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Schwerpunkt/Special Issue „International Shared Decision Making Conference 2022“|Articles in Press

Advances in Shared Decision Making in Brazil: The role of patient autonomy in curriculum reform, health system and clinical care

Published:October 04, 2022DOI:https://doi.org/10.1016/j.zefq.2022.05.005
Advances in Shared Decision Making in Brazil: The role of patient autonomy in curriculum reform, health system and clinical care
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      Abstract

      Clinical practice in Brazil has rapidly transformed. Doctor-patient relationships are the focus of these transformations, either within health policies or in the context of medical training. The Brazilian Curriculum Guidelines have emphasized the doctor-patient relationship as part of medical skills and competences, based on patient-centered care. In this article, we present the political advances in patient-centered care. In addition, we address an overview of the Brazilian status quo of decision aids tools. Finally, we share experiences in curriculum reform for the advances of communication skills and the interfaces with narrative medicine and the arts in curricular medical training as a means to advance towards the practice of shared decision making.

      Zusammenfassung

      Die klinische Praxis hat sich in Brasilien rasant verändert. Im Fokus dieser Transformationen stehen die Arzt-Patient-Beziehungen, und zwar entweder im Rahmen der Gesundheitspolitik oder im Kontext der medizinischen Ausbildung. Basierend auf einer patientenzentrierten Gesundheitsversorgung wird in den brasilianischen Lehrplanrichtlinien die Arzt-Patient-Beziehung als Bestandteil medizinischer Fertigkeiten und Kompetenzen hervorgehoben. In diesem Beitrag stellen wir die politischen Fortschritte in der patientenzentrierten Versorgung vor. Ferner geben wir einen Überblick über den aktuellen Stand von Entscheidungshilfe-Tools in Brasilien. Abschließend berichten wir über unsere Erfahrungen in Bezug auf die Reform der Ausbildungslehrpläne zur Förderung der Kommunikationsfertigkeiten und der Schnittstellen mit narrativer Medizin und den Künsten in der curricularen medizinischen Ausbildung als ein Mittel, um partizipative Entscheidungsfindung in der Praxis voranzutreiben.

      Keywords

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      Article info

      Publication history

      Published online: October 04, 2022
      Accepted: May 13, 2022
      Received in revised form: April 23, 2022
      Received: March 18, 2022

      Publication stage

      In Press Corrected Proof

      Identification

      DOI: https://doi.org/10.1016/j.zefq.2022.05.005

      Copyright

      © 2022 THE AUTHORS. Published by Elsevier BV on behalf of Faculty of Engineering, Alexandria University

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