The aim of this study was to assess empathy in family medicine trainees and to compare the level ... more The aim of this study was to assess empathy in family medicine trainees and to compare the level of empathy in first and final year trainees. Type of study: Cross-sectional. Location: Healthcare Regional Administrations (HRA) in Portugal. Population: Family medicine trainees in Portuguese HRA. Methods: We gave an anonymous, self-administered questionnaire, including the Jefferson Scale of Physician Empathy (JSPE), adapted and validated for Portugal, to a convenience sample of family medicine residents. The surveys were distributed in person or sent by personal e-mail. Statistical analysis was performed using SPSS (R) 19.0. Results:We collected 304 questionnaires. Of these, 84 were from trainees who began their training in 2012 (response rate (RR)=20.6%). The remaining 220 questionnaires were from trainees who began their training in 2016 (RR=42.3%). Most of the trainees were enrolled in programs in the Lisbon and Tejo Valley regions (52.4% and 61.4% respectively). There were no significant differences in gender between the two groups. There were no significant differences in the median levels (M) of empathy [ME(2012)=119.00; ME(2016)=118.00; p=0.678] between the first and final year trainees. Prior training in communication skills was not associated with a higher empathy score. Female participants had significantly higher empathy scores (p=0.008). Conclusions: Our results were comparable to national and international studies on empathy in medical students and trainees. Empathy does not seem to be associated with residency or undergraduate training. The low response rate obtained limits the representativeness of the sample and the validity of the findings. However this study presents an initial look at the variation in empathy during family medicine residency training in Portugal.
A doença mental configura atualmente a principal causa de incapacidade e uma das principais causa... more A doença mental configura atualmente a principal causa de incapacidade e uma das principais causas de morbilidade e morte prematura em todo o mundo, prevendo-se que, no ano de 2020, ocupe o segundo lugar na lista de patologias que condicionam a morbilidade a ní
Resumo Pretende-se conhecer as dificuldades sentidas pelos médicos de família (MF) na abordagem d... more Resumo Pretende-se conhecer as dificuldades sentidas pelos médicos de família (MF) na abordagem dos doentes com transtornos mentais (TM) e conhecer as suas propostas para melhorar os cuidados os cuidados de saúde mental (CSM). Estudo qualitativo. Realizaram-se entrevistas semiestruturadas e audio-gravadas a 10 MF. Com análise de conteúdo identificaram-se oito categorias temáticas: condições de trabalho percecionadas; formação em saúde; terapêuticas usadas para tratamento dos TM; instrumentos de saúde mental usados na consulta; TM abordados na atenção primária (AP) e referenciadas a cuidados hospitalares; reação do doente à referenciação; articulação da atenção primária com a psiquiatria; propostas para melhorar os CSM na AP. A articulação com os serviços de saúde mental é deficiente pela falta de acessibilidade, comunicação unidirecional e atraso na resposta. Para melhorar os MF propõem criação de consultorias; equipes multidisciplinares; plataformas que permitam a comunicação bidir...
IntroductionGood patient outcomes correlate with the physicians’ capacity for good clinical judge... more IntroductionGood patient outcomes correlate with the physicians’ capacity for good clinical judgement. Multimorbidity is common and it increases uncertainty and complexity in the clinical encounter. However, healthcare systems and medical education are centred on individual diseases. In consequence, recognition of the patient as the centre of the decision-making process becomes even more difficult. Research in clinical reasoning and medical decision in a real-world context is needed. The aim of the present review is to identify and synthesise available qualitative evidence on primary care physicians’ perspectives, views or experiences on decision-making with patients with multimorbidity.Methods and analysisThis will be a systematic review of qualitative research where PubMed, CINAHL, PsycINFO, Embase and Web of Science will be searched, supplemented with manual searches of reference lists of included studies. Qualitative studies published in Portuguese, Spanish and English language ...
