. This study highlights the need to strengthen the incorporation of the ethics into daily clinical practice in order to transform a physician-patient relationship which is merely bureaucratic, focused on the solution of a biological problem and on the fulfillment of an institutional commitment, into a relationship which is truly professional and at the service of the patient.
REFERENCES
Laín-Entralgo P (ed). La relación médico-enfermo: historia y teoría. Madrid: Alianza Editorial; 2003.
Bobbitt HR Jr, Breinholt RH, Doktor RH, McNaul JP. Organizational behavior, understanding and prediction. 2nd. Ed. Englewood Cliffs, NJ: Prentice-Hall, Inc.; 1978.
Nettleton S. The sociology of health and illness. 2nd. Ed. Cambridge, UK: Polity Press; 2006.
Encuesta Nacional de Salud y Nutrición 2006. Instituto Nacional de Salud Pública. Disponible en: http://wwwinsp.mx/ensanut2006/index.php [Consultado el 8 de junio 2010].
Sandelowski M. Sample size in qualitative research. Res Nurs Health 1995; 18: 179-83.
Morse JM, Richards L (eds.). Qualitative methods. Thousand Oaks, CA: SAGE Publications, Inc.; 2002.
Miles MB, Huberman AM (eds.). Qualitative data analysis. 2nd. Ed. Thousand Oaks, CA: SAGE Publications, Inc.; 1994.
Marvel KM, Schilling R, Doherty WJ, Baird MA. Levels of physician involvement with patients and their families. J Fam Prac 1994; 39: 535-44.
López-García A, Valdez-Martinez E, Bedolla M. A snapshot of medical care quality: Health professional and patient satisfaction. Rev Med IMSS 2009; 47: 603-10.
Pattison S, Pill R (eds.). Values in professional practice. Lessons for health, social care and other professionals. Oxford: Radcliffe Medical Press; 2004.
Lazcano-Ponce E, Ángeles-Llerenas A, Álvarez-del Río A, Salazar-Martinez E, Allen B, Hernandez-Ávila M, Kraus A. Ethics and communications between physicians and their patients with cancer, HIV/AIDS, and rheumatoid arthritis in Mexico. Arch Med Res 2004; 35: 66-75.
Herrera C, Campero L, Caballero M, Kendall T. Relación entre médicos y pacientes con VIH: influencia en apego terapéutico y calidad de vida. Rev Saúde Púb 2008; 42(2): 249-55.
Beauchamp TL, Childress JF (eds.). Principles of biomedical ethics. 5th. Ed. New York: Oxford University Press; 2001.
Bedolla M. The philosophical basis: what is medical ethics? In: Valdez-Martinez E, Bedolla M (eds.). Clinical ethics: an international view for Latin America. Mexico: Grupo Ixel S.A.; 2010, p. 7-13.