Thomas Matthew R, Dyrbye Liselotte N, Huntington Jefrey L, Lawson Karen L, Novotny Paul J, Sloan Jeff A, Shanafelt Tait D
Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
J Gen Intern Med. 2007 Feb;22(2):177-83. doi: 10.1007/s11606-006-0039-6.
To determine whether lower levels of empathy among a sample of medical students in the United States are associated with personal and professional distress and to explore whether a high degree of personal well-being is associated with higher levels of empathy.
Multi-institutional, cross-sectional survey.
All medical schools in Minnesota (a private medical school, a traditional public university, and a public university with a focus in primary care).
A total of 1,098 medical students.
Validated instruments were used to measure empathy, distress (i.e., burnout and symptoms of depression), and well-being (high quality of life).
Medical student empathy scores were higher than normative samples of similarly aged individuals and were similar to other medical student samples. Domains of burnout inversely correlated with empathy (depersonalization with empathy independent of gender, all P < .02, and emotional exhaustion with emotive empathy for men, P = .009). Symptoms of depression inversely correlated with empathy for women (all P < or = .01). In contrast, students' sense of personal accomplishment demonstrated a positive correlation with empathy independent of gender (all P < .001). Similarly, achieving a high quality of life in specific domains correlated with higher empathy scores (P < .05). On multivariate analysis evaluating measures of distress and well-being simultaneously, both burnout (negative correlation) and well-being (positive correlation) independently correlated with student empathy scores.
Both distress and well-being are related to medical student empathy. Efforts to reduce student distress should be part of broader efforts to promote student well-being, which may enhance aspects of professionalism. Additional studies of student well-being and its potential influence on professionalism are needed.
确定美国一群医学院学生较低的同理心水平是否与个人及职业困扰相关，并探究高度的个人幸福感是否与较高的同理心水平相关。
多机构横断面调查。
明尼苏达州的所有医学院（一所私立医学院、一所传统公立大学和一所专注于初级保健的公立大学）。
共1098名医学生。
使用经过验证的工具来测量同理心、困扰（即职业倦怠和抑郁症状）以及幸福感（高质量生活）。
医学生的同理心得分高于年龄相仿人群的常模样本，且与其他医学生样本相似。职业倦怠的各个维度与同理心呈负相关（去个性化与同理心的关系不受性别影响，所有P < 0.02；情感耗竭与男性的情感同理心呈负相关，P = 0.009）。抑郁症状与女性的同理心呈负相关（所有P ≤ 0.01）。相比之下，学生的个人成就感与同理心呈正相关，且不受性别影响（所有P < 0.001）。同样，在特定领域实现高质量生活与较高的同理心得分相关（P < 0.05）。在同时评估困扰和幸福感指标的多变量分析中，职业倦怠（负相关）和幸福感（正相关）均与学生的同理心得分独立相关。
困扰和幸福感均与医学生的同理心相关。减轻学生困扰的努力应成为促进学生幸福感这一更广泛努力的一部分，这可能会提升职业素养的各个方面。需要对学生幸福感及其对职业素养的潜在影响进行更多研究。