Revista Brasileira de Medicina de Família e Comunidade, 2016
Objetivo: Caracterizar a utilização mundial da Classificação Internacional em Atenção Primária (C... more Objetivo: Caracterizar a utilização mundial da Classificação Internacional em Atenção Primária (CIAP) e outras classificações de saúde ao nível da Atenção Primária à Saúde (APS) e identificar especificidades de utilização em cada país. Métodos: Questionário de autopreenchimento enviado a membros do Comitê Internacional de Classificações da WONCA (WICC) e médicos de família de cada um dos países reconhecidos como tal pela Organização das Nações Unidas (ONU). Resultados: Obtiveram-se contatos de e-mail de representantes de 109 países e foram recebidas 61 respostas (de 259 pedidos de colaboração enviados) de 52 diferentes países: 30 da Europa, 8 da Ásia, 7 da América, 6 de África e um da Oceania. Em 34 países (17%), há uma versão da CIAP disponível na língua nacional. A CIAP é usada na APS em 27 países (14%), mas é obrigatória em apenas 6 (3%). Em relação aos tópicos contabilizados nos registos clínicos, 10 países usam-na para classificar unicamente motivos de consulta e problemas e ap...
Revista da Associacao Medica Brasileira (1992), 2018
Surveys are a useful tool in primary care. However, low response rates can introduce selection bi... more Surveys are a useful tool in primary care. However, low response rates can introduce selection bias, impairing both external and internal validity. The aim of this study was to assess the average response rate in surveys with Portuguese general practitioners (GPs). We searched the Medline, Web of Science, Scopus, Embase, PsychInfo, SciELO, IndexRMP, RCAAP, Revista Portuguesa de Medicina Geral e Familiar, Acta Médica Portuguesa and the proceedings of conferences of general practice from incepton to December 2016. We included all postal, e-mail, telephone and personal surveys to primary care physicians without language restrictions. We did not assess risk of bias of included studies, since the main outcome was survey response rate. We performed planned subgroup analyses of the use of monetary incentives, the use of non-monetary incentives, survey delivery modes and prior contact with participants. A total of 1,094 papers were identified and 37 studies were included in this review. The...
Arterial Hypertension is a multifactorial cardiovascular risk factor responsible for high morbidi... more Arterial Hypertension is a multifactorial cardiovascular risk factor responsible for high morbidity and mortality. Given the complexity of its pathophysiology, a patient-oriented and holistic approach is essential in order to optimize blood pressure control and prevent complications from hypertension, as well as potential adverse effects related to overmedication. The authors present the case of a 44-year-old woman with poor blood pressure control, dealing with side effects from the prescribed medication, hoping to highlight the importance of a family-approach when addressing these factors.
Objectives: To describe the worldwide use of the International Classification of Primary Care (IC... more Objectives: To describe the worldwide use of the International Classification of Primary Care (ICPC) and other classifications in primary care settings and to identify details of ICPC use in each country. Methods: A research survey with a questionnaire requiring self-completion was emailed to members of the WONCA International Classification Committee (WICC) and family physicians (FP) from each country recognized by the United Nations (UN). Results: We obtained the e-mail addresses of representatives from 109 countries and received 61 responses (out of 259 requests sent) to the questionnaire from 52 different countries; 30 were obtained from Europe, 8 from Asia, 7 from America, 6 from Africa, and 1 from Oceania. In 34 countries (17%), a version of ICPC was available in a national language. ICPC was used in primary care setting in 27 countries (14%), but it was a mandatory standard in only 6 (3%). Assessment of the topics accounted for in the clinical records showed that 10 countries used ICPC to classify the patient's reasons for encounter and diagnosis, while just 5 countries used ICPC to classify the patient's reasons for encounter, diagnosis, and processes of care. Of the 24 countries responding that the use of ICPC for clinical records was not promoted in primary care, 19 used the 10 th edition of the International Classification of Diseases (ICD), 3 used other classifications, and 2 did not use any classification. Conclusions: Although the response rate to the questionnaire was low, we concluded that ICPC use is not widespread globally. Even for those countries reporting the use of ICPC in primary care, it is usually not a mandatory standard. Abstract Keywords: International Classification
