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Aim: Promoting autonomy means changing the paternalistic model for one in which people have an active role during health care, which their participation in medical decision-making will reflect. This issue needs to be sufficiently explored in Chile, so this article aims to describe the perception of users living with multimorbidity regarding exercising their autonomy during clinical care. Method: Qualitative case study in a sample of patients with multimorbility from a family health center in Santiago de Chile. Content analysis was performed according to the Krippendorf method. Results: The sample comprised 19 adult participants with an average of 2.7 chronic health conditions. Three categories emerged from the content analysis of the interviews: a) Meaning attributed by users to autonomy in health care, b) Elements that health care that respects user autonomy should consider, and c) Participation during clinical care. Conclusions: Considering the sustained increase in chronic health conditions, it is imperative to rethink how health care is provided, highlighting the value of user participation through shared decision-making as an expression of respect for people's autonomy and the promotion of patient-centered care.

Dois, A., & Bravo, P. (2024). Perception of Person-Centered Care and Autonomy in Clinical Care in Patients living with Multimorbidity. Revista Ciencias De La Salud, 22(2), 1–12. https://doi.org/10.12804/revistas.urosario.edu.co/revsalud/a.13299

Davis K, Schoenbaum SC, Audet A-M. A 2020 vision of patient-centered primary care. J Gen Intern Med. 2005 Oct; 20(10):953-7. https://doi.org/10.1111/j.1525-1497.2005. 0178.x

Prados-Torres A, del Cura-González I, Prados-Torres D, Leiva-Fernández F, López-Rodríguez J, Calderón-Larrañaga A, Muth C. Multimorbilidad en medicina de familia y los principios Ariadne: un enfoque centrado en la persona. Aten Prim. 2017;49(5):300-7. https://doi.org/10.1016/j.aprim.2016.11.013

Beca JP. La autonomía del paciente en la práctica clínica. Rev Chil Enferm Respir. 2017;33(4):269-71. https://doi.org/10.4067/S0717-73482017000400269

Krippendorff K. Content analysis: an introduction to its methodology. Thousand Oaks: Sage; 2004.

Graneheim U, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-12. https://doi.org/10.1016/j.nedt.2003.10.001

Guba E, Lincoln Y. Handbook of qualitative research. Thousand Oaks: Sage; 1994.

Margozzini P, Passi A. Encuesta Nacional de Salud, ENS 2016-2017: un aporte a la planificación sanitaria y políticas públicas en Chile. ARS Médica. 2018;43(1):30-4. https://doi.org/10.11565/arsmed.v43i1.1354

May C, Montori VM, Mair FS. We need minimally disruptive medicine. BMJ. 2009;339:b2803. https://doi.org/10.1136/bmj.b2803

Whitty C, JM, Mac Ewen C, Goddard A, Alderson D, Marshall M, Calderwood C et al. Rising to the challenge of multimorbidity. BMJ. 2020;368:l6964. https://doi.org/10.1136/bmj.l6964

Téllez A, Sapag J, Barros J, Poblete F, Zamorano P, Celhay P. Propuesta para la escalabilidad de un nuevo modelo de atención centrado en las personas y estratificado por riesgo para las personas con enfermedades crónicas en Chile. En: Centro de Políticas Públicas UC, editor. Propuestas para Chile: Concurso de Políticas Públicas 2019 [internet]. Santiago: Pontificia Universidad Católica de Chile; 2019. p. 83-114. Disponible en: https://politicaspublicas.uc.cl/wp-content/uploads/2020/03/CAP-3.pdf

Dois A, Contreras A, Bravo P, Mora I, Soto G, Solís C. Principios orientadores del Modelo Integral de Salud Familiar y Comunitario desde la perspectiva de los usuarios. Rev Méd Chile. 2016;144(5):585-92. https://doi.org/10.4067/S0034-98872016000500005

World Health Organization, United Nations Children’s Fund (Unicef). Primary health care measurement framework and indicators: monitoring health systems through a primary health care lens [internet]. Geneva; 2022. Disponible en: https://www.who.int/publications/i/item/9789240044210

Department of Health. Liberating the NHS: no decision about me without me [internet]. 2012. Disponible en: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216980/Liberating-the-NHS-No-decision-about-me-without-me-Government-response.pdf

Holzel LP, Kriston L, Harter M. Patient preference for involvement, experienced involvement, decisional conflict, and satisfaction with physician: a structural equation model test. BMC Health Serv Res. 2013;25(13):231. https://doi.org/10.1186/1472-6963-13-231

Thompson-Leduc P, Turcotte S, Labrecque M, Légaré F. Prevalence of clinically significant decisional conflict: an analysis of five studies on decision-making in primary care. BMJ Open. 2016;6(6). https://doi.org/10.1136/bmjopen-2016-011490

Urrutia M, Campos S, O'Connor A. Validación de una versión en español de la Escala de Conflicto Decisional. Rev Méd Chile. 2008;136(11):1439-47. https://doi.org/10.4067/S0034-98872008001100010

Stacey D, Légaré F, Lewis K, Barry MJ, Bennett CL, Eden KB, Holmes-Rovner M, Llewellyn-Thomas H, Lyddiatt A, Thomson R, Trevena L. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2017;4(4):CD001431. https://doi.org/10.1002/14651858.CD001431.pub5

Martínez V, Olmos A. De la autonomía personal al consentimiento informado y las direcciones avanzadas. BMDC. 2016;49(145):101-34. https://doi.org/10.22201/iij.24484873e.2016.145.4993

Emanuel EJ, Emanuel LL. Four models of the physician-patient relationship. JAMA. 1992;267(16):2221-6. https://doi.org/10.1001/jama.1992.03480160079038

Dois A, Bravo P. Buen trato en centros de atención primaria chilena: ¿privilegio o derecho humano? Rev Cubana Med Gen Integr. 2019;35(4):e813.

López M, Molina F, Roca A, Escuriet R, Galera J, Rubio, L. Modelo de decisiones compartidas en cáncer de mama: de la teoría a la práctica. Rev Int Organiz. 2018;21:43-62. https://doi.org/10.17345/rio21.43-62

Organización Mundial de la Salud. Informe mundial sobre el envejecimiento y la salud [internet]. Ginebra; 2015. Disponible en: https://apps.who.int/iris/bitstream/handle/10665/186471/WHO_FWC_ALC_15.01_spa.pdf

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