Residência médica: Fatores relacionados à "dificuldade para ajudar" na relação médico residente-paciente

Translated title of the contribution: Medical residency: Factors relating to "difficulty in helping" in the resident physician-patient relationship

Mario Alfredo de Marco, Vanessa Albuquerque Cítero, Maria Cezira Fantini Nogueira-Martins, Latife Yazigi, Lawrence Sagin Wissow, Luiz Antonio Nogueira-Martins, Sergio Baxter Andreoli

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


CONTEXT AND OBJECTIVE: Previous studies have attempted to understand what leads physicians to label patients as 'difficult'. Understanding this process is particularly important for resident physicians, who are developing attitudes that may have long-term impact on their interactions with patients. The aim of this study was to distinguish between patients' self-rated emotional state (anxiety and depression) and residents' perceptions of that state as a predictor of patients being considered difficult. DESIGN AND SETTING: Cross-sectional survey conducted in the hospital of Universidade Federal de São Paulo (Unifesp). METHODS: The residents completed a sociodemographic questionnaire and rated their patients using the Hospital Anxiety and Depression Scale (HADS) and Difficulty in Helping the Patient Questionnaire (DTH). The patients completed HADS independently and were rated using the Karnofsky Performance Status scale. RESULTS: On average, the residents rated the patients as presenting little difficulty. The residents' ratings of difficulty presented an association with their ratings for patient depression (r = 0.35, P = 0.03) and anxiety (r = 0.46, P = 0.02), but not with patients' self-ratings for depression and anxiety. Residents from distant cities were more likely to rate patients as difficult to help than were residents from the city of the hospital (mean score of 1.93 versus 1.07; P = 0.04). CONCLUSIONS: Understanding what leads residents to label patients as having depression and anxiety problems may be a productive approach towards reducing perceived difficulty.   Residents from distant cities may be more likely to find their patients difficult.

Translated title of the contributionMedical residency: Factors relating to "difficulty in helping" in the resident physician-patient relationship
Original languagePortuguese
Pages (from-to)5-10
Number of pages6
JournalSao Paulo Medical Journal
Issue number1
StatePublished - Jan 2011
Externally publishedYes


  • Anxiety
  • Depression
  • Education, medical
  • Internship and residency
  • Physician-patien relations

ASJC Scopus subject areas

  • Medicine(all)


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