Objetivo: Avaliar se o género do paciente condiciona o diagnóstico de depressão e ansiedade e a e... more Objetivo: Avaliar se o género do paciente condiciona o diagnóstico de depressão e ansiedade e a escolha da terapêutica antidepressiva no contexto dos cuidados de saúde primários (CSP) em Portugal. Tipo de estudo: Observacional, analítico e transversal. Local: Escolas de Outono da Associação Portuguesa de Medicina Geral e Familiar (APMGF) 2014. População: Definiu-se uma amostra de conveniência constituída por médicos de família e internos de medicina geral e familiar (MGF) que participaram no evento, sem restrição de anos de prática clínica. Métodos: Aplicou-se um questionário anónimo de autopreenchimento com base na leitura de uma história clínica com duas versões que diferiam apenas no género do paciente. Cada participante teve acesso a apenas uma versão. Resultados: Obtiveram-se 79 respostas para cada versão (158 inquiridos). Nesta amostra, 82,3% dos inquiridos são mulheres e 90,5% são internos.A média total de idades é 29,7 anos.A probabilidade de atribuir o diagnóstico de depressão foi ligeiramente superior na versão referente ao paciente do género feminino (p=0,046). Relativamente ao diagnóstico de ansiedade encontrou-se uma diferença estatisticamente significativa (p<0,001), sendo mais provável este diagnóstico quan- do o paciente é do sexo masculino. Não houve diferenças quanto à probabilidade de recuperar sem terapêutica, beneficiar de terapêutica antidepressiva ou psicoterapia e na gravidade atribuída ao quadro depressivo. Conclusões: Perante um quadro clínico de depressão, o género do paciente não parece influenciar o diagnóstico de depressão. Face aos mesmos sintomas, o género masculino correlaciona-se com uma maior probabilidade de diagnóstico de ansiedade. Contudo, a abordagem com recurso a histórias clínicas padronizadas pode não representar as escolhas dos participantes na prática clínica.A amostra selecionada tem maioritariamente internos, inviabilizando a extrapolação para a população de especialistas. Este trabalho serve como ponto de partida para uma reflexão crítica relativamente à possibilidade da perceção clínica ser afetada por estereótipos associados ao género.
Objective: To assess whether the gender of the patient is associated with the diagnosis of depres... more Objective: To assess whether the gender of the patient is associated with the diagnosis of depression and anxiety and the use of antidepressant therapy by family physicians in Portugal. Type of study: cross-sectional. Place: Autumn Schools of Associação Portuguesa de Medicina Geral e Familiar in 2014. Population: A convenience sample of family physicians and family medicine residents participating in this continuing education event. Methods:We distributed an anonymous, self-administered questionnaire containing two case vignettes that differed only in the gender of the patient. Each participant had access to only one version. Results:We collected 79 responses for each version (158 respondents). In this sample, 82.3% of respondents were female and 90.5% were family medicine residents. The average age of the sample is 29.7 years. The difference between the male and female case vignette for the diagnosis of depression was p=0.046. The diagnosis of anxiety was more likely in male patients with a statistically significant difference (p<0.001). There were no differences between genders regarding the prediction of recovery without medication, predicted benefit from antidepressant therapy or psychotherapy, and the severity of depression. Conclusions:When facing symptoms of a major depressive episode, the patient’s gender does not appear to influence the diagnosis of depression by family physicians. Given the same symptoms, male patients were more likely to be diagnosed with anxiety. The use of standardized clinical vignettes may not represent the participants’ actual choices in clinical situations. This sample was composed mainly of family medicine residents attending an educational event. It may not be representative of all family physicians in Portugal. This study may serve as a starting point for critical reflection on the effects of patient gender on clinical perception.
The aim of this study was to assess empathy in family medicine trainees and to compare the level ... more The aim of this study was to assess empathy in family medicine trainees and to compare the level of empathy in first and final year trainees. Type of study: Cross-sectional. Location: Healthcare Regional Administrations (HRA) in Portugal. Population: Family medicine trainees in Portuguese HRA. Methods: We gave an anonymous, self-administered questionnaire, including the Jefferson Scale of Physician Empathy (JSPE), adapted and validated for Portugal, to a convenience sample of family medicine residents. The surveys were distributed in person or sent by personal e-mail. Statistical analysis was performed using SPSS (R) 19.0. Results:We collected 304 questionnaires. Of these, 84 were from trainees who began their training in 2012 (response rate (RR)=20.6%). The remaining 220 questionnaires were from trainees who began their training in 2016 (RR=42.3%). Most of the trainees were enrolled in programs in the Lisbon and Tejo Valley regions (52.4% and 61.4% respectively). There were no significant differences in gender between the two groups. There were no significant differences in the median levels (M) of empathy [ME(2012)=119.00; ME(2016)=118.00; p=0.678] between the first and final year trainees. Prior training in communication skills was not associated with a higher empathy score. Female participants had significantly higher empathy scores (p=0.008). Conclusions: Our results were comparable to national and international studies on empathy in medical students and trainees. Empathy does not seem to be associated with residency or undergraduate training. The low response rate obtained limits the representativeness of the sample and the validity of the findings. However this study presents an initial look at the variation in empathy during family medicine residency training in Portugal.
