Interconsulta psicológica em hospital geral: uma análise documental

Abstract

This dissertation comprises two independent yet complementary articles that examine the potentialities and limitations of the psychological consultation-liaison model in an adult inpatient unit of a tertiary university hospital. Psychological consultation-liaison constitutes an important care strategy in the hospital setting, as it promotes communication among healthcare teams and broadens the understanding of the emotional demands of hospitalized patients. This is a documentary, qualitative study based on the analysis of 170 psychological consultation requests recorded between September 2024 and February 2025 in the Internal Medicine ward, as well as the full records of the initial psychological assessments conducted in response to these requests. Article 1 aimed to characterize the psychological consultation requests submitted by the ward team, considering sociodemographic, clinical, and institutional variables. The study described patient profiles, length of hospitalization, timing of the requests, and the main reasons for referral, using descriptive statistical analysis. Results indicated that most requests were made by physicians within the first days of hospitalization and were predominantly directed toward women, individuals with low educational attainment, and a high proportion of older adults, with greater concentration in the specialties of Cardiology and Internal Medicine. Depressive symptoms and the need for family support were among the main reasons for consultation, highlighting the relevance of Psychology as an integral component of care in high-complexity clinical settings. Article 2 specifically analyzed the potentialities and limitations of the psychological consultation-liaison model based on a detailed review of medical records and documentation from the first psychological encounter. A standardized data extraction protocol, thematic content analysis, and comparison between the stated reason for referral and the psychologist’s assessment were employed. Eight recurring themes were identified, with emphasis on women in caregiving roles for hospitalized patients, communication with the multidisciplinary team, experiences of grief and functional losses, and lack of information about health status. The most frequent interventions involved ongoing psychological follow-up, emotional support, active listening, validation, and psychoeducation. Agreement between the referral reason and the psychological assessment occurred in 75.9% of cases, alongside records of disagreement and nonspecific requests, which point to limitations in understanding the psychologist’s role and in formalizing care demands. The findings underscore the centrality of communicational interventions and the mediating role of psychologists among patients, families, and healthcare teams, suggesting that institutionalizing care pathways and investing in continuing education may strengthen psychological consultation-liaison practices as a strategy for promoting comprehensive care in general hospital settings. This dissertation reaffirms the relevance of psychological consultation-liaison as a tool that goes beyond responding to isolated demands, establishing itself as a privileged space for dialogue, emotional support, and the shared construction of meaning within the hospital environment.