<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2182-5173</journal-id>
<journal-title><![CDATA[Revista Portuguesa de Medicina Geral e Familiar]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Port Med Geral Fam]]></abbrev-journal-title>
<issn>2182-5173</issn>
<publisher>
<publisher-name><![CDATA[Associação Portuguesa de Medicina Geral e Familiar]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2182-51732022000400417</article-id>
<article-id pub-id-type="doi">10.32385/rpmgf.v38i4.13171</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Teleconsulta de medicina geral e familiar em doze passos: uma adaptação em tempos de pandemia]]></article-title>
<article-title xml:lang="en"><![CDATA[Twelve steps for family medicine remote consultations: one pandemic times adaptation]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gomes]]></surname>
<given-names><![CDATA[Ana Catarino]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alves]]></surname>
<given-names><![CDATA[Paula Brandão]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,ACeS Oeste Sul USF Arandis ]]></institution>
<addr-line><![CDATA[Torres Vedras ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,ACeS Oeste Sul USF Arandis ]]></institution>
<addr-line><![CDATA[Torres Vedras ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>08</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>08</month>
<year>2022</year>
</pub-date>
<volume>38</volume>
<numero>4</numero>
<fpage>417</fpage>
<lpage>424</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2182-51732022000400417&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2182-51732022000400417&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2182-51732022000400417&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo Este artigo propõe uma estrutura para as teleconsultas de medicina geral e familiar, explorando estratégias para ultrapassar barreiras comunicacionais. Propõem-se doze passos divididos em três fases. Fase I: Preparação. Passo 1. Escolha do local: avaliar as condições do gabinete. Passo 2. Verificação da conexão: verificar a disponibilidade de telefone, computador e de impressora e a existência uma boa conexão de Internet. Passo 3. Preparação do consultório: certificar-se de que há boa luminosidade e que todos os objetos que possam a vir a ser necessários estão posicionados corretamente. Passo 4. Organização do pensamento: ler os registos médicos prévios e algum alerta importante. Fase II: Teleconsulta. Passo 5. Preparar a sessão: certificar-se de que tem o contacto correto do utente, password da sessão bem como o número telefónico de uma linha de apoio informático. Passo 6. Primeiros minutos: certificar-se de que o vídeo e o áudio estão a trabalhar corretamente; confirmar a identificação do paciente e garantir a sua privacidade. Passo 7. Avaliação rápida: avaliar rapidamente se o paciente está severamente doente ou não; se doença grave, escrever uma pequena história clínica e avaliar os parâmetros vitais de forma a decidir se deve encaminhar-se o doente para uma observação médica. Passo 8. Exploração: história da doença atual. Passo 9. Avaliação: este é o passo mais complexo; descrições do paciente, imagens de vídeo em direto ou enviadas posteriormente para o email, valores de dispositivos médicos que o paciente possua e uso de várias escalas médicas são uma excelente ajuda. Passo 10. Decisão: interpretação das monitorizações de forma a decidir o melhor seguimento em consenso com o doente. Fase III: Final. Passo 11. Encerramento: deve confirmar-se que foram abordados todos os temas propostos para a consulta e verificar se o utente compreendeu o plano. Passo 12. Reflexão final: finalizar os registos clínicos e realizar uma autorreflexão da consulta que teve lugar. Para a comunicação de más notícias deve usar-se o protocolo de SPIKES. Este artigo foi pensado como um guia de consulta para teleconsultas de medicina geral e familiar como forma de melhorar a abordagem médica durante a pandemia COVID-19.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract This article proposes a structure for family medicine remote consultations, exploring strategies to overcome communicational barriers. The authors propose twelve steps divided into three phases. Phase I. Preparation. Step 1. Place choice: evaluate room conditions. Step 2. Connection verification: verify telephone, computer, and printer availability and the presence of a good internet connection. Step 3. Room preparation: make sure there is good lighting and that all objects you may need are properly placed. Step 4. Organizing ideas: read the previous medical records and any important alerts. Phase II. Remote consultation. Step 5. Sessions make ready: make sure you have the correct patient&#8217;s contact, session passwords as well as the computer&#8217;s department helpline number. Step 6. First minutes: make sure video and sound are working correctly; confirm patient&#8217;s identification and ensure privacy. Step 7. Quick assessment: quick assessment if the patient is severely ill or not; if severe illnesses, write a short anamnesis and assess vital signs in order to decide whether or not to send the patient to seek medical attention. Step 8. Exploration: present illness anamnesis. Step 9. Evaluation: this is the most complex step; patient descriptions, live video images or emailed afterward, measurements with patient&#8217;s medical devices, and the use of various medical scales are of great help. Step 10. Decision: gathering all the information in other to manage the correct follow-up procedures with patients&#8217; agreement. Phase III. Final. Step 11. Closure: make sure that all topics were discussed, and that the patient understands the plan. Step 12: Final reflection: medical records should be finished and a doctor&#8217;s self-reflection on the consultation should take place. For breaking bad news SPIKES protocol should be used. This article was thought of as a consultation guide for family medicine remote consultations in order to improve doctors&#8217; approach during the COVID-19 pandemic.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Teleconsulta]]></kwd>
<kwd lng="pt"><![CDATA[Medicina geral e familiar]]></kwd>
<kwd lng="en"><![CDATA[Teleconsultation]]></kwd>
<kwd lng="en"><![CDATA[Family practice]]></kwd>
</kwd-group>
</article-meta>
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