Conhecimentos e atitudes do estudante de medicina e dos médicos dos programas de residência de geriatria, neurologia, psiquiatria e clínica médica da Faculdade de Medicina de Botucatu - Unesp em relação aos quadros de demência em idosos
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Data
2017-06-23
Autores
Leite, Ananda Ghelfi Raza [UNESP]
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Universidade Estadual Paulista (Unesp)
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Introdução: As demências são comuns nos idosos e sua prevalência aumentou nas últimas décadas. Em 2025, o Brasil estará na sexta posição mundial em número absoluto de idosos. No país, a grade curricular do curso de graduação em Medicina, de acordo com as Diretrizes Curriculares para este curso, contempla o ensino de demência e seu manejo, havendo poucos relatos na literatura cientifica sobre a qualidade do ensino oferecido ou sobre o conhecimento e a capacidade de identificação da demência. Diante disso, propõe-se estudo sobre os conhecimentos e atitudes a respeito de questões relacionadas ao declínio cognitivo em idosos por parte de estudantes e residentes de Medicina. Objetivo: Avaliar os conhecimentos e atitudes em demências por parte de estudantes de medicina e dos médicos residentes das áreas que mais atuam com demência em idosos. Métodos: Estudo transversal no qual foi realizada a aplicação aos estudantes e residentes de um questionário contendo itens sobre o aprendizado em demências durante a graduação médica e um instrumento britânico, adaptado transculturalmente ao Brasil, sobre conhecimentos e atitudes em demências em idosos. Os resultados de conhecimento e atitudes sobre demência foram comparados entre especialistas e generalistas e entre os momentos de suas carreiras. Resultados: Dos participantes deste estudo, 57% eram do sexo feminino, 60,3% relataram ter tido base em alterações cognitivas durante a graduação, e destes, 57% relataram ter tido base teórica e prática; 89,8% dos participantes afirmaram ter realizado curso extracurricular durante a graduação no qual foi abordado o tema. Com relação ao questionário de conhecimentos, os graduandos acertaram menos questões do escore “epidemiologia” do que os residentes iniciantes e menos do que os residentes finalistas. No escore “diagnóstico”, os alunos do sexto ano acertaram menos do que os residentes iniciantes e finalistas, assim como os residentes iniciantes acertaram menos do que os residentes finalistas. Observou-se que as os alunos do sexto ano concordaram mais com as afirmações referentes às atitudes “2” (“As famílias preferem ser informadas a respeito da demência de seu parente o mais rápido possível”) e “4” (“Fornecer diagnóstico geralmente é mais útil do que prejudicial”) do que os residentes iniciantes. Já na atitude “6” (“Os pacientes com demência podem esgotar recursos com resultado pouco positivo”), os graduandos concordaram menos com a afirmação do que os residentes iniciantes. Conclusão: Os resultados permitiram uma leitura mais detalhada dos tópicos envolvidos na capacitação médica para a detecção de alterações cognitivas em idosos, assim como a avaliação do perfil do especialista e do generalista quanto à avaliação dos quadros demenciais e das atitudes frente ao paciente, sendo que os graduandos, apesar de acertarem menor quantidade de questões no questionário de conhecimentos, apresentaram atitudes mais positivas frente ao paciente com demência.
Introduction: Dementias are common in the elderly and its prevalence has increased in the recent decades. By 2025, Brazil will rank sixth among countries with the highest numbers of elderly persons. In Brazil, the curriculum of the undergraduate course in Medicine, according to the Curricular Guidelines for this course, include dementia education and its management, but there are few reports in the scientific literature about the quality of education offered. Therefore, we propose a study on the knowledge and attitudes about issues related to cognitive decline in the elderly by students and medical residents. Objective: To assess the knowledge and attitudes about dementia by medical students and medical residents of the areas that the most act with dementia in the elderly. Methods: Crosssectional study; questionnaires containing topics about dementia education during medical graduation and knowledge and attitudes about dementia were used. The results of the knowledge and attitudes about dementia were compared between: students and residents, residents of the different programs and residents in different moments of their residency. Results: Of the participants of this study, 57% were female, 60.3% reported having basis on dementia during graduation, and of these, 57% reported having both theoretical and practical basis; 89.8% of the subjects attended extracurricular courses on dementia during graduation in which the topic was addressed Regarding the knowledge questionnaire, medical students’scores on “epidemiology” were lower than the scores of the residents in the beginning and in the end of the residency. Considering the scores on "diagnosis", the medical students’ scores were lower than the scores of the residents in the beginning of the residency and the latters’ scores were lower than the scores of the residents in the end of the residency. It was observed that the medical students agreed more with the statement of the attitude 2 (The families prefer to be informed about the dementia of their relative as rapidly as possible) and 4 (Providing the diagnosis is generally more useful than harmful.) than junior residents. Considering attitude 6(The patients with dementia can drain resources with little positive result), the medical students agreed less than the residents of the beginning of the programs. Conclusion: The results allowed a more detailed reading of the topics involved in medical training for the detection of cognitive alterations in the elderly, as well as the evaluation of the expert and generalist profile regarding the evaluation of dementia and attitudes towards the patient, although they answered less questions in the knowledge questionnaire, presented more positive attitudes towards the patient with dementia.
Introduction: Dementias are common in the elderly and its prevalence has increased in the recent decades. By 2025, Brazil will rank sixth among countries with the highest numbers of elderly persons. In Brazil, the curriculum of the undergraduate course in Medicine, according to the Curricular Guidelines for this course, include dementia education and its management, but there are few reports in the scientific literature about the quality of education offered. Therefore, we propose a study on the knowledge and attitudes about issues related to cognitive decline in the elderly by students and medical residents. Objective: To assess the knowledge and attitudes about dementia by medical students and medical residents of the areas that the most act with dementia in the elderly. Methods: Crosssectional study; questionnaires containing topics about dementia education during medical graduation and knowledge and attitudes about dementia were used. The results of the knowledge and attitudes about dementia were compared between: students and residents, residents of the different programs and residents in different moments of their residency. Results: Of the participants of this study, 57% were female, 60.3% reported having basis on dementia during graduation, and of these, 57% reported having both theoretical and practical basis; 89.8% of the subjects attended extracurricular courses on dementia during graduation in which the topic was addressed Regarding the knowledge questionnaire, medical students’scores on “epidemiology” were lower than the scores of the residents in the beginning and in the end of the residency. Considering the scores on "diagnosis", the medical students’ scores were lower than the scores of the residents in the beginning of the residency and the latters’ scores were lower than the scores of the residents in the end of the residency. It was observed that the medical students agreed more with the statement of the attitude 2 (The families prefer to be informed about the dementia of their relative as rapidly as possible) and 4 (Providing the diagnosis is generally more useful than harmful.) than junior residents. Considering attitude 6(The patients with dementia can drain resources with little positive result), the medical students agreed less than the residents of the beginning of the programs. Conclusion: The results allowed a more detailed reading of the topics involved in medical training for the detection of cognitive alterations in the elderly, as well as the evaluation of the expert and generalist profile regarding the evaluation of dementia and attitudes towards the patient, although they answered less questions in the knowledge questionnaire, presented more positive attitudes towards the patient with dementia.
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Palavras-chave
Alterações cognitivas, Demência, Idosos, Formação médica, Médico generalista, Cognitive impairment, Dementia, Elderly, Medical training, General practitioner