<?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>2696-1296</journal-id>
<journal-title><![CDATA[Revista mexicana de medicina familiar]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Mex. med. familiar]]></abbrev-journal-title>
<issn>2696-1296</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Especialistas y Residentes en Medicina Familiar A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2696-12962024000100017</article-id>
<article-id pub-id-type="doi">10.24875/rmf.23000140</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Resignificación del concepto «respuesta al placebo» a «respuesta al significado» en un grupo Balint con residentes de medicina familiar]]></article-title>
<article-title xml:lang="en"><![CDATA[Resignification of the concept "response to placebo" to "response to meaning2 in a Balint group with family medicine residents]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez-Villaseñor]]></surname>
<given-names><![CDATA[Ismael]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Morfín-López]]></surname>
<given-names><![CDATA[Teresita]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ray-Bazán]]></surname>
<given-names><![CDATA[Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Colegio Jalisciense de Medicina Familiar Comisión Académica ]]></institution>
<addr-line><![CDATA[Guadalajara Jalisco]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Jesuita de Guadalajara  ]]></institution>
<addr-line><![CDATA[Tlaquepaque Jalisco]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad Jesuita de Guadalajara  ]]></institution>
<addr-line><![CDATA[Tlaquepaque Jalisco]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2024</year>
</pub-date>
<volume>11</volume>
<numero>1</numero>
<fpage>17</fpage>
<lpage>26</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2696-12962024000100017&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2696-12962024000100017&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2696-12962024000100017&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Antecedentes En la educación médica prevalece la enseñanza del concepto «respuesta al placebo» sin reconocer que las respuestas clínicas que ocurren se deben a los significados del paciente y que no pueden ser producidas por sustancias inertes.  Objetivo Explorar el aprendizaje, las opiniones y los significados sobre el concepto «respuesta al significado» y su contraste con la idea de respuesta al placebo de los residentes participantes.  Material y métodos Se realizó un estudio cualitativo con diseño y análisis acorde con la teoría fundamentada. Participaron tres residentes de medicina familiar que leyeron y discutieron en un grupo Balint un artículo que critica el concepto de respuesta al placebo y que propone el de respuesta al significado. Las discusiones se grabaron, transcribieron y codificaron con el método de la teoría fundamentada.  Resultados Los residentes lograron describir el concepto de respuesta al significado y su versión de sus componentes a partir de sus experiencias con pacientes.  Conclusiones La respuesta al significado se genera por la atención empática, centrarse en la persona, la comunicación adecuada y generando confianza; es influida por la cultura y su carácter es cambiante. El significado es potente para médico y paciente, se requiere formación al respecto, el médico debe aceptar que los pacientes responden clínicamente a los significados de la relación médico-paciente y que esta debe ser lo más horizontal posible.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background In medical education, the teaching of the concept of "placebo response" prevails without recognizing that the clinical responses that occur are due to the patient´s meanings and that they cannot be produced by inert substances.  Objective Explore the learning, opinions, and meanings about the concept of "response to meaning" and its contrast with the idea of response to placebo among the participating residents.  Materials and methods A qualitative study was carried out with design and analysis in accordance with the grounded theory. Three family medicine residents red and discussed in a Balint group an article that criticizes the concept of response to placebo and that proposes the concept of response to meaning. The group discussions carried out were recorded, transcribed, and coded with the grounded theory method.  Results The residents could describe the concept of response to meaning and described their version of its components based on their experiences with patients.  Conclusions The response to meaning is generated by empathic attention, focusing on the person, appropriate communication and generating trust; it is influenced by culture and its character is changing. The meaning is powerful for doctor and patient, training is required in this regard, the doctor must accept that patients respond clinically to the meanings of the doctor-patient relationship and that this should be as horizontal as possible.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Educación médica]]></kwd>
<kwd lng="es"><![CDATA[Respuesta al significado]]></kwd>
<kwd lng="es"><![CDATA[Respuesta al placebo]]></kwd>
<kwd lng="es"><![CDATA[Medicina familiar]]></kwd>
<kwd lng="en"><![CDATA[Medical education]]></kwd>
<kwd lng="en"><![CDATA[Response to meaning]]></kwd>
<kwd lng="en"><![CDATA[Placebo response]]></kwd>
<kwd lng="en"><![CDATA[Family medicine]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[McWhinney]]></surname>
