Strategies used by primary health care physicians in appointments for unexplained symptoms
a scoping review
DOI:
https://doi.org/10.5712/rbmfc20(47)3369Keywords:
Physicians family, Medically unexplained symptoms, Primary health careAbstract
Introduction: Medically unexplained symptoms are common in the routine of family and community physicians. Nevertheless, many doctors face challenges in appointments for this type of complaint. Objective: To identify the difficulties faced and the strategies used by Primary Health Care physicians in appointments with people with unexplained symptoms. Methods: A scoping review was performed. The searches were carried out in the following sources: MEDLINE via Pubmed, Cochrane Library, LILACS via VHL, and Epistemonikos. Studies that evaluated physicians who care for people with unexplained symptoms (either resident physicians or experienced physicians), the difficulties faced and the strategies used in appointments with people with unexplained symptoms in the context of primary health care were included. Results: Eight studies were selected. Based on such studies, the difficulties reported were: concerns about iatrogenesis, negative feelings arising from these appointments (frustration and anxiety), discomfort with uncertainty, biomedical model, and limited explanations. Some strategies were identified, among which the most cited were: ensuring the person’s care and the absence of severity; adopting the biopsychosocial model; having a quality dialogue; and validating symptoms as well as suffering. Conclusions: There is no set of strategies that work for all cases of medically unexplained symptoms. We present some difficulties experienced by primary health care physicians in appointments for unexplained symptoms and reported the strategies used by them, which serve as a subsidy to improve our provision of care.
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