Academic journal article The Spanish Journal of Psychology

Practice of Biopsychosocial Medicine in Portugal: Perspectives of Professionals Involved

Academic journal article The Spanish Journal of Psychology

Practice of Biopsychosocial Medicine in Portugal: Perspectives of Professionals Involved

Article excerpt

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.

Keywords: biopsychosocial medicine, integrative care, family systems medicine

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 saludfamiliar todavía está empezando en Portugal. Este artículo describe un estudio cualitativo quese centra en la comprensión de las percepciones de los psicólogos y médicos de familia desu 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.

The practice of "Family Systems Medicine," as a field, was coined in 1983 with the publication of the journal «Family Systems Medicine». The new field was characterized by an alliance between medicine, family therapy and a systems thinking orientation (Bloch, 1983). The changes in medical and mental health practice, the establishment of family medicine and family therapy, and the epistemological shift from linear to systemic thinking created the conditions that culminated in the end of the schism between the medical and mental health field. Family Systems Medicine, as a territory, emerged as a functional related unit that emphasized the importance of the systemic paradigm in Medicine or the use of the biopsychosocialmodel (Engel, 1977).

The field of Medicine has been going through a continued evolution. The discovery of new technologies in recent years has increased the efficiency in the treatment of several diseases and has also raised the awareness of the importance of larger levels of organization i.e., psychological, social, community, etc. that impact and receive impact from «pure» physiologic functions. Engel (1977) argued that a true scientific medical model needs to involve the psychological context in which disease occurs. …

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