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医生的同理心与糖尿病患者的临床结局。

Physicians' empathy and clinical outcomes for diabetic patients.

机构信息

Department of Psychiatry and Human Behavior, Jefferson Longitudinal Study of Medical Education, Center for Research in Medical Education and Health Care, Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA.

出版信息

Acad Med. 2011 Mar;86(3):359-64. doi: 10.1097/ACM.0b013e3182086fe1.

Abstract

PURPOSE

To test the hypothesis that physicians' empathy is associated with positive clinical outcomes for diabetic patients.

METHOD

A correlational study design was used in a university-affiliated outpatient setting. Participants were 891 diabetic patients, treated between July 2006 and June 2009, by 29 family physicians. Results of the most recent hemoglobin A1c and LDL-C tests were extracted from the patients' electronic records. The results of hemoglobin A1c tests were categorized into good control (<7.0%) and poor control (>9.0%). Similarly, the results of the LDL-C tests were grouped into good control (<100) and poor control (>130). The physicians, who completed the Jefferson Scale of Empathy in 2009, were grouped into high, moderate, and low empathy scorers. Associations between physicians' level of empathy scores and patient outcomes were examined.

RESULTS

Patients of physicians with high empathy scores were significantly more likely to have good control of hemoglobin A1c (56%) than were patients of physicians with low empathy scores (40%, P < .001). Similarly, the proportion of patients with good LDL-C control was significantly higher for physicians with high empathy scores (59%) than physicians with low scores (44%, P < .001). Logistic regression analyses indicated that physicians' empathy had a unique contribution to the prediction of optimal clinical outcomes after controlling for physicians' and patients' gender and age, and patients' health insurance.

CONCLUSIONS

The hypothesis of a positive relationship between physicians' empathy and patients' clinical outcomes was confirmed, suggesting that physicians' empathy is an important factor associated with clinical competence and patient outcomes.

摘要

目的

检验医师共情与糖尿病患者临床结局呈正相关的假说。

方法

在一所大学附属医院的门诊环境中进行了一项相关性研究设计。研究对象为 891 名糖尿病患者,由 29 名家庭医生于 2006 年 7 月至 2009 年 6 月间进行治疗。从患者的电子病历中提取了最近一次血红蛋白 A1c 和 LDL-C 测试的结果。血红蛋白 A1c 测试的结果分为良好控制(<7.0%)和控制不佳(>9.0%)。同样,LDL-C 测试的结果也分为良好控制(<100)和控制不佳(>130)。2009 年完成了杰斐逊共情量表的医生被分为高、中、低共情评分组。研究人员检查了医生共情评分与患者结局之间的关联。

结果

具有高共情评分的医生的患者,其血红蛋白 A1c 控制良好的比例明显更高(56%),而共情评分较低的医生的患者(40%,P<.001)。同样,具有高共情评分的医生的患者中,LDL-C 控制良好的比例明显更高(59%),而共情评分较低的医生的患者(44%,P<.001)。逻辑回归分析表明,在控制医生和患者的性别和年龄以及患者的健康保险后,医生的共情对预测最佳临床结局具有独特的贡献。

结论

医生共情与患者临床结局之间存在正相关关系的假说得到了证实,这表明医生的共情是与临床能力和患者结局相关的一个重要因素。

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