<given-names><![CDATA[IR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The importance of being different.]]></article-title>
<source><![CDATA[BJGP.]]></source>
<year>1996</year>
<volume>46</volume>
<page-range>433-6</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lam-Díaz]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
<name>
<surname><![CDATA[Hernández-Ramírez]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[El placebo y el efecto placebo.]]></article-title>
<source><![CDATA[Rev Cub Hematol Inmunol Hemoter.]]></source>
<year>2014</year>
<volume>30</volume>
<page-range>214-22</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3.</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moerman]]></surname>
<given-names><![CDATA[DE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Against placebo´. The case for changing our language, and for the meaning response.]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Colloca]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Flaten]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Meissner]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<source><![CDATA[Placebo and pain: from bench to bedside.]]></source>
<year>2013</year>
<page-range>183-8</page-range><publisher-loc><![CDATA[Amsterdam ]]></publisher-loc>
<publisher-name><![CDATA[Academic Press]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B4">
<label>4.</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Meinert]]></surname>
<given-names><![CDATA[CL]]></given-names>
</name>
<name>
<surname><![CDATA[Tonascia]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[Clinical trials, design, conduct, and analysis.]]></source>
<year>1986</year>
<publisher-loc><![CDATA[New York ]]></publisher-loc>
<publisher-name><![CDATA[Oxford University Press]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B5">
<label>5.</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Freeman]]></surname>
<given-names><![CDATA[TR]]></given-names>
</name>
</person-group>
<source><![CDATA[McWhinney´s Textbook of family medicine.]]></source>
<year>2016</year>
<publisher-loc><![CDATA[New York ]]></publisher-loc>
<publisher-name><![CDATA[Oxford University Press]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B6">
<label>6.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Reeves]]></surname>
<given-names><![CDATA[RR]]></given-names>
</name>
<name>
<surname><![CDATA[Ladner]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hart]]></surname>
<given-names><![CDATA[RH]]></given-names>
</name>
<name>
<surname><![CDATA[Burke]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Nocebo effects with antidepressant clinical drug trial placebos.]]></article-title>
<source><![CDATA[Gen Hosp Psych.]]></source>
<year>2007</year>
<volume>29</volume>
<page-range>275-7</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moerman]]></surname>
<given-names><![CDATA[DE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Against the "placebo effect": a personal point of view.]]></article-title>
<source><![CDATA[Complement Ther Med.]]></source>
<year>2013</year>
<volume>21</volume>
<page-range>125-30</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moerman]]></surname>
<given-names><![CDATA[DE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Looking at placebos through a cultural lens and finding meaning: modern perspectives on placebos in society.]]></article-title>
<source><![CDATA[MBR.]]></source>
<year>2015</year>
<volume>2</volume>
<page-range>63-72</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Beauregard]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mind does really matter: evidence from neuroimaging studies of emotional self-regulation, psychotherapy, and placebo effect.]]></article-title>
<source><![CDATA[Prog Neurobiol.]]></source>
<year>2007</year>
<volume>81</volume>
<page-range>218-36</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10.</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bañoz-Diez]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[El efecto placebo.]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Albaladejo]]></surname>
<given-names><![CDATA[MF]]></given-names>
</name>
<name>
<surname><![CDATA[Bañoz-Diez]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
</person-group>
<source><![CDATA[Principios de farmacología clínica.]]></source>
<year>2002</year>
<page-range>169-77</page-range><publisher-loc><![CDATA[Barcelona ]]></publisher-loc>
<publisher-name><![CDATA[Masson]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B11">
<label>11.</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nies]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Principles of therapeutics.]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Hardman]]></surname>
<given-names><![CDATA[GJ]]></given-names>
</name>
<name>
<surname><![CDATA[Goodman]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
<name>
<surname><![CDATA[Limbird]]></surname>
<given-names><![CDATA[EL]]></given-names>
</name>
</person-group>
<source><![CDATA[Goodman &amp; Gilman´s The pharmacological basis of therapeutics.]]></source>
<year>1996</year>
<page-range>43-62</page-range><publisher-loc><![CDATA[New York ]]></publisher-loc>
<publisher-name><![CDATA[McGraw-Hill]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B12">
<label>12.</label><nlm-citation citation-type="">
<collab>Facultad de Medicina, Universidad Nacional Autónoma de México.</collab>
<source><![CDATA[Plan de estudios médico cirujano.]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B13">
