Prática Centrada na Pessoa no contexto da Atenção Primária à Saúde: uma revisão de escopo

Abstract

Person-Centered Practice (PCP) is an approach that guides care toward the needs, values, and active participation of the user, and is considered strategic for improving Primary Health Care (PHC). The objective was to map and analyze the available evidence on actions related to Person-Centered Practice in the context of PHC, identifying its geographical distribution and the main implementation strategies. This is a scoping review conducted according to the Joanna Briggs Institute (JBI) methodology, guided by the Population-Concept-Context (PCC) strategy. The search was conducted in July 2024 in the PubMed, Cochrane Library, Web of Science, Embase, Science Direct, ProQuest, LILACS, and Google Scholar databases, using descriptors related to person-centered practice and primary health care. Original quantitative, qualitative, and mixed studies conducted in PHC services were included. After applying the eligibility criteria and reading the studies in full, 21 studies comprised the final sample. There was a predominance of publications from high-income countries, especially Europe and North America, with a lower concentration in Latin America and a scarcity of studies in low- and middle-income countries, highlighting inequality in scientific production on the topic. The evidence pointed to three main axes of PCP implementation: professional training focused on communication and shared decision-making; use of person-centered practice assessment tools; and consultations conducted by professionals trained in this care model. The actions were based on valuing the biopsychosocial context, strengthening the therapeutic bond, and active user participation in the care plan, and were associated with improved patient experience, greater treatment adherence, and better outcomes in chronic conditions. It is concluded that Person-Centered Practice in PHC is mainly operationalized through changes in the work process and professional qualification, with positive impacts on the quality of care. However, inequalities in scientific production and gaps in the standardization of instruments and sustainability of interventions persist.