A doença mental configura atualmente a principal causa de incapacidade e uma das principais causa... more A doença mental configura atualmente a principal causa de incapacidade e uma das principais causas de morbilidade e morte prematura em todo o mundo, prevendo-se que, no ano de 2020, ocupe o segundo lugar na lista de patologias que condicionam a morbilidade a ní
Resumo Pretende-se conhecer as dificuldades sentidas pelos médicos de família (MF) na abordagem d... more Resumo Pretende-se conhecer as dificuldades sentidas pelos médicos de família (MF) na abordagem dos doentes com transtornos mentais (TM) e conhecer as suas propostas para melhorar os cuidados os cuidados de saúde mental (CSM). Estudo qualitativo. Realizaram-se entrevistas semiestruturadas e audio-gravadas a 10 MF. Com análise de conteúdo identificaram-se oito categorias temáticas: condições de trabalho percecionadas; formação em saúde; terapêuticas usadas para tratamento dos TM; instrumentos de saúde mental usados na consulta; TM abordados na atenção primária (AP) e referenciadas a cuidados hospitalares; reação do doente à referenciação; articulação da atenção primária com a psiquiatria; propostas para melhorar os CSM na AP. A articulação com os serviços de saúde mental é deficiente pela falta de acessibilidade, comunicação unidirecional e atraso na resposta. Para melhorar os MF propõem criação de consultorias; equipes multidisciplinares; plataformas que permitam a comunicação bidir...
IntroductionGood patient outcomes correlate with the physicians’ capacity for good clinical judge... more IntroductionGood patient outcomes correlate with the physicians’ capacity for good clinical judgement. Multimorbidity is common and it increases uncertainty and complexity in the clinical encounter. However, healthcare systems and medical education are centred on individual diseases. In consequence, recognition of the patient as the centre of the decision-making process becomes even more difficult. Research in clinical reasoning and medical decision in a real-world context is needed. The aim of the present review is to identify and synthesise available qualitative evidence on primary care physicians’ perspectives, views or experiences on decision-making with patients with multimorbidity.Methods and analysisThis will be a systematic review of qualitative research where PubMed, CINAHL, PsycINFO, Embase and Web of Science will be searched, supplemented with manual searches of reference lists of included studies. Qualitative studies published in Portuguese, Spanish and English language ...
Revista Brasileira de Medicina de Família e Comunidade, 2016
Objetivo: Caracterizar a utilização mundial da Classificação Internacional em Atenção Primária (C... more Objetivo: Caracterizar a utilização mundial da Classificação Internacional em Atenção Primária (CIAP) e outras classificações de saúde ao nível da Atenção Primária à Saúde (APS) e identificar especificidades de utilização em cada país. Métodos: Questionário de autopreenchimento enviado a membros do Comitê Internacional de Classificações da WONCA (WICC) e médicos de família de cada um dos países reconhecidos como tal pela Organização das Nações Unidas (ONU). Resultados: Obtiveram-se contatos de e-mail de representantes de 109 países e foram recebidas 61 respostas (de 259 pedidos de colaboração enviados) de 52 diferentes países: 30 da Europa, 8 da Ásia, 7 da América, 6 de África e um da Oceania. Em 34 países (17%), há uma versão da CIAP disponível na língua nacional. A CIAP é usada na APS em 27 países (14%), mas é obrigatória em apenas 6 (3%). Em relação aos tópicos contabilizados nos registos clínicos, 10 países usam-na para classificar unicamente motivos de consulta e problemas e ap...
Revista da Associacao Medica Brasileira (1992), 2018
Surveys are a useful tool in primary care. However, low response rates can introduce selection bi... more Surveys are a useful tool in primary care. However, low response rates can introduce selection bias, impairing both external and internal validity. The aim of this study was to assess the average response rate in surveys with Portuguese general practitioners (GPs). We searched the Medline, Web of Science, Scopus, Embase, PsychInfo, SciELO, IndexRMP, RCAAP, Revista Portuguesa de Medicina Geral e Familiar, Acta Médica Portuguesa and the proceedings of conferences of general practice from incepton to December 2016. We included all postal, e-mail, telephone and personal surveys to primary care physicians without language restrictions. We did not assess risk of bias of included studies, since the main outcome was survey response rate. We performed planned subgroup analyses of the use of monetary incentives, the use of non-monetary incentives, survey delivery modes and prior contact with participants. A total of 1,094 papers were identified and 37 studies were included in this review. The...
