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Practice of Biopsychosocial Medicine in Portugal: Perspectives of Professionals Involved

Published online by Cambridge University Press:  10 January 2013

M. Graça Pereira*
Affiliation:
Universidade do Minho (Portugal)
Alfonso Alonso Fachado
Affiliation:
Vila Verde Health Care Center (Portugal)
Thomas Edward Smith
Affiliation:
Florida State University (USA)
*
Correspondence concerning this article should be addressed to M. Graça Pereira. Universidade do Minho. IEP. 4710 Braga, Portugal. Phone: 351-938471039. E-mail: [email protected]

Abstract

Although, recently, the biopsychosocial approach has been emphasized in the practice of family medicine, how psychologists and physicians interact in collaborative family health care practice is still emerging in Portugal. This article describes a qualitative study that focused on the understanding of psychologists and family physicians' perceptions of their role and the collaborative approach in health care.

A questionnaire gathered information regarding collaboration, referral, training and the practice of biopsychosocial medicine. A content analysis on respondents' discourse was performed. Results show that both physicians and psychologists agree on the importance of the biopsychosocial model and interdisciplinary collaboration. However, they also mentioned several difficulties that have to do with the lack of psychologists working full time in health care centers, lack of communication and different expectancies regarding each other roles in health care delivery.

Both physicians and psychologists acknowledge the lack of academic training and consider the need for multidisciplinary teams in their training and practice to improve collaboration and integrative care. Implications for future research and for the practice of biopsychosocial medicine are addressed.

Aunque recientemente se ha subrayado el abordaje biopsicosocial en la práctica de la medicina familiar, la forma en que interactúan psicólogos y médicos en el cuidado de la salud familiar todavía está empezando en Portugal. Este artículo describe un estudio cualitativo que se centra en la comprensión de las percepciones de los psicólogos y médicos de familia de su papel y del abordaje colaborativo en el cuidado de la salud.

Mediante un cuestionario, se recogió información acerca de la colaboración, derivación, entrenamiento y práctica de la medicina biopsicosocial. Se realizó un análisis de contenido del discurso de los respondientes. Los resultados muestran que tanto médicos como psicólogos están de acuerdo en la importancia del modelo biopsicosocial y la colaboración multidisciplinaria. Sin embargo, también mencionaron varias dificultades que tienen que ver con la falta de psicólogos que trabajen a tiempo completo en los centros de salud, la falta de comunicación y las diferentes expectativas acerca de sus roles en el servicio del cuidado de salud. Tanto los médicos como los psicólogos reconocen

la falta de formación académica y consideran la necesidad de equipos multidisciplinarios en su formación y práctica para mejorar la colaboración y el cuidado íntegro. Se comentan las implicaciones para la investigación futura y para la práctica de la medicina biopsicosocial.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2009

