| Summary: | Objetivos: Conocer las expectativas de los pacientes sobre la toma de decisiones ante diferentes problemas de salud cuando consultan con su médico de familia, e identificar las características de los pacientes y del médico relacionadas con dichas expectativas, con especial interés por el sexo de ambos. Métodos: Estudio transversal, multicéntrico, con 360 pacientes. Cuestionario en domicilio con características sociodemográficas, clínicas y satisfacción; sexo y formación posgrado del médico de familia; expectativas de que el médico de familia «escuche, informe y tenga en cuenta la opinión del paciente»; y expectativas sobre la «toma de decisiones» al consultar por cinco problemas o escenarios clínicos hipotéticos (dolor fuerte en el pecho, resfriado con fiebre, flujo anormal, depresión o tristeza, problema familiar grave), y escala: a) «Sólo el médico»; b) «El médico teniendo en cuenta mi opinión»; c) «Yo, teniendo en cuenta la opinión del médico»; d) «Sólo yo». Regresión logística para toma de decisiones. Resultados: Responden el 90%. Edad: 47,3±16,5 años, 51% mujeres. Las expectativas del paciente de que su médico de familia le escuche, explique y tenga en cuenta su opinión son más elevadas que las de participar en la toma de decisiones; estas segundas dependen del problema estudiado: para dolor de pecho desea participar el 32%, y para problema familiar el 49%. Las mujeres tienen menos expectativas de participar para depresión y para problema familiar, y quienes tienen una médica esperan participar más para problema familiar y resfriado. Conclusiones: La mayoría de los pacientes desean ser escuchados, informados y tenidos en cuenta por su médico de familia, y en menor medida desean tomar la decisión de forma autónoma, sobre todo para problemas de tipo biomédico.<br>Objectives: To identify patient expectations of clinical decision-making at consultations with their general practitioners for distinct health problems and to determine the patient and general practitioner characteristics related to these expectations, with special focus on gender. Methods: We performed a multicenter cross-sectional study in 360 patients who were interviewed at home. Data on patients' sociodemographic, clinical characteristics and satisfaction were gathered. General practitioners supplied information on their gender and postgraduate training in family medicine. A questionnaire was used to collect data on patients' expectations that their general practitioner «listen, explain, and take account of their opinion and on expectations of clinical decision making» at consultations with their general practitioner for five problems or hypothetical clinical scenarios (strong chest pain/cold with fever/abnormal discharge/depression or sadness/severe family problem). Patients were asked to indicate their preference that decisions on diagnosis and treatment be taken by: a) the general practitioner alone; b) the general practitioner, taking account of the patient's opinion; c) the patient, taking account of the general practitioner's opinion and d) the patient alone. A logistic regression was performed for clinical decision-making. Results: The response rate was 90%. The mean age was 47.3±16.5 years and 51% were female. Patients' expectations that their general practitioner listen, explain and take account of their opinions were higher than their expectations of participating in decision-making, depending on the problem in question: 32% wished to participate in chest pain and 49% in family problems. Women had lower expectations of participating in depression and family problems. Patients with female general practitioners had higher expectations of participating in family problems and colds. Conclusions: Most patients wished to be listened to, informed and taken into account by their general practitioners and, to a lesser extent, wished to take decisions autonomously, especially for biomedical problems.
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