Integração da espiritualidade à educação médica: uma revisão integrativa

Abstract

Introduction: Spirituality and Health is a theme that has attracted great interest from researchers in the medical field, and the evidence from scientific research points to its importance in clinical practice. It remains to be clarified whether this importance has been recognized by the educators and materialized in curricular programs in the Medical Schools. Objective: To analyze the bibliometric characteristics of the scientific production on the Integration of Spirituality to Medical Education. Theoretical referential: This study started from the working hypothesis that, within a secular vision, the approach of the theme should be centered in the concept of Spirituality, and that, from the perspective of Harold G. Koenig, in the research, a strict and well-defined definition of spirituality should be adopted. Material and Methods: This was an integrative review. The search for papers was carried out in April and May of 2017, through PUBMED. It was used as MeSH descriptors of PUBMED: 'Spirituality' AND 'Medical Education'; 'Spirituality' AND 'Undergraduate Medical Education'; Spirituality' AND 'Medical Schools'; 'Spirituality' AND 'Medical Students'; and 'Spirituality' AND 'Taching Hospitals', in which we obtained 169 preselected papers. It was included in the review the original papers of empirical research published until December 2016 that had as their central theme the Spirituality in Medical Education; papers that had as subject the undergraduate students in Medicine; and papers that were available in full on the CAPES Portal platform. At the end of the process, 26 papers were selected for data extraction. Results: 65% of the selected papers (n = 17) were published as of 2012, the year in which a visible increase of publications on Integration of Spirituality to Medical Education begins; 46% (n = 12) of the selected papers were published in the United States of America (USA), with Brazil in second place, with 11.5% (n = 3); 38% (n = 10) of the selected papers were published in journals in the Medical Education field; 42% of the papers (n = 11) focused on the impact and relevance of Spirituality in the training of medical students; the most prevalent research methods are intervention study (34%) and evaluative study (23%); only 38% of the selected papers (n= 10) presented definitions of spirituality and religiosity, with imprecision when they are present; 58% (n = 15) of the papers suggest that a spiritual dimension to health is recognized, and the acceptability of providing spiritual care to patients, and 19% (n = 5) indicate a development and inclusion of a curriculum in Spirituality and Health in Medical Schools; 50% (n = 13) of the papers referred to the use of 1 (n = 12 ) or 2 (n = 1) Medical Schools as study scenarios as a limitation; 34% (n = 9) of the papers indicated the need to investigate the bases of the curriculum development in Spirituality and Health in medical training. Final considerations: In spite of the incipience of interest in the subject, the investigations related to them are promising. There is a need for multicentric studies and more robust methods on the pedagogical basis of curriculum and teaching in Spirituality and Health in Medical Schools.