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References

Bardin, L. (1991). Análise de Conteúdo. Lisboa edições 70.Google Scholar
Benson, H., & Stuart, E.M. (1993). The Wellness Book: The comprehensive guide to maintaining health and treating stress-related illness. Simon & Schuster, New YorkGoogle Scholar
Bloch, D. A. (1983). Family Systems Medicine: The field and the journal. Family Systems Medicine, 2, 3745.Google Scholar
Bloch, D. A. (1984). You can tell a book by its cover. Family Systems Medicine, 2(2), 123124.Google Scholar
Blount, A. (2003). Integrated primary care: Organizing the evidence. Family, Systems and Health, 21(2), 121134.CrossRefGoogle Scholar
Campbell, T. L. & McDaniel, S.H. (1987). Applying a systems approach to common medical problems. In Crouch, M. and Roberts, L. (Eds). The family in medical practice: A systems primer. New York. Springer-Verlag.Google Scholar
Capra, F. (1982). The turning point: Science, society and the rising culture. New York, Simon and Schuster.Google Scholar
Crane, D.D. (1986). The family therapist, the primary care physician, and the health maintenance organization: Pitfalls and possibilities. Family Systems Medicine, 7(29), 208212.Google Scholar
DeVries, M. J. (1981). The redemption of the intangible in medicine. London: Psychosynthesis Monographs.Google Scholar
Doherty, W. J., Baird, M. A., & Becker, L. (1987). Family medicine and the biopsychosocial model: The road toward integration. Marriage and Family Review, 10, 5170.CrossRefGoogle Scholar
Dossey, L. (1984). Beyond illness: Discovering the experience of health. Boulder, CO New Science Library.Google Scholar
Dymn, B. & Berman, S. (1986). The primary health care team: Family physician and family therapist in joint practice. Family Systems Medicine, 4, 921.Google Scholar
Engel, G. L. (1977). The need of a new medical model: A challenge for biomedicine. Science, 196, 129136.CrossRefGoogle Scholar
Glenn, M. L. (1985). Toward collaborative family -oriented health care. Family Systems Medicine, 3(4), 466475.CrossRefGoogle Scholar
Glenn, M. L. (1985). Toward collaborative family -oriented health care. Family Systems Medicine, 3(4), 466475.CrossRefGoogle Scholar
Hemmings, A. (2000). A systemic review of the effectiveness of brief psychological therapies in primary health care. Family, Systems and Helth, 18, 279313.CrossRefGoogle Scholar
Hepworth, J, Gavazzi, S.M., Adlin, M.S. & Miller, W. L. (1988). Training for collaboration: Internships for family therapy students in a medical setting. Family Systems Medicine, 6, (1), 6979.CrossRefGoogle Scholar
McDaniel, S. H., & Amos, S. (1983). The risk of change: Teaching the family as the unit of care. Family Systems Medicine, 1(3), 2530.CrossRefGoogle Scholar
McDaniel, S. H., Hepworth, J., & Doherty, W. J. (1992). Medical family therapy. New York: Guildford.Google Scholar
McDaniel, S.Campbell, T. & Seaburn, D. (1995). Principles for collaboration between health and mental health providers in primary care. Family Systems Medicine, 13, 283298.CrossRefGoogle Scholar
Miller, H., Hall, S. & Hunley, S. (2004). Value perceptions of integrative health care: A study of primary care physiians and professionals clinical counselors. Journal of Contemporary Psychotherapy, 34(2, 117124.CrossRefGoogle Scholar
Pereira, M. G. & Smith, T. (2006). Evolution of the biopsychosocial model in the practice of family therapy. International Journal of Clinical and Health Psychology, 6(2), 455467.Google Scholar
Pereira, M.G. & Rotan, L. (1996). O psicólogo no Contexto de Saúde: Modelos de Colaboração. Análise Psicológica, (2/3), Serie (XIV), 357361.Google Scholar
Pereira, M.G. & Smith, T. (2003). Collaborative family health care: What do Practitioners think? International Journal of Clinical and Health Psychology, 3(2), 283299.Google Scholar
Pereira, M.G. & Smith, T. (2004). Collaborative family health care in an hospital setting: A pilot study on physicians and therapists' perceptions. International Journal of Clinical and Health Psychology, 4(3), 639650.Google Scholar
Pereira, M.G. & Smith, T. (2006). Family Systems Medicine: What's in a name?. Arquivos de Psiquiatria, (3,)12, 7183.Google Scholar
Ransom, D.C. (1987). Ethical questions and systems approaches. Family Systems Medicine, 5(1), 135143.CrossRefGoogle Scholar
Ripado, C. (1977). Editorial. Familiarmente, 0 (0), 1.Google Scholar
Seaburn, D.B., Lorenz, A, Gunn, W. B. Jr., Gawinsky, BA, & Mauksch, L.B. (1996). Models of collaboration. New York, Basic Books.Google Scholar
Smith, T. E., Sells, S., & Clevenger, T. (1994). Ethnographic content analysis of couple and therapist perceptions in a Reflecting Team setting. Journal of Marital and Family Therapy, 20, 267286.CrossRefGoogle Scholar
Spradley, J. P. (1979). The ethnographic interview. New York: Holt, Rinehart & WinstonGoogle Scholar
Stozier, M. & Walsh, M. (1998). Developmental models for integrating medical and mental health care. Family Systems and Health, 16(1/2), 2740.CrossRefGoogle Scholar
Von Bertalanffy, , (1968). General Systems Theory. New York, George Braziller.Google Scholar
Wynne, L. C. (1988). An Overview of the State of Art: What should be expected in current family therapy research? In Wynne, L. C. (Ed.), The state of the art in family therapy research: Controversies and recommendations (pp. 14). New York: Family Process Press.Google Scholar