Relação entre comunicação médico-doente e resultados clínicos na hipertensão

• Autor(a) principal: Márcia Maria da Rocha Oliveira
• Data de Publicação: 2023
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://hdl.handle.net/10216/150246
• topic: Ciências médicas e da saúde; Medical and Health sciences

Background: High blood pressure is a chronical condition with a significant prevalence in Portugal, representing a major risk factor for cardiovascular diseases. Adherence to the therapeutics and acceptance of a healthier lifestyle have proven to have a remarkable effect on controlling this condition, although many patients do not reach ideal blood pressure values. An effective communication between patient and doctor might contribute to improve patients' adherence to the therapeutics and to healthier lifestyles, promoting better overall clinical results. Objectives: To assess the association between the quality of doctor-patient communication, from the patient's point of view, and the outcomes regarding controlled blood pressure levels. In addition to that, the study also aimed to understand which particular aspects of doctor-patient communication were more associated with managing a better blood pressure control. Methods: In this retrospective observational study, blood pressure levels were obtained from the electronical data base that contains patients' clinical records. Participants were asked to respond to a questionnaire on doctor-patient communication (the Communication Assessment Tool - CAT) regarding the relationship with their doctor. The study was approved by the ARS Norte's ethical commission. Statistical analysis was conducted using SPSS software and included non-parametric tests and logistic regression models. Results: High blood pressure values were registered for all n=78 (100%) patients in their inaugural doctor's appointment, consistent with a high blood pressure diagnosis (systolic pressure ≥ 140 mmHg; n=78; diastolic pressure ≥ 90 mmHg; n=65). In their most recent appointment, n=49 (62,8%) patients had their systolic pressure lowered to a controlled value, and n=65 (83.3%) patients had their diastolic pressure lowered to controlled values. The group with controlled blood pressure values showed a higher quality of doctor-patient communication when compared to the group with uncontrolled blood pressure values (p < 0.05), even after adjusting for potential confounding variables (p < 0.02). Twelve out of the fourteen clinical communication aspects evaluated by the CAT were significantly associated with the control of systolic blood pressure values, and eight of the fourteen were simultaneously associated with the control of both systolic and diastolic blood pressure values, such as "Speaking to the patient in terms they can understand" or "Being attentive to the patient (looking at and listening to them carefully)" (p < 0.05). Conclusion: Controlled blood pressure levels were associated with a better doctor-patient relationship. Keywords: High blood pressure, doctor-patient communication, Therapeutical relationship, Physiological markers.