La Comunicación Con Los Pacientes
La Comunicación Con Los Pacientes
La Comunicación Con Los Pacientes
ISSN: 0120-5307
revistaiee@gmail.com
Universidad de Antioquia
Colombia
/DFRPXQLFDFLyQFRQORVSDFLHQWHV
,VDEHO&ULVWLQD1DUDQMR%HUP~GH]D*ORULD3DWULFLD5LFDXUWH*DUFtDE
,1752'8&&,Ï1
/
D FRPXQLFDFLyQ WHUDSpXWLFD HV HO SURFHVR PHGLDQWH HO
FXDOHOSURIHVLRQDOGHHQIHUPHUtDHVWDEOHFHXQDUHODFLyQ
FRQHOSDFLHQWH3DUDORJUDUXQDHIHFWLYDFRPXQLFDFLyQHVLPSRUWDQWH D (VWXGLDQWHGHHQIHUPHULD9,QLYHO8QLYHUVLGDGGH
WHQHU HQ FXHQWD FDUDFWHUtVWLFDV WDOHV FRPR OD HGDG HO VH[R HO QLYHO $QWLRTXLD&RUUHRHOHFWUyQLFR
HGXFDWLYR HO QLYHO VRFLRHFRQyPLFR \ OD UHOLJLyQ &RQRFLpQGRODV LVDEHOB#\DKRRFRPDU
SRGHPRVGH¿QLUFyPRDFHUFDUQRVDpOTXpWpUPLQRVXWLOL]DUSDUDORJUDU E (VWXGLDQWHGHHQIHUPHULD9QLYHO8QLYHUVLGDGGH
XQD FRPXQLFDFLyQ DGHFXDGD GRQGH VH HMHU]DQ KDELOLGDGHV \ GHVWUH]DV $QWLRTXLD&RUUHRHOHFWUyQLFR
JORULDZDO#KRWPDLOFRP
8QLYHUVLGDGGH$QWLRTXLD)DFXOWDGGH(QIHUPHUtD
&RPPXQLFDWLRQZLWKSDWLHQWV
,VDEHO&ULVWLQD1DUDQMR%HUP~GH]*ORULD3DWULFLD5LFDXUWH*DUFtD
PX\LQGHIHQVRSHURDOPLVPRWLHPSRFRQ $%675$&7
QHFHVLGDG GH TXH DOJXLHQ OH D\XGDUD
0H DFHUTXp D pO \ PH PLUy OR VDOXGp &RPPXQLFDWLRQZLWKSDWLHQWVLVQRWRQO\YHUEDO1RQYHUEDOH[SUH
PHUHVSRQGLyFRQXQJHVWRDPDEOH\PH VVLRQV DQG VLOHQFHV DUH DOVR IRUPV RI FRPPXQLFDWLRQ$V IXWXUH
GLMR DOJR TXH QR HQWHQGt SHUR GH WRGDV QXUVLQJSURIHVVLRQDOVZHVKRXOGOHDUQDELOLWLHVDQGVNLOOVWRDFFXUD
PDQHUDV PH VDOXGyLQVLVWt HQ VHJXLU WHO\LQWHUSUHWZKDWWKHSDWLHQWZDQWVWRH[SUHVVHYHQZKHQZRUGV
OH KDEODQGR KDVWD TXH PH VRQULy PH DUHDEVHQW
SUHJXQWy HQ VXV SRFDV SDODEUDV FODUDV 7R SURYLGH LQWHJUDO FDUH LW LV LPSRUWDQW WR HVWDEOLVK D WUXVWIXO DQG
TXHGyQGHHVWDEDVXPDPi\TXHWHQtD KHOSIXOUHODWLRQVKLSEHWZHHQSDWLHQWDQGQXUVHZKHUHWUXHGLDORJXH
VHGOHGLDJXD\QRODUHFLELyOHVHJXt FDUHIXOOLVWHQLQJFOHDUDQGFRPSUHKHQVLYHWHUPLQRORJ\PDNHHDV\
SUHJXQWDQGR¢TXpTXLHUHV"0HUHVSRQ FRPPXQLFDWLRQSRVVLEOHWRWLPHO\LGHQWLI\DQGVDWLVI\WKHSDWLHQW¶V
GLyDQVLRVDPHQWHTXHTXHUtDXQDEHELGD QHHGV
GHWHUPLQDGD VHJ~Q OH SXGH HQWHQGHU 7KLVDUWLFOHWULHVWRGHPRQVWUDWHWKURXJKDQDFDGHPLFQXUVLQJSUDF
FODUDPHQWHLQGDJXpHQODKLVWRULDFOtQLFD WLFHKRZLPSRUWDQWLVWKHHVWDEOLVKPHQWRIDQDGHTXDWHFRPPXQL
