O ensino da religiosidade e da espiritualidade na residência médica em Psiquiatria: revisão sistemática de literatura e proposta curricular

Abstract

Introduction: Religiosity and spirituality (R / S) are very prevalent in the world population and have a significant impact on mental health. One of the main barriers to R / S approach in the clinic is the lack of training. Objectives: To carry out a systematic review of the literature on R / S teaching in medical residency in psychiatry (RMP) and to propose a curriculum based on this evidence. Methods: search in multiple databases beyond the contact with authors of the studies in search of new references. Articles are reviewed based on 18 categories. In the end, an R / S curriculum for RMPs was proposed based on the strategies and recommendations most prevalent in the articles, in the general and R / S teaching guidelines for the RMP of psychiatric associations, and in the experience of the author and his / her supervisors. Results: 11 articles were selected. There was significant heterogeneity between the interventions, comprising 23 topics and 31 different teaching methods. Main topics: R / S history (n = 10), transference, countertransference / self-knowledge (n = 10), pastoral counseling / chaplaincy and interconsultation (n = 9), R / S definitions (n = 9); psychotherapy, theology and spirituality (n = 9), differential diagnosis (n = 8); historical aspects in psychiatry, science and religion (n = 8). Main methods: theoretical classes (n = 10), case presentation (n = 10), discussion groups (n = 9), clinical supervision (n = 8), seminars and related activities (n = 7). Initiatives in general were well accepted and evaluated positively by residents. The proposed 12-hour curriculum was divided into six sessions of 2 hours each. 1. Concepts and research in R / S and mental health. 2: R / S history collection and bio-psico-social-spiritual formulation. 3: Historical Aspects in Psychiatry, Science and Religion. 4: Main local religious traditions. 5: Differential diagnosis (R / S experiencies and psychopathology). 6: Integration of R / S in the treatment. Discussion: Studies have suggested that interventions have generally been well accepted by residents and may improve their sense of competence in addressing R / S related issues. It is still unclear how commonly and effectively R / S competencies are being taught to students of psychiatry around the world. Conclusion: It was suggested that future studies use control groups and minimally standardized structures (topics, methods and evaluation) to measure the effects of these educational interventions, for comparative purposes. The proposed R / S curriculum was intended to be both comprehensive and easy to implement, keeping the cultural differences of each context. It is still necessary to investigate the impact of this educational intervention. (PROSPERO: CRD42018093618).