<label>13.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Levine]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[Gordon]]></surname>
<given-names><![CDATA[NC]]></given-names>
</name>
<name>
<surname><![CDATA[Fields]]></surname>
<given-names><![CDATA[HL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The mechanism of placebo analgesia.]]></article-title>
<source><![CDATA[Lancet.]]></source>
<year>1978</year>
<volume>2</volume>
<page-range>654-7</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[McNaughton]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Discourse(s) of emotion within medical education: the ever-present absence.]]></article-title>
<source><![CDATA[Med Educ.]]></source>
<year>2013</year>
<volume>47</volume>
<page-range>71-9</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15.</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Valles]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
</person-group>
<source><![CDATA[Técnicas cualitativas de investigación social.]]></source>
<year>2009</year>
<publisher-loc><![CDATA[Madrid ]]></publisher-loc>
<publisher-name><![CDATA[Síntesis]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B16">
<label>16.</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jarvinen]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Mik-Meyer]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<source><![CDATA[Qualitative analysis: eight approaches for the social sciences.]]></source>
<year>2020</year>
<publisher-loc><![CDATA[Los Angeles, CA ]]></publisher-loc>
<publisher-name><![CDATA[SAGE]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B17">
<label>17.</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Flick]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
</person-group>
<source><![CDATA[The qualitative research process.]]></source>
<year>2014</year>
<publisher-loc><![CDATA[London ]]></publisher-loc>
<publisher-name><![CDATA[SAGE]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B18">
<label>18.</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Charmaz]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<source><![CDATA[Constructing grounded theory (introducing qualitative methods series).]]></source>
<year>2014</year>
<edition>2nd ed</edition>
<publisher-loc><![CDATA[Los Angeles, CA ]]></publisher-loc>
<publisher-name><![CDATA[SAGE]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B19">
<label>19.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Villaseñor]]></surname>
<given-names><![CDATA[IR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La enseñanza de la relación médico-paciente con poder terapéutico, enfocado con la teoría fundamentada constructivista.]]></article-title>
<source><![CDATA[Rev Mex Med Fam.]]></source>
<year>2022</year>
<volume>9</volume>
<page-range>20-30</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Balint]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The structure of the training-cum-research-seminars. Its implications for medicine.]]></article-title>
<source><![CDATA[J R Coll Gen Pract.]]></source>
<year>1969</year>
<volume>17</volume>
<page-range>201-11</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21.</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Balint]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Introduction.]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Balint]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[The doctor, his patient and the illness.]]></source>
<year>2000</year>
<page-range>I-V</page-range><publisher-loc><![CDATA[Edinburgh, UK ]]></publisher-loc>
<publisher-name><![CDATA[Churchill Livingstone]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B22">
<label>22.</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Van der Kolk]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<source><![CDATA[El cuerpo lleva la cuenta. Cerebro, mente y cuerpo en la superación del trauma.]]></source>
<year>2015</year>
<publisher-loc><![CDATA[Barcelona ]]></publisher-loc>
<publisher-name><![CDATA[Viking Penguin, Eleftheria]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B23">
<label>23.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ramírez-Villaseñor]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[García-Serrano]]></surname>
<given-names><![CDATA[VG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La respuesta al significado (antes respuesta placebo) y la medicina familiar.]]></article-title>
<source><![CDATA[Arch Med Fam.]]></source>
<year>2019</year>
<volume>21</volume>
<page-range>61-8</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stewart]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Brown]]></surname>
<given-names><![CDATA[JB]]></given-names>
</name>
<name>
<surname><![CDATA[Donner]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The impact of patient-centered care on outcomes.]]></article-title>
<source><![CDATA[J Fam Pract.]]></source>
<year>2000</year>
<volume>49</volume>
<page-range>796-804</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kitto]]></surname>
<given-names><![CDATA[SC]]></given-names>
</name>
<name>
<surname><![CDATA[Chesters]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Grbich]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Criteria for authors and assessors in the submission and assessment of qualitative research articles for the Medical Journal of Australia.]]></article-title>
<source><![CDATA[MJA.]]></source>
<year>2008</year>
<volume>188</volume>
<page-range>243-6</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