\FRQODMHIDGHOVHUYLFLRVLVHODSRGtD FDWLRQZLWKWKHSDWLHQWJURXQGHGLQWKHHWKLFDOSULQFLSOHVZDUUDQWLQJ
GDU(QYLDPRVSRUODJDVHRVD\FXDQGR WKHQXUVLQJFDUH
OH GLMH TXH OH WHQtD XQD VRUSUHVD PH
PLUy FRQ PXFKR DVRPEUR OH PRVWUp OD .H\:RUGV&RPPXQLFDWLRQLQKHDOWK
ERWHOOD\JULWyFRQHXIRULDHOQRPEUHGH HPSDWK\QXUVLQJFDUHSDWLHQWQXUVHUHODWLRQVKLS
ODJDVHRVDPHGLRODVJUDFLDV\HPSH]y
DWRPDU\DWRPDUKDVWDWHUPLQDUOD
0H GL FXHQWD GH TXH HO SDFLHQWH Vt
HQWHQGtD TXH Vt VH GDED FXHQWD GH WRGR 8QDUHÀH[LyQVREUHODFRPXQLFDFLyQFRQORVSDFLHQWHV
(PSHFpDEULQGDUOHHQHVDPDxDQDWRGRV
³(OVLOHQFLRGHORVSDFLHQWHVHV
ORVFXLGDGRVGHHQIHUPHUtDTXHUHTXHUtD\
LQWHUSUHWDEOHSRUORTXHVXDFHSWDFLyQ
pOPHKDEOyWRGRHOWLHPSRKDVWDTXHORJUp FRPRWDOSXHGHVHUPDVXQDFRQGLFLyQ
HQWHQGHU H LQWHUSUHWDU WRGR VX OHQJXDMH GHVRUGHUDSURIHVLRQDOTXH
&XDQGR WHUPLQp OD URWDFLyQ PH GHVSHGt GHLQFDSDFLGDGGHKDEODU´
GHpO\PHODQ]yXQEHVR
(VWDH[SHULHQFLDQRVPRWLYyDDQDOL]DUTXHDXQTXHHOSDFLHQWH
0H VRUSUHQGLy TXH D OD VHPDQD VHD XQ VHU KHWHUyQRPR QR SXHGH GHMDUVH HQ HO ROYLGR SRUTXH DOOt VH
VLJXLHQWH PH HQYLDUDQ D EXVFDU GHO HQFXHQWUDXQVHUKXPDQRYDOLRVRTXHQHFHVLWDXQFXLGDGRFRQFDOLGDG
VHUYLFLR GRQGH HVWDED SRUTXH GHVGH HO SDUD ORJUDU VX ELHQHVWDU ELRVLFRVRFLDO FRQ OD LQWHUDFFLyQ TXH VH
YLHUQHVQRFRPtDQDGD\HVWDEDHQWUDQGR HVWDEOH]FD
HQGHSUHVLyQFXDQGROOHJXpORVDOXGpWRGR
HOSHUVRQDOGHVDOXGHVWDEDDODH[SHFWDWLYD /DFRPXQLFDFLyQFRQORVSDFLHQWHVQRVyORHVWiGDGDSRUSDODEUDV
SRUTXHQLVXPDGUHKDEtDORJUDGRQDGDeO SXHVFRPRH[SUHVD'HOD&XHVWD ³HOGHVDItRSDUDORVFXLGDGRUHVDKRUD
VyORPHPLUy\FXDQGRPHUHFRQRFLyPH HVKDFHUVHHQWHQGHUGHOSDFLHQWH\HQWHQGHUOHDpOKDEODUFRQpOHQXQ
WRPyODPDQR\KDEOyFRVDTXHQRKDFtD OHQJXDMH TXH SDUD DPERV WHQJD VHQWLGR \ FXDQGR QR KD\D SDODEUDV
GHVGH KDFtD GtDV OH LQVLVWt TXH FRPLHUD HQFRQWUDUODPDQHUDGHFRPXQLFDUVH(OFXLGDGRUWLHQHDKRUDODWDUHDQR
\ DVt OR KL]R VRUSUHQGLGRV WRGRV \ VyORGHKDFHUSRUHOSDFLHQWHVLQRWDPELpQGHFRQYHQFHUORFRQWUXFRV\
PiV \R HQWHQGt TXH OD HPSDWtD ORJUD OD DUWLPDxDVSDUDTXHVHGHMHFXLGDURSDUDSURSRUFLRQDUOHORTXHQHFHVLWD
FRPXQLFDFLyQ\TXHKD\PXFKDVIRUPDV DKRUDKDGHVDEHUORTXHQHFHVLWDKDGHSRGHUVROLFLWDUVXFRRSHUDFLyQ
