Integrative Care Model of Complementary Therapies and Humanizing Practices in Primary Health Care: Qualitative Meta-synthesis.

ABSTRACT

Context The World Health Organization (WHO) seeks to support member states in providing Traditional, Complementary, and Integrative Medicine (TCIM) services within Primary Health Care (PHC). Health professionals' offer of and referral to complementary therapies and humanizing practices can encounter some difficulties due to both conventional medical knowledge and institutional organizations. An integrative care model of complementary therapies and humanizing practices may be a strategy to overcome such difficulties. Objective: The study aimed to identify an integrative care model of complementary therapies and humanizing practices and to determine their influence on PHC. Design: The research team performed (1) a qualitative meta-synthesis based on data from two systematic reviews that included more than 15000 professionals from 18 countries, and (2) qualitative research conducted with 24 participants, professionals from the South and Southeast regions of São Paulo, SP, Brazil. Setting: The study occurred at the Paulista School of Medicine at the Federal University of Sao Paulo (UNIFESP) in Sao Paulo, Brazil. Results: The analysis of the integrative care model resulted in two syntheses (1) that PHC is offering complementary therapies and humanizing practices that have had a positive and subjective influence on PHC and (2) complementary therapies and humanizing practices improve PHC's service quality and resolvability and reduce medicalization. Conclusions: The work process in PHC may pose difficulties for the provision of integrative and holistic care yet promoting a model to integrate complementary therapies and humanizing practices with conventional medicine in health services may improve PHC and the perceptions of health professionals, managers, and patients about the positive and subjective effects of these practices.