Arterial Hypertension is a multifactorial cardiovascular risk factor responsible for high morbidi... more Arterial Hypertension is a multifactorial cardiovascular risk factor responsible for high morbidity and mortality. Given the complexity of its pathophysiology, a patient-oriented and holistic approach is essential in order to optimize blood pressure control and prevent complications from hypertension, as well as potential adverse effects related to overmedication. The authors present the case of a 44-year-old woman with poor blood pressure control, dealing with side effects from the prescribed medication, hoping to highlight the importance of a family-approach when addressing these factors.
Objectives: To describe the worldwide use of the International Classification of Primary Care (IC... more Objectives: To describe the worldwide use of the International Classification of Primary Care (ICPC) and other classifications in primary care settings and to identify details of ICPC use in each country. Methods: A research survey with a questionnaire requiring self-completion was emailed to members of the WONCA International Classification Committee (WICC) and family physicians (FP) from each country recognized by the United Nations (UN). Results: We obtained the e-mail addresses of representatives from 109 countries and received 61 responses (out of 259 requests sent) to the questionnaire from 52 different countries; 30 were obtained from Europe, 8 from Asia, 7 from America, 6 from Africa, and 1 from Oceania. In 34 countries (17%), a version of ICPC was available in a national language. ICPC was used in primary care setting in 27 countries (14%), but it was a mandatory standard in only 6 (3%). Assessment of the topics accounted for in the clinical records showed that 10 countries used ICPC to classify the patient's reasons for encounter and diagnosis, while just 5 countries used ICPC to classify the patient's reasons for encounter, diagnosis, and processes of care. Of the 24 countries responding that the use of ICPC for clinical records was not promoted in primary care, 19 used the 10 th edition of the International Classification of Diseases (ICD), 3 used other classifications, and 2 did not use any classification. Conclusions: Although the response rate to the questionnaire was low, we concluded that ICPC use is not widespread globally. Even for those countries reporting the use of ICPC in primary care, it is usually not a mandatory standard. Abstract Keywords: International Classification
Objetivo: Avaliar se o género do paciente condiciona o diagnóstico de depressão e ansiedade e a e... more Objetivo: Avaliar se o género do paciente condiciona o diagnóstico de depressão e ansiedade e a escolha da terapêutica antidepressiva no contexto dos cuidados de saúde primários (CSP) em Portugal. Tipo de estudo: Observacional, analítico e transversal. Local: Escolas de Outono da Associação Portuguesa de Medicina Geral e Familiar (APMGF) 2014. População: Definiu-se uma amostra de conveniência constituída por médicos de família e internos de medicina geral e familiar (MGF) que participaram no evento, sem restrição de anos de prática clínica. Métodos: Aplicou-se um questionário anónimo de autopreenchimento com base na leitura de uma história clínica com duas versões que diferiam apenas no género do paciente. Cada participante teve acesso a apenas uma versão. Resultados: Obtiveram-se 79 respostas para cada versão (158 inquiridos). Nesta amostra, 82,3% dos inquiridos são mulheres e 90,5% são internos.A média total de idades é 29,7 anos.A probabilidade de atribuir o diagnóstico de depressão foi ligeiramente superior na versão referente ao paciente do género feminino (p=0,046). Relativamente ao diagnóstico de ansiedade encontrou-se uma diferença estatisticamente significativa (p<0,001), sendo mais provável este diagnóstico quan- do o paciente é do sexo masculino. Não houve diferenças quanto à probabilidade de recuperar sem terapêutica, beneficiar de terapêutica antidepressiva ou psicoterapia e na gravidade atribuída ao quadro depressivo. Conclusões: Perante um quadro clínico de depressão, o género do paciente não parece influenciar o diagnóstico de depressão. Face aos mesmos sintomas, o género masculino correlaciona-se com uma maior probabilidade de diagnóstico de ansiedade. Contudo, a abordagem com recurso a histórias clínicas padronizadas pode não representar as escolhas dos participantes na prática clínica.A amostra selecionada tem maioritariamente internos, inviabilizando a extrapolação para a população de especialistas. Este trabalho serve como ponto de partida para uma reflexão crítica relativamente à possibilidade da perceção clínica ser afetada por estereótipos associados ao género.