GHFRPXQLFDUVH \SRU~OWLPRHVWDEOHFHUXQDUHODFLyQGHFXLGDGRSDUDHOORQHFHVLWDGH
XQOHQJXDMH´
,QYHVWLJDFLyQ\(GXFDFLyQHQ(QIHUPHUtD0HGHOOtQ9RO;;,91PDU]RGH
(QFXHQWURV\GHVHQFXHQWURV
0DWFKHVDQGPLVPDWFKHV
6HJ~QODPLVPDDXWRUDHVSRUPHGLRGHODFRPXQLFDFLyQFRPR 2WURIDFWRUTXHDIHFWDODFRPXQLFDFLyQ
ODHQIHUPHUDSXHGHFXPSOLUFRQHOREMHWLYRGHVXSURIHVLyQD\XGDQGR FRQHOSDFLHQWHFRPRORVXVWHQWD-RYHOO
DORVLQGLYLGXRV\DODVIDPLOLDVDSUHYHQLU\DIURQWDUODH[SHULHQFLDGH HVODGLYHUVLGDGGHLQWHUSUHWDFLRQHVTXHVH
OD HQIHUPHGDG \ HO VXIULPLHQWR \ HQ FDVR QHFHVDULR D\XGDUOHV D GDU SXHGDQUHDOL]DUGHFRQFHSWRVFRPRHOGH
VHQWLGRDHVWDVH[SHULHQFLDV´6LQHPEDUJRODUHODFLyQHQIHUPHUDR DWHQFLyQLQWHJUDOGHOSDFLHQWH3DUDDOJXQRV
SDFLHQWHVHYHFDGDYH]PiVDIHFWDGDSRUODEDUUHUDTXHHVWDEOHFHQOD ODDWHQFLyQLQWHJUDOLQFOX\HODLQIRUPDFLyQ
WHFQL¿FDFLyQGHOHQWRUQRORVSURFHGLPLHQWRV\GLDJQyVWLFRVGHORVTXH \ OD FRPXQLFDFLyQ FRQ HO SDFLHQWH \ VX
HOSDFLHQWHDSHQDVWLHQHQRWLFLD\ODPLVPDLPDJHQGHODEDWDEODQFD IDPLOLD SDUD RWURV VLJQL¿FD UHDOL]DU HQ
TXHLPSLGHQXQDFRPXQLFDFLyQPiVÀXLGD\DELHUWD/DDFDGHPLDQRV HO SDFLHQWH WRGRV ORV SURFHGLPLHQWRV TXH
LQFXOFDXQDIRUPDFLyQKXPDQL]DGDSDUDODSUiFWLFDFOtQLFDSHURHVWD QHFHVLWH VLQ LPSRUWDU OR TXH pO VLHQWD
UDUDYH]VHFXPSOHSRUTXHORVSURFHGLPLHQWRVHQDOJXQDVLQVWLWXFLRQHV R SLHQVH DO UHVSHFWR D HVWD YDULHGDG VH
SRUORPHQRVHQQXHVWURPHGLRVHHQFXHQWUDQSURWRFROL]DGRV\WRGRHO VXPD OD GL¿FXOWDG GH FRRUGLQDFLyQ HQWUH
SHUVRQDOVHGHEHUHJLUSRUORTXHDOOtHVWpHVFULWROLPLWDQGRVXHMHUFLFLR SURIHVLRQDOHVHVSHFLDOLVWDV\HQWUHQLYHOHV
SURIHVLRQDO SRU RWUR ODGR H[LVWH XQD WHQGHQFLD FUHFLHQWH KDFLD OD DVLVWHQFLDOHVDYHFHVODGHOLPLWDFLyQGHO
HVSHFLDOL]DFLyQ\ODLQYHVWLJDFLyQDVtDYHFHVQRVLPSRUWDPiVHOFDVR FDPSR SURIHVLRQDO HVWi EDVDGD PiV HQ
FOtQLFRGHOSDFLHQWHSDUDVRFLDOL]DUORHQJUXSRTXHHOSDFLHQWHHQVt FULWHULRVFRUSRUDWLYRVTXHHQODVQHFHVLGDGHV
GHMDQGRDXQODGRODDWHQFLyQGHVXVQHFHVLGDGHVEiVLFDV\HOFXLGDGR GHORVSDFLHQWHV
LQWHJUDOTXHUHTXLHUH
3DUD GDUQRV FXHQWD GH FyPR DVXPH
8QVHJXQGRIDFWRUTXHGLILFXOWDHODFHUFDPLHQWRGHORVSURIHVLR HOSDFLHQWHHOFXLGDGRQRVGHEHPRVSRQHU
QDOHVDORVHQIHUPRVHVODOLPLWDFLyQGHOUHFXUVRKXPDQR\ODIDOWDGH HQVXOXJDUWDOFRPRORSURSRQH9LUJLQLD
