Practice of biopsychosocial medicine in Portugal: perspectives of professionals involved

• M. Graça Pereira ^[1] ; Alfonso Alonso Fachado ^[3] ; Thomas Edward Smith ^[2]
  1. [1] Universidade do Minho

     Universidade do Minho

     Braga (São José de São Lázaro), Portugal

     
  2. [2] Florida State University

     Florida State University

     Estados Unidos

     
  3. [3] Vila Verde Health Care Center

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• Localización: The Spanish Journal of Psychology, ISSN 1138-7416, Vol. 12, Nº. 1, 2009, págs. 217-225
• Idioma: inglés
• DOI: 10.1017/s1138741600001621
• Enlaces
  • Texto completo
• Resumen
  • español

    Aunque recientemente se ha subrayado el abordaje biopsicosocial en la práctica de la medicina familiar, la forma en que interactúan psicólogos y médicos en el cuidado de la salud familiar todavía está empezando en Portugal. Este artículo describe un estudio cualitativo que se centra en la comprensión de las percepciones de los psicólogos y médicos de familia de su papel y del abordaje colaborativo en el cuidado de la salud. Mediante un cuestionario, se recogió información acerca de la colaboración, derivación, entrenamiento y práctica de la medicina biopsicosocial. Se realizó un análisis de contenido del discurso de los respondientes. Los resultados muestran que tanto médicos como psicólogos están de acuerdo en la importancia del modelo biopsicosocial y la colaboración multidisciplinaria. Sin embargo, también mencionaron varias dificultades que tienen que ver con la falta de psicólogos que trabajen a tiempo completo en los centros de salud, la falta de comunicación y las diferentes expectativas acerca de sus roles en el servicio del cuidado de salud. Tanto los médicos como los psicólogos reconocen la falta de formación académica y consideran la necesidad de equipos multidisciplinarios en su formación y práctica para mejorar la colaboración y el cuidado íntegro. Se comentan las implicaciones para la investigación futura y para la práctica de la medicina biopsicosocial.

  • English

    Although, recently, the biopsychosocial approach has been emphasized in the practice of family medicine, how psychologists and physicians interact in collaborative family health care practice is still emerging in Portugal. This article describes a qualitative study that focused on the understanding of psychologists and family physicians' perceptions of their role and the collaborative approach in health care. A questionnaire gathered information regarding collaboration, referral, training and the practice of biopsychosocial medicine. A content analysis on respondents' discourse was performed. Results show that both physicians and psychologists agree on the importance of the biopsychosocial model and interdisciplinary collaboration. However, they also mentioned several difficulties that have to do with the lack of psychologists working full time in health care centers, lack of communication and different expectancies regarding each other roles in health care delivery. Both physicians and psychologists acknowledge the lack of academic training and consider the need for multidisciplinary teams in their training and practice to improve collaboration and integrative care. Implications for future research and for the practice of biopsychosocial medicine are addressed.

• Referencias bibliográficas
  • Bardin, L. (1991). Análise de Conteúdo. Lisboa edições 70.
  • Benson, H., & Stuart, E.M. (1993). The Wellness Book: The comprehensive guide to maintaining health and treating stress-related illness....
  • Bloch, D. A. (1983). Family Systems Medicine: The field and the journal. Family Systems Medicine, 2, 37–45.
  • Bloch, D. A. (1984). You can tell a book by its cover. Family Systems Medicine, 2(2), 123–124.
  • Blount, A. (2003). Integrated primary care: Organizing the evidence. Family, Systems and Health, 21(2), 121–134.
  • Campbell, T. L. & McDaniel, S.H. (1987). Applying a systems approach to common medical problems. In Crouch, M. and Roberts, L. (Eds)....
  • Capra, F. (1982). The turning point: Science, society and the rising culture. New York, Simon and Schuster.
  • Crane, D.D. (1986). The family therapist, the primary care physician, and the health maintenance organization: Pitfalls and possibilities....
  • DeVries, M. J. (1981). The redemption of the intangible in medicine. London: Psychosynthesis Monographs.
  • Doherty, W. J., Baird, M. A., & Becker, L. (1987). Family medicine and the biopsychosocial model: The road toward integration. Marriage...
  • Dossey, L. (1984). Beyond illness: Discovering the experience of health. Boulder, CO New Science Library.
  • Dymn, B. & Berman, S. (1986). The primary health care team: Family physician and family therapist in joint practice. Family Systems Medicine,...
  • Engel, G. L. (1977). The need of a new medical model: A challenge for biomedicine. Science, 196, 129–136.
  • Glenn, M. L. (1985). Toward collaborative family -oriented health care. Family Systems Medicine, 3(4), 466–475.
  • Glenn, M. L. (1985). Toward collaborative family -oriented health care. Family Systems Medicine, 3(4), 466–475.
  • Hemmings, A. (2000). A systemic review of the effectiveness of brief psychological therapies in primary health care. Family, Systems and Helth,...
  • Hepworth, J, Gavazzi, S.M., Adlin, M.S. & Miller, W. L. (1988). Training for collaboration: Internships for family therapy students in...
  • McDaniel, S. H., & Amos, S. (1983). The risk of change: Teaching the family as the unit of care. Family Systems Medicine, 1(3), 25–30.
  • McDaniel, S. H., Hepworth, J., & Doherty, W. J. (1992). Medical family therapy. New York: Guildford.
  • McDaniel, S.Campbell, T. & Seaburn, D. (1995). Principles for collaboration between health and mental health providers in primary care....
  • Miller, H., Hall, S. & Hunley, S. (2004). Value perceptions of integrative health care: A study of primary care physiians and professionals...
  • Pereira, M. G. & Smith, T. (2006). Evolution of the biopsychosocial model in the practice of family therapy. International Journal of...
  • Pereira, M.G. & Rotan, L. (1996). O psicólogo no Contexto de Saúde: Modelos de Colaboração. Análise Psicológica, (2/3), Serie (XIV), 357–361.
  • Pereira, M.G. & Smith, T. (2003). Collaborative family health care: What do Practitioners think? International Journal of Clinical and...
  • Pereira, M.G. & Smith, T. (2004). Collaborative family health care in an hospital setting: A pilot study on physicians and therapists'...
  • Pereira, M.G. & Smith, T. (2006). Family Systems Medicine: What's in a name?. Arquivos de Psiquiatria, (3,)12, 71–83.
  • Ransom, D.C. (1987). Ethical questions and systems approaches. Family Systems Medicine, 5(1), 135–143.
  • Ripado, C. (1977). Editorial. Familiarmente, 0 (0), 1.
  • Seaburn, D.B., Lorenz, A, Gunn, W. B. Jr., Gawinsky, BA, & Mauksch, L.B. (1996). Models of collaboration. New York, Basic Books.
  • Smith, T. E., Sells, S., & Clevenger, T. (1994). Ethnographic content analysis of couple and therapist perceptions in a Reflecting Team...
  • Spradley, J. P. (1979). The ethnographic interview. New York: Holt, Rinehart & Winston
  • Stozier, M. & Walsh, M. (1998). Developmental models for integrating medical and mental health care. Family Systems and Health, 16(1/2),...
  • Von Bertalanffy, , (1968). General Systems Theory. New York, George Braziller.
  • Wynne, L. C. (1988). An Overview of the State of Art: What should be expected in current family therapy research? In Wynne, L. C. (Ed.), The...