Department of Family Medicine, University of Wisconsin-Madison, Madison, WI, USA.
Patient Educ Couns. 2011 Dec;85(3):390-7. doi: 10.1016/j.pec.2011.01.009. Epub 2011 Feb 5.
To evaluate the effects of patient-practitioner interaction on the severity and duration of the common cold.
We conducted a randomized controlled trial of 719 patients with new cold onset. Participants were randomized to three groups: no patient-practitioner interaction, "standard" interaction or an "enhanced" interaction. Cold severity was assessed twice daily. Patients randomized to practitioner visits used the Consultation and Relational Empathy (CARE) measure to rate clinician empathy. Interleukin-8 (IL-8) and neutrophil counts were obtained from nasal wash at baseline and 48 h later.
Patients' perceptions of the clinical encounter were associated with reduced cold severity and duration. Encounters rated perfect on the CARE score had reduced severity (perfect: 223, sub-perfect: 271, p=0.04) and duration (perfect: 5.89 days, sub-perfect: 7.00 days, p=0.003). CARE scores were also associated with a more significant change in IL-8 (perfect: mean IL-8 change 1586, sub-perfect: 72, p=0.02) and neutrophil count (perfect: 49, sub-perfect: 12, p=0.09).
When patients perceive clinicians as empathetic, rating them perfect on the CARE tool, the severity, duration and objective measures (IL-8 and neutrophils) of the common cold significantly change.
This study helps us to understand the importance of the perception of empathy in a therapeutic encounter.
评估医患互动对普通感冒严重程度和持续时间的影响。
我们对 719 例新发感冒患者进行了一项随机对照试验。参与者被随机分为三组：无医患互动、“标准”互动或“增强”互动。每日两次评估感冒严重程度。随机接受医生访视的患者使用咨询和关系同理心（CARE）量表对临床医生同理心进行评分。在基线和 48 小时后，从鼻洗液中获取白细胞介素-8（IL-8）和中性粒细胞计数。
患者对临床接触的看法与感冒严重程度和持续时间的降低有关。在 CARE 评分中被评为完美的患者，其感冒严重程度（完美：223 例，次完美：271 例，p=0.04）和持续时间（完美：5.89 天，次完美：7.00 天，p=0.003）降低。CARE 评分也与 IL-8（完美：平均 IL-8 变化 1586，次完美：72，p=0.02）和中性粒细胞计数（完美：49，次完美：12，p=0.09）的变化更显著相关。
当患者认为临床医生富有同理心，在 CARE 工具中给予他们完美评分时，普通感冒的严重程度、持续时间和客观指标（IL-8 和中性粒细胞）会显著改变。
本研究帮助我们理解在治疗性接触中同理心感知的重要性。
