Hojat Mohammadreza, Gonnella Joseph S, Nasca Thomas J, Mangione Salvatore, Vergare Michael, Magee Michael
Center for Research in Medical Education and Health Care, Department of Psychiatry and Human Behavior, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Am J Psychiatry. 2002 Sep;159(9):1563-9. doi: 10.1176/appi.ajp.159.9.1563.
There is a dearth of empirical research on physician empathy despite its mediating role in patient-physician relationships and clinical outcomes. This study was designed to investigate the components of physician empathy, its measurement properties, and group differences in empathy scores.
A revised version of the Jefferson Scale of Physician Empathy (with 20 Likert-type items) was mailed to 1,007 physicians affiliated with the Jefferson Health System in the greater Philadelphia region; 704 (70%) responded. Construct validity, reliability of the empathy scale, and the differences on mean empathy scores by physicians' gender and specialty were examined.
Three meaningful factors emerged (perspective taking, compassionate care, and standing in the patient's shoes) to provide support for the construct validity of the empathy scale that was also found to be internally consistent with relatively stable scores over time. Women scored higher than men to a degree that was nearly significant. With control for gender, psychiatrists scored a mean empathy rating that was significantly higher than that of physicians specializing in anesthesiology, orthopedic surgery, neurosurgery, radiology, cardiovascular surgery, obstetrics and gynecology, and general surgery. No significant difference was observed on empathy scores among physicians specializing in psychiatry, internal medicine, pediatrics, emergency medicine, and family medicine.
Empathy is a multidimensional concept that varies among physicians and can be measured with a psychometrically sound tool. Implications for specialty selection and career counseling are discussed.
尽管医生同理心在医患关系和临床结果中起中介作用,但关于它的实证研究却很匮乏。本研究旨在调查医生同理心的组成部分、其测量属性以及同理心得分的组间差异。
将修订版的杰斐逊医生同理心量表(含20个李克特式项目)邮寄给大费城地区杰斐逊医疗系统的1007名医生;704人(70%)回复。检验了同理心量表的结构效度、信度,以及医生性别和专业在平均同理心得分上的差异。
出现了三个有意义的因素(换位思考、同情关怀和设身处地为患者着想),为同理心量表的结构效度提供了支持,该量表在时间上也具有内部一致性且得分相对稳定。女性得分比男性略高,几乎达到显著水平。在控制性别后,精神科医生的平均同理心评分显著高于麻醉科、骨科、神经外科、放射科、心血管外科、妇产科和普通外科的医生。精神科、内科、儿科、急诊科和家庭医学科的医生在同理心得分上未观察到显著差异。
同理心是一个多维概念,在医生中存在差异,并且可以用一种心理测量学上合理的工具进行测量。讨论了对专业选择和职业咨询的启示。