Este estudo aborda a humanização da comunicação médica à luz da Medicina Centrada na Pessoa. A família como colaboradora ou substituta do paciente, representa um valor substancial na assistência demandada. Nesta direção, o recorte empírico tem como objetivo descrever e discutir opiniões de médicos de um CTI- Adulto sobre a comunicação com famílias de pacientes internados em um Hospital Universitário do Brasil. O método utilizado é qualitativo com uso da análise de conteúdo temática que resultou em duas categorias: visão de totalidade para um cuidado ampliado \"a família como colaboradora ou substituta do paciente\" e a segunda, comunicação humanizada \"olhares sobre aspectos objetivos e subjetivos para uma prática clínica centrada na pessoa\". A partir dos dados coletados e com base no referencial teórico, descrevem-se e discutem-se, conteúdos chave que enfatizam a humanização, o contexto comunicativo e o preparo do médico como um todo para o desenvolvimento permanente de habilidades demandadas. Os achados apontam reflexão sobre um cuidado ampliado tendo a medicina centrada na pessoa como norteadora, o aprendizado nesta direção enquanto permanente e com foco em competências pessoais, a comunicação como instrumento de apoio técnico somada as demais rotinas do serviço, o ato comunicativo como aliança estratégica para uma assistência qualificada, as emoções dos médicos em interface com a importância do autoconhecimento para se comunicar, o desafio de lidar com sentimentos da família, a prática de orientação e acolhimento para informar e ouvir, a empatia como legitimação do familiar. Estas considerações podem ser ponto de referência para novos campos de pesquisas e estudos de comunicação em sua amplitude no universo da saúde / This study discusses the humanization of medical communication in the light of the Person Centered Medicine. The family as a collaborator or replacement of the patient, is substantial value in the demanded assistance. In this sense, the empirical cut aims to describe and discuss opinions of doctors of a Intensive Care Unit about communicating with families of patients admitted to a university hospital in Brazil. The method used is qualitative with use of thematic content analysis which resulted in two categories: full of vision for an expanded care \"the family as a collaborator or replacement of the patient\" and humanized communication \"looks on objective and subjective aspects of a clinical practice person-centered\". From the collected data and based on the theoretical framework and complementary bibliography, are described and discussed as key elements of a humanized view of the object of study that includes: the communicative context, the feelings and emotions in this interaction, communication as a resource for diagnosis and treatment, the doctor\'s self knowledge to the communicative competence, and the preparation as a whole as a gap for the continued development of skills required to communicate with families. These considerations can be a reference point for new fields of research and studies on their range in the world of health

Este estudo aborda a humanização da comunicação médica à luz da Medicina Centrada na Pessoa. A família como colaboradora ou substituta do paciente, representa um valor substancial na assistência demandada. Nesta direção, o recorte empírico tem como objetivo descrever e discutir opiniões de médicos de um CTI- Adulto sobre a comunicação com famílias de pacientes internados em um Hospital Universitário do Brasil. O método utilizado é qualitativo com uso da análise de conteúdo temática que resultou em duas categorias: visão de totalidade para um cuidado ampliado \"a família como colaboradora ou substituta do paciente\" e a segunda, comunicação humanizada \"olhares sobre aspectos objetivos e subjetivos para uma prática clínica centrada na pessoa\". A partir dos dados coletados e com base no referencial teórico, descrevem-se e discutem-se, conteúdos chave que enfatizam a humanização, o contexto comunicativo e o preparo do médico como um todo para o desenvolvimento permanente de habilidades demandadas. Os achados apontam reflexão sobre um cuidado ampliado tendo a medicina centrada na pessoa como norteadora, o aprendizado nesta direção enquanto permanente e com foco em competências pessoais, a comunicação como instrumento de apoio técnico somada as demais rotinas do serviço, o ato comunicativo como aliança estratégica para uma assistência qualificada, as emoções dos médicos em interface com a importância do autoconhecimento para se comunicar, o desafio de lidar com sentimentos da família, a prática de orientação e acolhimento para informar e ouvir, a empatia como legitimação do familiar. Estas considerações podem ser ponto de referência para novos campos de pesquisas e estudos de comunicação em sua amplitude no universo da saúde / This study discusses the humanization of medical communication in the light of the Person Centered Medicine. The family as a collaborator or replacement of the patient, is substantial value in the demanded assistance. In this sense, the empirical cut aims to describe and discuss opinions of doctors of a Intensive Care Unit about communicating with families of patients admitted to a university hospital in Brazil. The method used is qualitative with use of thematic content analysis which resulted in two categories: full of vision for an expanded care \"the family as a collaborator or replacement of the patient\" and humanized communication \"looks on objective and subjective aspects of a clinical practice person-centered\". From the collected data and based on the theoretical framework and complementary bibliography, are described and discussed as key elements of a humanized view of the object of study that includes: the communicative context, the feelings and emotions in this interaction, communication as a resource for diagnosis and treatment, the doctor\'s self knowledge to the communicative competence, and the preparation as a whole as a gap for the continued development of skills required to communicate with families. These considerations can be a reference point for new fields of research and studies on their range in the world of health

