Brazilian medical students’ attitudes towards patient-centered care

Abstract

Background: The doctor-patient relationship is essencial to medical care (Engel 1980; Balint 1984), however, medical schools focus mainly on biomedical subjects and don’t give the necessary attention to communication skills, humanistic attitudes, and professional values (Haidet et al. 2001, 2002).

Methods: Attitudes of medical students towards the doctor-patient relationship have been examined and the Patient-Practitioner Orientation Scale (PPOS) has been used to measure students’ and practitioners’ patient-centered beliefs, first in USA (Haidet et al. 2002), and then in several other countries (Choi & Moon 2005; Tsimtsiou et al. 2005; Shankar et al. 2006).

This study aimed to examine the attitudes of Brazilian medical students towards the doctor-patient relationship by using the PPOS.

The scale was translated into Portuguese and was administered to approximately 800 students in their first, fifth, seventh, ninth, tenth and twelfth semesters of medical school along with a socio-demographic questionnaire.

Results: A total of 738 students (>90%) completed data collection. For the entire cohort, female gender (p < 0.000), later semester in medical school (p < 0.000), primary-care specialty choice (p < 0.02) and lower familial income (p < 0.03) were significantly associated with more patient-centered attitudes. Sharing sub-scores, measuring beliefs about power and information between physician and patient, were significantly more patient-centered for twelfth semester male students than for first semester males (p < 0.000), but not for female students. Caring sub-scores, which measure beliefs about attending to patient's emotions and lifestyle, did not change with the years of school. In general, Caring scores were considerably higher than Sharing scores. Total PPOS scores in Brazil are comparable to those found among medical students in the United States, however they are considerably higher than PPOS total scores in Nepal, Greece, and Korea.

Conclusions: Communication skills and patient care needs to be critically examined by Brazilian teachers and students aiming to change attitudes toward the doctor-patient relationship to be more patient-centered attitudes.

Additional information

Notes on contributors

Maria Mônica Freitas Ribeiro

RIBEIRO, MMF conceived and designed the research, carried out data collection, analysis and interpretation and article drafting.

Edward Krupat

KRUPAT, E the author of PPOS Scale, gave permission to its use. He also gave valuable information regarding data analysis and interpretation and critically revised the manuscript.

Carlos Faria Santos Amaral

AMARAL, CFS has contributed to the conception and design of the research, the analysis and interpretation of data and also critically revised the manuscript.