WLHPSRSRUTXHHQODPD\RUtDGHODVLQVWLWXFLRQHVKD\SRFRSHUVRQDO +HQGHUVRQ/DHQIHUPHUDGHEHUiHVIRU]DUVH
DOTXHDGHPiVVHOHDVLJQDXQJUDQQ~PHURGHSDFLHQWHV\IXQFLRQHV HQ FRPSUHQGHU DO SDFLHQWH FXDQGR pVWH
(VWDEOHFHU XQD FRPXQLFDFLyQ SOHQDPHQWH KXPDQD HQWUH HQIHUPHUD QR SRVHD OD YROXQWDG OD FRQFLHQFLD R OD
\SDFLHQWHUHTXLHUHWLHPSRFRPRORH[SOLFD-RYHOO (VWRWUDHFRPR IRUWDOH]D QHFHVDULD OD HQIHUPHUD GHEH
FRQVHFXHQFLD XQD LQDGHFXDGD XWLOL]DFLyQ WHUDSpXWLFD GHO \R GHILQL ³SRQHUVH HQ VX OXJDU´ HV GHFLU SRU XQRV
GD FRPR ³OD FDSDFLGDG GH XWLOL]DU OD SURSLD SHUVRQDOLGDG GH IRUPD PRPHQWRV DGRSWDU HO SDSHO GHO HQIHUPR
FRQVFLHQWH\FRQSOHQDLQWHQFLyQSDUDLQWHQWDUHVWDEOHFHUUHODFLRQHV H LQWHQWDU YLYLU GH FHUFD HVD VLWXDFLyQ GH
\HVWUXFWXUDUODLQWHUYHQFLyQGHHQIHUPHUtD5HTXLHUHLQWURVSHFFLyQ LQFHUWLGXPEUH\HQFDPDPLHQWR3DUDTXH
FRPSUHQVLyQGHXQRPLVPRHQWHQGLPLHQWRGHODGLQiPLFDGHODFRQ H[LVWD XQD EXHQD UHODFLyQ SURIHVLRQDO
GXFWDKXPDQDFDSDFLGDGSDUD LQWHUSUHWDUODVDSWLWXGHVSURSLDV\ODVGH HQIHUPHUD ± SDFLHQWH TXH GLVPLQX\D OD
ORVGHPiV\ KDELOLGDGHVSDUDLQWHUYHQLUFRQH¿FDFLDHQODVVLWXDFLRQHV VHQVDFLyQGHVROHGDG HLQGHIHQVLyQGHHVWH
GHHQIHUPHUtD´ ~OWLPRVHGHEHQWHQHUHQFXHQWDVXGHWHULRUR
8QLYHUVLGDGGH$QWLRTXLD)DFXOWDGGH(QIHUPHUtD
/DFRPXQLFDFLyQFRQORVSDFLHQWHV
,QYHVWLJDFLyQ\(GXFDFLyQHQ(QIHUPHUtD0HGHOOtQ9RO;;,91PDU]RGH
(QFXHQWURV\GHVHQFXHQWURV
0DWFKHVDQGPLVPDWFKHV
$OH[DQGHU-('H0HHVWHU':/DXHU77RPH\$01HDO6( ODLQYHQFLyQDQWHODDGYHUVLGDGHG0HGHOOtQ8QLYHUVLGDGGH
:LLOLDPV6'H¿QLFLyQGHHQIHUPHUtD(Q0DUULQHU7RPH\ $QWLRTXLDS
$0$OOLJRRG 05 0RGHORV \ WHRUtDV HQ HQIHUPHUtD HG
0DGULG+DUFRXUW%UDFHSS
%,%/,2*5$)Ë$
'H OD &XHVWD & /D DUWHVDQtD GHO FXLGDGR (VWUDWHJLDV SDUD
FXLGDUSDFLHQWHVFRQGHPHQFLDDYDQ]DGD(Q&XLGDGRDUWHVDQDO +HQGHUVRQ93RGHPRVGDUXQSDSHOHVWHODUDORVSDFLHQWHV,QYHVW
ODLQYHQFLyQDQWHODDGYHUVLGDGHG0HGHOOtQ8QLYHUVLGDG HGXFHQIHUP
GH$QWLRTXLDSS
5LRV &DVWLOOR -$YLOD 5RMDV 7$OJXQDV FRQVLGHUDFLRQHV HQ HO
'HOD&XHVWD&/DDUWHVDQtDGHOFXLGDGR(VWUDWHJLDVSDUD DQiOLVLVGHOFRQFHSWRVDWLVIDFFLyQGHOSDFLHQWH,QYHVWHGXF
FXLGDUSDFLHQWHVFRQGHPHQFLDDYDQ]DGD(Q&XLGDGRDUWHVDQDO HQIHUP
8QLYHUVLGDGGH$QWLRTXLD)DFXOWDGGH(QIHUPHUtD