The advent of medical journalism was initially felt to be an answer to the problem of communicating health and medical information to the public. However, currently, there is a concern among scientists with the way the media, newspapers in particular, communicate health and medical information. The concern of the medical community in particular and of the scientific community in general is that newspapers ‘distort’ health and medical information. In order to deal with this ‘perceived’ problem, scientists adopt a mechanical view and propose to solve it by issuing guidelines for journalists to follow when writing health and medical news. Close investigation of journalistic practice shows that many of the proposed guidelines are already present in journalistic practice, and yet, the concern for ‘distortion’ remains. The overall aim of the thesis is to contribute to this issue. Adopting an Applied Linguistics perspective, more specifically, using the discourse analytic methodology of Genre Analysis, the thesis demonstrates that Health and Medical News Reports are first and foremost news stories and that the proposed guidelines fail to achieve the envisaged changes precisely because they seem to be ignorant of this essential reality. In order to reach this conclusion, Genre Analysis is applied to different types of texts with a view to comparing their structures. Some of the text types used have already been described in the literature, but others are analysed for the first time in this thesis. Thus, comparison is made between Health and Medical Research Articles and Health and Medical News Reports, between Popularised Health and Medical Texts and Health and Medical News Reports, between News Texts and Health and Medical News Reports and between Health and Medical Press Releases and Health and Medical News Reports. Genre Analysis shows that Health and Medical News Reports are first and foremost news stories and, therefore, that the discourse of ‘distortion’ is somewhat ‘misguided’. However, because of its nature as a structural analysis, Genre Analysis leaves one important question unanswered, namely the ‘why’ of the discourse of distortion. Although it is beyond the scope of this thesis to investigate this question, in the thesis, it is indicated that a more context-sensitive analysis, using Critical Discourse Analysis (CDA) for example, could fruitfully be pursued. This thesis draws on four types of data. The main data set consists of Health and Medical News Reports published in The Herald and The Guardian between April and May 2007, where possible, corresponding press releases were collected. Email interviews were conducted with authors whose research was reported in the two newspapers. Finally, ethnographic observation of newsrooms and face-to-face semi-structured interviews were conducted with journalists who wrote the reports over a period of one week.

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Communication competence and medical communication competence served as the theoretical framework for this research that seeks to identify specific communication behaviors associated with what nurses say constitute a communicatively competent patient handoff at the nursing change of shift. Data collected from 286 nurses responding to an online modified Medical Communication Competence Scale posted at www.allnurses.com supported the hypotheses that information exchange (information giving, seeking and verifying) and socioemotional communication behaviors are rated more highly in the best patient handoffs than in the worst ones. Research questions found that the incoming nursing role rated behaviors associated with information verifying and socioemotional communication higher than did the outgoing nursing role, and that the worst handoffs were those in which the incoming nursing role gave the lowest ratings for information-giving behaviors. Additional insight into other communication-related characteristics associated with quality handoffs were provided as well, including location, tools/type and environment for the patient handoff at the nursing change of shift. These findings offer a foundation for future research into development of communication-based standardized patient handoff processes and training that ultimately may reduce patient care errors caused by communication failures during the patient handoff at the nursing change of shift.

För många akut sjuka patienter är alarmeringssjukvården och ambulanssjukvården den första kontakten med sjukvården. Därför är det viktigt att dessa patienter prioriteras korrekt i förhållande till sjukdomstillståndets allvarlighetsgrad. Allra viktigast är det när patientens tillstånd är potentiellt akut livshotande, i situationer när tid är liv. Förutom det fysiska hotet kan tiden kännas outhärdligt lång innan ambulansen är på plats. Rädsla för att inte bli hittad och rädsla för att tillståndet ska försämras ytterligare kan innebära en skarp konfrontation med tankar om livets ändlighet. Syftet med studien var att kartlägga om det förelåg några skillnader i prioritering mellan alarmeringssjukvården och ambulanssjukvården, vid uppdrag där ambulanssjukvården bedömt att patienten led av ett potentiellt akut livshotande tillstånd. Alarmerings- och ambulansuppdrag från en region i sydvästra Sverige analyserades i en retrospektiv kvantitativ studie. Data inkluderade varje uppdrag under 2014 som ambulanssjukvården bedömt som Prio 1 vid avtransport (n=17 184). Av dessa uppdrag var 82,4 % (n=14 676) utlarmade som Prio 1 av alarmeringssjukvården. De resterande 17,6 % (n=3138) larmades ut som Prio eller Prio 3. Väntetiden för de patienter som bedömdes som Prio 2 eller Prio 3 vid utlarmningen var 100 % längre jämfört med som larmades ut som Prio 1. De bedömda tillstånd som oftast prioriterades upp var ”Ryggbesvär” (71,7 %) och ”Buk/urinvägar” (47,6 %). Kvinnor (19,7 %) prioriterades upp i högre utsträckning än män (18,3 %). Den största skillnaden förekom i gruppen ”Våld-misshandel” där andelen upprioriterade män var 14,7 % och andelen upprioriterade kvinnor var 41,7 %. Skillnader i prioritering i relation till ålder var högst för patienter som var 81 år eller äldre (26,0 %). Slutsatsen är att det förekommer omotiverade skillnader i vård för den aktuella patientgruppen. Skillnaderna är väsentliga eftersom tillståndens svårighetsgrad är bedömda som potentiellt akut livshotande och för en del av tillstånden är effekten av både åtgärder och väntan stor. Studien visar var skillnaderna är som störst, vilket gör det lättare att bedöma vilka vidare studier som sannolikt ger mest patientnytta.

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