Medicina Materno-Feto-Neonatal: Decisões compartilhadas, uma mudança urgente
Resumo
O presente artigo apresenta o debate entre modelos para contemplar a autonomia dos pacientes, em nosso caso especificamente aplicado à Medicina Materno-Feto-Neonatal. Apresenta as vantagens da aplicação do modelo de ‘Decisões Compartilhadas’, amplamente recomendado pela literatura. Relacionamos essa abordagem aos resultados práticos de sua aplicação na Maternidade Universitária do Hospital de Clínicas.
Downloads
Referências
Illich. Némesis médica: La expropiación de la salud. 1975 efaidnbmnnnibpcajpcglclefindmkaj/https://www.ivanillich.org.mx/Nemesis.pdf
WHO Global Strategy on Integrated People-Centered Health Services 2016–2026 https://iris.who.int/items/9b35cc4a-8507-4b81-ae2bfd4f0c13aa2c
O’Neill, O. (2002). Autonomy and Trust in Bioethics. Cambridge University Press.) https://www.cambridge.org/core/books/autonomy-and-trust-in-bioethic s/901685A151865B0C07590E711BDBD2C9
Coppola F., Marin M., Oholeguy P, Barquet J, y Cols. Quality Management System in a University Maternity Hospital: A Strategy for the Sustained Reduction of the Cesarean Section Rate- An Facultad Med (Univ Repúb Urug). 2026; 13(1):e202 DOI: 10.25184/anfamed2026v13n1a4
Pellikka HK, P¨olkki T, Sankilampi U, et al. Finnish parents’ responsibilities for their infant’s care when they stayed ina single family room in a neonatal intensive care unit. J Pediatr Nurs 2020; 53: e28–e34. DOI: 10.1016/j.
pedn.2020.01.019
Pellikka H., Axelin A. , Sankilampi U, Kangasniemi M., Shared responsibility for decision-making in NICU: A scoping review Nurs Ethics 2023 May;30(3):462-476. doi: 10.1177/09697330221134948
Montori V., Ruissen M, Hargraves IG., Brito JP1, Kunneman M. Shared decision-making as a method of care. BMJ Evid Based Med. 2022 Dec 2;28(4):213–217. doi: 10.1136/bmjebm-2022-112068
Hawke M., Considine J. ,Sweet L. Maternity clinician use of shared decisionmaking in antenatal care: A scoping review. Birth. 2024;51:475–483. DOI: 10.1111/birt.12805
Muscat DM, Shepherd HL, Nutbeam D, Trevena L, McCaffery KJ. Health literacy and shared decision-making: exploring the relationship to enable meaningful patient engagement in healthcare. J Gen Intern Med 2021;36:521-4.
Roodbeen R, Vreke A, Boland G, Rademakers J, van den Muijsenbergh M, Noordman J, et al. Communication and shared decision-making with patients with limited health literacy; helpful strategies, barriers and suggestions for
improvement reported by hospital-based palliative care providers. PLoS One 2020;15:e0234926
Montori VM, Ruissen MM, Hargraves IG, Brito JP, Kunneman M Shared decision-making as a method of care BMJ Evid Based Med. 2022 Dec 2;28(4):213–217. doi: 10.1136/bmjebm-2022-112068
National Institute for Clinical Excellence. Shared Decision Making. NICE; 2021 Accessed 21 October, 2022. https:// www.nice. org. uk/ guida nce/ ng197
American College of Obstetricians and Gynecologists. Informed Consent and Shared Decision Making in Obstetrics andGynecology. ACOG; 2021 Accessed 21 October, 2022. https://www. acog. org/ clini cal/ clini calguidance/ commi ttee-opinion/ artic les/ 2021/ 02/ informed-consent-andshared-decision-making-in-bstetrics -and-gynecology.
The Maternity Transformation Programme. Better Births Four Years On: a review of progress. England. 2020 Accessed 21 October, 2022. https:// www.engla nd. nhs. uk/ wp-conte nt/ uploads/ 2020/ 03/ bette r-births-four-yearson-progress-report.pdf
COAG Health Council. Woman-Centred Care: Strategic Directions for Australian Maternity Services. Department of Health; 2019 Accessed October 21, 2022. https:// www. health.gov. au/ sites/ defau lt/ files/ docum ents/
/ 11/ woman centred-care-strategic-directions -for-australian -maternityservices.pdf
Lantos JD. Ethical problems in decision making in the neonatal ICU. N Engl J Med 2018;379:1851-60.
Katz AL, Webb SA. Informed consent in decision-making in pediatric practice. Pediatrics 2016;138:e20161485.
Kon AA, Morrison W. Shared decision-making in pediatric practice: a broad view. Pediatrics 2018;142(Suppl 3):S129-32.
Elwyn G, Hutchings H, Edwards A, Rapport F, Wensing M, Cheung WY, et al. The OPTION scale: measuring the extent that clinicians involve patients in decision-making tasks. Health Expect 2005;8:34-42.
Simon D, Schorr G, Wirtz M, Vodermaier A, Caspari C, Neuner B, et al. Development and first validation of the shared decision-making questionnaire (SDM-Q). Patient Educ Couns 2006;63:319-27
Copyright (c) 2026 Francisco Cóppola, Fernanda Blasina
This work is licensed under a Creative Commons Attribution 4.0 International License.
Os autores mantêm seus direitos autorais e cedem à revista o direito de primeira publicação de seu trabalho, que estará simultaneamente sujeito à Licença Creative Commons Atribuição 4.0 Internacional. que permite a partilha do trabalho desde que seja indicada a publicação inicial nesta revista.
