Toma de decisiones compartidas en la atención de pacientes con diabetes mellitus: un desafío para Latinoamérica

Serrano, Valentina; Larrea-Mantilla, Laura; Rodríguez-Gutiérrez, René; Spencer‐Bonilla, Gabriela; Málaga, Germán; Hargraves, Ian; Montori, Víctor M.

doi:10.4067/s0034-98872017000500012

Cited by 6 publications

(6 citation statements)

References 32 publications

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“…Treatments must be made available to allow for more flexible and feasible regimens that could be implemented without overwhelming patients and families. Shared decision making [ 26 ] and conversations supported by the instrument for patient capacity assessment [ 25 , 27 ], properly adapted, may facilitate this process. Information systems must be attuned to signals that care may have become overwhelming, e.g., poor fidelity to treatment programs, missed appointments, poor disease control.…”

Section: Discussionmentioning

confidence: 99%

The burden of treatment in people living with type 2 diabetes: A qualitative study of patients and their primary care clinicians

Espinoza

Varela²,

Vargas

et al. 2020

PLoS ONE

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Background The burden of treatment can overwhelm people living with type 2 diabetes and lead to poor treatment fidelity and outcomes. Chronic care programs must consider and mitigate the burden of treatment while supporting patients in achieving their goals. Objective To explore what patients with type 2 diabetes and their health providers consider are the workload and the resources they must mobilize, i.e., their capacity, to shoulder it. Methods We conducted focus groups comprised of 30 patients and 32 clinicians from three community health centers in Chile implementing the Chronic Care Model to reduce cardiovascular risk in patients with type 2 diabetes. Transcripts were analyzed using thematic content analysis techniques illuminated by the Minimally Disruptive Medicine framework. Findings Gaining access to and working with their clinicians, implementing complex medication regimens, and changing lifestyles burdened patients. To deal with the distress of the diagnosis, difficulties achieving disease control, and fear of complications, patients drew capacity from their family (mostly men), social environment (mostly women), lay expertise, and spirituality. Clinicians found that administrative tasks, limited formulary, and protocol rigidity hindered their ability to modify care plans to reduce patient workload and support their capacity. Conclusions Chronic primary care programs burden patients living with type 2 diabetes while hindering clinicians’ ability to reduce treatment workloads or support patient capacity. A collaborative approach toward Minimally Disruptive Medicine may result in treatments that fit the lives and loves of patients and improve outcomes.

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Section: Discussionmentioning

confidence: 99%

The burden of treatment in people living with type 2 diabetes: A qualitative study of patients and their primary care clinicians

Espinoza

Varela²,

Vargas

et al. 2020

PLoS ONE

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“…To know more about them, we carried out a search using keywords both in English and Spanish. We found 11 studies carried out in Mexico [9,13,[15][16][17][18][19][20][21][22]. One of these in process of publication.…”

Section: Research On Shared Decision Making (Sdm) In Mexicomentioning

confidence: 99%

“…Four studies were published in English [16][17][18]22], and the rest in Spanish. Five of them were original research [16][17][18][19][20], five were literature reviews [9,13,15,[21][22].…”

Section: Research On Shared Decision Making (Sdm) In Mexicomentioning

confidence: 99%

An overview on the promotion on patient-centered care and shared decision-making in Mexico

Armenta-Arellano

Muños-Hernández

Pavón-León

et al. 2022

Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheit

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“…En el modelo biomédico tradicional, usualmente la decisión terapéutica es tomada únicamente por el personal médico, quién informa la terapia a seguir (Menéndez, 1992). Esta concepción ha ido cambiando con el tiempo, contemplando la participación activa de los pacientes/usuarios en la toma de decisiones sobre su propia salud, demostrándose beneficios significativos (Serrano et al, 2017). En este espacio la concepción e incorporación de la interculturalidad en salud (Álvarez, 2014) ha permitido abrir caminos que reconocen, valoran y contemplan las creencias y conocimientos de los pacientes/usuarios, permitiendo un diálogo más horizontal en el espacio de salud.…”

Section: El Espacio De Atención De La Salud Como Espacio De Encuentro...unclassified

¿Qué es lo cultural del encuentro intercultural de atención de salud de poblaciones migrantes internacionales en Chile? Algunas reflexiones antropológicas

Urrutia¹,

Correa-Matus²,

Cabieses³

et al. 2022

CUHSO

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Chile se ha vuelto un país receptor de población migrante internacional en los últimos años, con creciente influjo en el tiempo. Dentro de los desafíos de la migración internacional se encuentra el acceso equitativo y oportuno de migrantes internacionales al sistema de salud, reportándose diversas barreras para el acceso a la atención de salud. Dentro de las barreras se identifica el encuentro intercultural en salud y la atención de salud con pertinencia cultural a las necesidades de la población migrante. En este ensayo se desarrolla una reflexión sobre los aspectos culturales propios del espacio de atención de salud, considerando el lugar, actores que participan de la interacción y tiempo en que ocurre la atención. Se desarrolla un marco conceptual previo para sentar bases para la reflexión, basados en los conceptos de cultura, interculturalidad en salud e interaccionismo simbólico como propuesta de acercamiento a este fenómeno. Para la realización de este artículo se lleva a cabo una revisión bibliográfica en bases de datos científicos (Pubmed, Scielo y Google Scholar) y literatura gris nacional e internacional, con el objetivo de reflexionar sobre lo cultural en el encuentro de atención de salud entre población migrante internacional y los profesionales de salud que los atienden.

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Toma de decisiones compartidas en la atención de pacientes con diabetes mellitus: un desafío para Latinoamérica

Cited by 6 publications

References 32 publications

The burden of treatment in people living with type 2 diabetes: A qualitative study of patients and their primary care clinicians

The burden of treatment in people living with type 2 diabetes: A qualitative study of patients and their primary care clinicians

An overview on the promotion on patient-centered care and shared decision-making in Mexico

¿Qué es lo cultural del encuentro intercultural de atención de salud de poblaciones migrantes internacionales en Chile? Algunas reflexiones antropológicas

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