The problem map - An instrument for handling multiple morbidity

Abstract

Introduction: Uncertainty regarding the diagnostic evaluation, intervention and prognosis always foiuma reality of medical practice and can reach very high levels in situations of multiple chronic morbidity. The uniqueness of each person with multiple morbidity is one of the most difficult and interesting challenges of day-to-day general practice. The approach to this problem, due to complexity and near absence of clinical research and production of evidence requires the use of tools to facilitate clinical reasoning and decision. Concept: A conceptual mapping follows its own methodology, which is similar in different areas. The map of health problems to a patient is a graphical representation in two dimensions. The idea that led to its development came to the authors a few years ago in response to a practical need for day-to-day. Reflected an evolution of the classical approach of linear list of problems, which is a component of the method developed by Lawrence Weed, for a systemic approach that seeks to study and understand the relationships and linkages between the various problems that coexist in the same person. Looking represent two dimensions, in the same plane, different problems and their possible interrelationships. Visa help address more clearly all the different issues each time (or query) can be placed in the care of patients with multiple morbidity. The map serves as an auxiliary cognitive ideas amplifier, enabling a reflective approach and a systemic understanding of the health problems of each person as an alternative to traditional linear model. Discussion: The map is a graphical representation problems containing elements of two-dimensional dynamic representation that aims to support the cognitive process. The main limitations of this method are its length in the query context, and may be used in specific situations more complex as, for example, when making points situation of patients with multiple morbidity and summaries using flowcharts. Like all systems of record omits the emotional dimension and the temporal dimension.