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医生的同理心:定义、与结果的相关性及其在患者护理和医学教育中的衡量

Physician empathy: definition, outcome-relevance and its measurement in patient care and medical education.

作者信息

Neumann Melanie, Scheffer Christian, Tauschel Diethard, Lutz Gabriele, Wirtz Markus, Edelhäuser Friedrich

机构信息

Witten/Herdecke University, Faculty of Health, School of Medicine, Integrated Curriculum for Anthroposophic Medicine (ICURAM) at the Gerhard Kienle Chair for Medical Theory, Integrative and Anthroposophic Medicine, Witten, Germany.

出版信息

GMS Z Med Ausbild. 2012;29(1):Doc11. doi: 10.3205/zma000781. Epub 2012 Feb 15.

Abstract

OBJECTIVE

The present study gives a brief introduction into 1. the definition of physician empathy (PE) and 2. its influence on patients' health outcomes. Furthermore 3. we present assessment instruments to measure PE from the perspective of the patient and medical student. The latter topic will be explored in detail as we conducted a pilot study on the German versions of two self-assessment instruments of empathy, which are mostly used in medical education research, namely the "Jefferson Scale of Physician Empathy, Student Version" (JSPE-S) and the "Interpersonal Reactivity Index" (IRI).

METHODS

We first present an overview of the current empirical and theoretical literature on the definition and outcome-relevance of PE. Additionally, we conducted basic psychometric analyses of the German versions of the JSPE-S and the IRI. Data for this analyses is based on a cross-sectional pilot-survey in N=44 medical students and N=63 students of other disciplines from the University of Cologne.

RESULTS

PE includes the understanding of the patient as well as verbal and non-verbal communication, which should result in a helpful therapeutic action of the physician. Patients' health outcomes in different healthcare settings can be improved considerably from a high quality empathic encounter with their clinician. Basic psychometric results of the German JSPE-S and IRI measures show first promising results.

CONCLUSION

PE as an essential and outcome-relevant element in the patient-physician relationship requires more consideration in the education of medical students and, thus, in medical education research. The German versions of the JSPE-S and IRI measures seem to be promising means to evaluate these education aims and to conduct medical education research on empathy.

摘要

目的

本研究简要介绍了以下内容:1. 医生同理心(PE)的定义;2. 其对患者健康结局的影响。此外,3. 我们还介绍了从患者和医学生角度测量PE的评估工具。由于我们对两种主要用于医学教育研究的同理心自我评估工具的德语版本进行了一项试点研究,因此将对后一个主题进行详细探讨,这两种工具分别是“杰斐逊医生同理心量表,学生版”(JSPE-S)和“人际反应指数”(IRI)。

方法

我们首先概述了当前关于PE的定义及其与结局相关性的实证和理论文献。此外,我们对JSPE-S和IRI的德语版本进行了基本的心理测量分析。该分析的数据基于对科隆大学44名医学生和63名其他学科学生的横断面试点调查。

结果

PE包括对患者的理解以及言语和非言语交流,这应导致医生采取有益的治疗行动。在不同的医疗环境中,患者与临床医生进行高质量的共情接触后,其健康结局可得到显著改善。德语版JSPE-S和IRI测量的基本心理测量结果显示出初步的良好结果。

结论

PE作为医患关系中一个至关重要且与结局相关的要素,在医学生教育以及医学教育研究中需要更多的关注。JSPE-S和IRI测量的德语版本似乎是评估这些教育目标以及开展同理心医学教育研究的有前景的手段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b414/3296095/1e5a64d943c5/ZMA-29-11-t-001.jpg

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