Como se estuda o que não se diz: uma revisão sobre demanda oculta

Antônio Augusto Dall'Agnol Modesto; Marcia Thereza Couto

doi:10.5712/rbmfc11(38)1250

Autores/as

Antônio Augusto Dall'Agnol Modesto Departamento de Medicina Preventiva da Faculdade de Medicina da Universidade de São Paulo http://orcid.org/0000-0002-5898-3957
Marcia Thereza Couto Departamento de Medicina Preventiva da Faculdade de Medicina da Universidade de São Paulo http://orcid.org/0000-0001-5233-4190

DOI:

https://doi.org/10.5712/rbmfc11(38)1250

Palabras clave:

Relaciones Médico-Paciente. Comunicación. Necesidades y Demandas de Servicios de Salud. Atención Primaria de Salud.

Resumen

Objetivos: Personas con demandas aparentemente bien definidas pueden frecuentemente tener quejas o inquietudes ocultas o tardíamente presentadas, llamadas en inglés de hidden agenda, by the way syndrome o doorknob syndrome (“síndrome del pomo de la puerta”). Pocos estudios en contexto clínico discuten sus aspectos o consecuencias para el cuidado desde un punto de vista sociocultural. Una investigación cualitativa realizada sobre salud masculina requirió estudiar la literatura científica relacionada con la hidden agenda de forma descriptiva e interpretativa. Métodos: Esta revisión, de tipo estado de la cuestión, abarcó artículos que abordaban la hidden agenda (o expresiones similares) en contextos clínicos generales o especializados, médicos o multidisciplinares, en portugués, inglés o español, de 2000 a 2014. Partiendo de 210 resultados de tres bases de datos internacionales, se seleccionaron 39 publicaciones, evaluadas cuanto a características objetivas y subjetivas. Resultados: Identificando temas predominantes en las pesquisas, observamos que hidden agenda es la expresión más específica, y demanda oculta, su mejor traducción. Casi todos los estudios relacionaban la atención a demandas ocultas a mejores resultados, aunque ninguno de ellos evaluaba estas consecuencias en profundidad. Conclusiones: La revisión deja claro que la demanda oculta es un elemento problematizador para pensar en la práctica médica y potenciador de la clínica, sobre todo al buscarse una atención integral y un diálogo efectivo entre profesional y usuario(a). Se necesitan estudios que relacionen el fenómeno con aspectos socioculturales y tecnoasistenciales, y que incluyan alguna discusión sobre construcción de la demanda, ausente de los artículos revisados.

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Biografía del autor/a

Antônio Augusto Dall'Agnol Modesto, Departamento de Medicina Preventiva da Faculdade de Medicina da Universidade de São Paulo

Graduação em Medicina pela Universidade Federal do Rio de Janeiro (2007).

Residência em Medicina de Família e Comunidade pela Faculdade de Medicina da Universidade de São Paulo (2010).

Doutorando em Medicina Preventiva na Faculdade de Medicina da Universidade de São Paulo.

Preceptor da residência de Medicina de Família e Comunidade da Universidade do Estado do Rio de Janeiro.

Marcia Thereza Couto, Departamento de Medicina Preventiva da Faculdade de Medicina da Universidade de São Paulo

Graduação em Ciências Sociais pela Universidade Federal de Pernambuco (1992)

Mestrado em Antropologia (1996) e doutorado em Sociologia (2001) pela mesma universidade.

Tem experiência nas áreas de Ciências Sociais e Saúde Coletiva, atuando principalmente nos seguintes temas: gênero e saúde, masculinidades, pesquisa qualitativa, violência e atenção primária à saúde.

Professora do Departamento de Medicina Preventiva da Faculdade de Medicina da Universidade de São Paulo.

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