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• W272211299 abstract "The electrocardiogram (ECG) is a diagnostic test with a history of over 100 years that aims the study and follow-up of the heart diseases, where its validity is established. The practice of Primary Health Care pays more attention to the person as a whole biopsychosocial. It’s therefore more inclusive of the process of diseases and this characteristic justifies some kind of deviations from other practices focused mainly in specific pathology. Aim: To characterize the utilization of the ECG in the practice of Primary Health Care Services, with regard to the reasons for ordering the examination, to the abnormalities present in patients, to the impact of the test in clinical guidance, and to the ability of GPs to read the tests. Methods: We designed three observational studies in order to answer the research questions formulated. Using a consecutive series of patients at the Centro de Saude de S. Joao, in Porto, Portugal, who performed the ECG on the premises of Health Centre, and a form created for the request of the test, we proceeded to the analysis of outcome variables: the reasons to ask for an ECG; diagnoses of the ECG performed at the Health Centre, impact on clinical guidance of the patients who made an ECG, quality evaluation of ECG’s readings by General Practitioners and the impact of making the ECG in patients with chest pain. Results: In this Primary Health Care setting, the ECG is sought mainly for clinical reasons to answer to symptoms and signs that patients present in the visit. A larger proportion of tests are normal and there are few diagnoses to describe the abnormalities found. We have established General Practitioners skills to carry out its interpretation. In most patients the xxii Eletrocardiograma nos Cuidados de Saude Primarios clinical guidance remains unchanged as compared to what was previously defined before the ECG was made. The main reason for ordering an ECG is the chest pain, which patients have twice the probability of seeing their clinical guidance changed in comparison to healthy people that made the ECG by routine. Patients with chest pain were further classified by the probability a priori of coronary disease in typical and atypical chest pain. The presence of ECG abnormalities is determinant, leading to the modification of medications and to a higher referral to hospital care, especially in patients with typical chest pain. The group of atypical chest pain presents a profile closer to the healthy controls. In these patients the results of ECG is also remarkable but psychological factors assume a significant role. A normal test contributes to the reassurance of patients changing the way they manage their own health. This is objectified by a low utilization of health care services of 0,6 visits/year measured in the 12 months after the realization of the ECG. Conclusion: The ECG is part of the clinical practice of Family Medicine. It has low impact if the review is directed to the study of diseases related to the heart. When the variables related to patients are included in the analysis, a wider effect is apparent, covering the symbolic reality of the heart and the way people understand and experience it. O Eletrocardiograma nos Cuidados de Saude Primarios xxiii" @default.
• W272211299 created "2016-06-24" @default.
• W272211299 creator A5079265896 @default.
• W272211299 date "2014-07-17" @default.
• W272211299 modified "2023-09-27" @default.
• W272211299 title "O Eletrocardiograma nos Cuidados de Saúde Primários" @default.
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