Objective: To assess whether the gender of the patient is associated with the diagnosis of depres... more Objective: To assess whether the gender of the patient is associated with the diagnosis of depression and anxiety and the use of antidepressant therapy by family physicians in Portugal. Type of study: cross-sectional. Place: Autumn Schools of Associação Portuguesa de Medicina Geral e Familiar in 2014. Population: A convenience sample of family physicians and family medicine residents participating in this continuing education event. Methods:We distributed an anonymous, self-administered questionnaire containing two case vignettes that differed only in the gender of the patient. Each participant had access to only one version. Results:We collected 79 responses for each version (158 respondents). In this sample, 82.3% of respondents were female and 90.5% were family medicine residents. The average age of the sample is 29.7 years. The difference between the male and female case vignette for the diagnosis of depression was p=0.046. The diagnosis of anxiety was more likely in male patients with a statistically significant difference (p<0.001). There were no differences between genders regarding the prediction of recovery without medication, predicted benefit from antidepressant therapy or psychotherapy, and the severity of depression. Conclusions:When facing symptoms of a major depressive episode, the patient’s gender does not appear to influence the diagnosis of depression by family physicians. Given the same symptoms, male patients were more likely to be diagnosed with anxiety. The use of standardized clinical vignettes may not represent the participants’ actual choices in clinical situations. This sample was composed mainly of family medicine residents attending an educational event. It may not be representative of all family physicians in Portugal. This study may serve as a starting point for critical reflection on the effects of patient gender on clinical perception.
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Papers by Nuno Basilio
of its pathophysiology, a patient-oriented and holistic approach is essential in order to optimize blood pressure control and prevent complications from hypertension, as well as potential adverse
effects related to overmedication. The authors present the case of a 44-year-old woman with poor blood pressure control, dealing with side
effects from the prescribed medication, hoping to highlight the importance of a family-approach when addressing these factors.
Tipo de estudo: Observacional, analítico e transversal.
Local: Escolas de Outono da Associação Portuguesa de Medicina Geral e Familiar (APMGF) 2014.
População: Definiu-se uma amostra de conveniência constituída por médicos de família e internos de medicina geral e familiar (MGF) que participaram no evento, sem restrição de anos de prática clínica.
Métodos: Aplicou-se um questionário anónimo de autopreenchimento com base na leitura de uma história clínica com duas versões que diferiam apenas no género do paciente. Cada participante teve acesso a apenas uma versão.
Resultados: Obtiveram-se 79 respostas para cada versão (158 inquiridos). Nesta amostra, 82,3% dos inquiridos são mulheres e 90,5% são internos.A média total de idades é 29,7 anos.A probabilidade de atribuir o diagnóstico de depressão foi ligeiramente superior na versão referente ao paciente do género feminino (p=0,046). Relativamente ao diagnóstico de ansiedade encontrou-se uma diferença estatisticamente significativa (p<0,001), sendo mais provável este diagnóstico quan-
do o paciente é do sexo masculino. Não houve diferenças quanto à probabilidade de recuperar sem terapêutica, beneficiar de terapêutica antidepressiva ou psicoterapia e na gravidade atribuída ao quadro depressivo.
Conclusões: Perante um quadro clínico de depressão, o género do paciente não parece influenciar o diagnóstico de depressão. Face aos mesmos sintomas, o género masculino correlaciona-se com uma maior probabilidade de diagnóstico de ansiedade. Contudo, a abordagem com recurso a histórias clínicas padronizadas pode não representar as escolhas dos participantes na prática clínica.A amostra selecionada tem maioritariamente internos, inviabilizando a extrapolação para a população de especialistas. Este trabalho serve como ponto de partida para uma reflexão crítica relativamente à possibilidade da perceção clínica ser afetada por estereótipos associados ao género.
use of antidepressant therapy by family physicians in Portugal.
Type of study: cross-sectional.
Place: Autumn Schools of Associação Portuguesa de Medicina Geral e Familiar in 2014.
Population: A convenience sample of family physicians and family medicine residents participating in this continuing education
event.
Methods:We distributed an anonymous, self-administered questionnaire containing two case vignettes that differed only
in the gender of the patient. Each participant had access to only one version.
