Comunicación clínica del dolor crónico: marcos, procesos, barreras y competencias relacionales potencialmente vinculados a la humanización de la atención. Revisión de alcance
DOI:
https://doi.org/10.35669/rcys.2027.17.e421Palabras clave:
Dolor crónico, comunicación centrada en la persona, validación del dolor, toma de decisiones compartida, relación médico-paciente, alianza terapéutica, humanización de la atención, comunicación clínicaResumen
Introducción: La comunicación clínica constituye una dimensión central en la atención del dolor crónico por su papel en el reconocimiento del sufrimiento y en la relación terapéutica, dimensiones potencialmente relacionadas con una atención humanizada. Sin embargo, la evidencia disponible permanece dispersa entre estudios empíricos, revisiones y trabajos conceptuales. Metodología: Se realizó una revisión de alcance siguiendo el marco metodológico del Joanna Briggs Institute y las directrices PRISMA-ScR. La búsqueda se efectuó el 24 de febrero de 2026 en siete fuentes bibliográficas y dos estrategias complementarias. Se incluyeron publicaciones en inglés y español, publicadas entre 2010 y 2026, que abordaran explícitamente la comunicación clínica en dolor crónico en contextos sanitarios. Resultados: Se identificaron 4.928 registros y 148 publicaciones cumplieron los criterios de inclusión, de las cuales 131 fueron estudios empíricos y 17 revisiones o publicaciones conceptuales y metodológicas. Predominaron los estudios cualitativos y los contextos de atención clínica general y atención primaria. La atención centrada en la persona, la alianza terapéutica relacional y la toma de decisiones compartida representaron conjuntamente el 77,7 % del corpus total. El análisis de sensibilidad restringido a los 131 estudios empíricos mantuvo el orden de estas categorías, que agruparon el 78,6 % de la evidencia empírica. La relación terapéutica fue el tema dominante más frecuente en ambos análisis. Discusión: En las publicaciones incluidas predominaron los enfoques relacionales de la comunicación clínica, especialmente aquellos centrados en la calidad del vínculo terapéutico, la validación de la experiencia y la participación del paciente. La humanización o deshumanización fue abordada explícitamente en ocho publicaciones; en el resto del corpus, su relación con las competencias y prácticas comunicativas corresponde a una inferencia analítica de esta revisión. Conclusiones: La atención centrada en la persona, la validación, la empatía clínica y la participación del paciente constituyen dimensiones potencialmente relacionadas con una atención humanizada, pero no deben interpretarse como indicadores de un impacto demostrado. Persisten brechas en la definición, operacionalización y evaluación directa de la humanización y de los constructos comunicativos.
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Derechos de autor 2026 Enrique Barros-Beracaza, Estrella Martínez- Rodrigo, Francisco García-García
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