Results:We collected 79 responses for each version (158 respondents). In this sample, 82.3% of respondents were female
and 90.5% were family medicine residents. The average age of the sample is 29.7 years. The difference between the male
and female case vignette for the diagnosis of depression was p=0.046. The diagnosis of anxiety was more likely in male patients
with a statistically significant difference (p<0.001). There were no differences between genders regarding the prediction
of recovery without medication, predicted benefit from antidepressant therapy or psychotherapy, and the severity of
depression.
Conclusions:When facing symptoms of a major depressive episode, the patient’s gender does not appear to influence the
diagnosis of depression by family physicians. Given the same symptoms, male patients were more likely to be diagnosed
with anxiety. The use of standardized clinical vignettes may not represent the participants’ actual choices in clinical situations.
This sample was composed mainly of family medicine residents attending an educational event. It may not be representative
of all family physicians in Portugal. This study may serve as a starting point for critical reflection on the effects of
patient gender on clinical perception.
of its pathophysiology, a patient-oriented and holistic approach is essential in order to optimize blood pressure control and prevent complications from hypertension, as well as potential adverse
effects related to overmedication. The authors present the case of a 44-year-old woman with poor blood pressure control, dealing with side
effects from the prescribed medication, hoping to highlight the importance of a family-approach when addressing these factors.
Tipo de estudo: Observacional, analítico e transversal.
Local: Escolas de Outono da Associação Portuguesa de Medicina Geral e Familiar (APMGF) 2014.
População: Definiu-se uma amostra de conveniência constituída por médicos de família e internos de medicina geral e familiar (MGF) que participaram no evento, sem restrição de anos de prática clínica.
Métodos: Aplicou-se um questionário anónimo de autopreenchimento com base na leitura de uma história clínica com duas versões que diferiam apenas no género do paciente. Cada participante teve acesso a apenas uma versão.
Resultados: Obtiveram-se 79 respostas para cada versão (158 inquiridos). Nesta amostra, 82,3% dos inquiridos são mulheres e 90,5% são internos.A média total de idades é 29,7 anos.A probabilidade de atribuir o diagnóstico de depressão foi ligeiramente superior na versão referente ao paciente do género feminino (p=0,046). Relativamente ao diagnóstico de ansiedade encontrou-se uma diferença estatisticamente significativa (p<0,001), sendo mais provável este diagnóstico quan-
do o paciente é do sexo masculino. Não houve diferenças quanto à probabilidade de recuperar sem terapêutica, beneficiar de terapêutica antidepressiva ou psicoterapia e na gravidade atribuída ao quadro depressivo.
Conclusões: Perante um quadro clínico de depressão, o género do paciente não parece influenciar o diagnóstico de depressão. Face aos mesmos sintomas, o género masculino correlaciona-se com uma maior probabilidade de diagnóstico de ansiedade. Contudo, a abordagem com recurso a histórias clínicas padronizadas pode não representar as escolhas dos participantes na prática clínica.A amostra selecionada tem maioritariamente internos, inviabilizando a extrapolação para a população de especialistas. Este trabalho serve como ponto de partida para uma reflexão crítica relativamente à possibilidade da perceção clínica ser afetada por estereótipos associados ao género.
use of antidepressant therapy by family physicians in Portugal.
Type of study: cross-sectional.
Place: Autumn Schools of Associação Portuguesa de Medicina Geral e Familiar in 2014.
Population: A convenience sample of family physicians and family medicine residents participating in this continuing education
event.
Methods:We distributed an anonymous, self-administered questionnaire containing two case vignettes that differed only
in the gender of the patient. Each participant had access to only one version.
Results:We collected 79 responses for each version (158 respondents). In this sample, 82.3% of respondents were female
and 90.5% were family medicine residents. The average age of the sample is 29.7 years. The difference between the male
and female case vignette for the diagnosis of depression was p=0.046. The diagnosis of anxiety was more likely in male patients
with a statistically significant difference (p<0.001). There were no differences between genders regarding the prediction
of recovery without medication, predicted benefit from antidepressant therapy or psychotherapy, and the severity of
depression.
Conclusions:When facing symptoms of a major depressive episode, the patient’s gender does not appear to influence the
diagnosis of depression by family physicians. Given the same symptoms, male patients were more likely to be diagnosed
with anxiety. The use of standardized clinical vignettes may not represent the participants’ actual choices in clinical situations.
This sample was composed mainly of family medicine residents attending an educational event. It may not be representative
of all family physicians in Portugal. This study may serve as a starting point for critical reflection on the effects of
patient gender on clinical perception.