Squier R W
Department of Clinical Psychology, Eastbourne Health Authority, Hellingly Hospital, Hailsham, England.
Soc Sci Med. 1990;30(3):325-39. doi: 10.1016/0277-9536(90)90188-x.
Empathic understanding in practitioner relationships is postulated as necessary for adherence to therapeutic regimens. It is considered to be one of the most important practitioner relationship skills leading ultimately to patient health benefit. Research literature from a wide-range of health disciplines including personality theory, social psychology, psychotherapy, psycho-analysis, and practitioner-patient communication highlights the key role of empathic processes in personal health care. A model of empathic understanding is described which attempts to integrate the substantive findings in the research literature and seeks to generate new ideas for further investigation. The model addresses theoretical relationships between practitioners' empathic understanding, patients' knowledge of their illness and motivation to get better, adherence to treatment advice, and outcome. Recent work on the selection and training of medical and nursing staff in empathic skills is reviewed. A number of areas for future research are outlined including the effect of individual practitioner differences in the components of empathy, empathic compatibility in practitioner-patient dyads, fluctuations in levels of practitioner empathy during long-term care, specific practitioner behaviours which communicate empathy, and the relationship between factors of patient satisfaction and the perception of empathic understanding.
在医患关系中，共情理解被假定为坚持治疗方案所必需的。它被认为是最重要的医患关系技能之一，最终会给患者的健康带来益处。来自包括人格理论、社会心理学、心理治疗、精神分析以及医患沟通等广泛健康学科的研究文献强调了共情过程在个人医疗保健中的关键作用。本文描述了一个共情理解模型，该模型试图整合研究文献中的实质性发现，并力求为进一步研究提出新的思路。该模型探讨了医生的共情理解、患者对自身疾病的认知以及康复动机、坚持治疗建议和治疗结果之间的理论关系。本文回顾了近期关于医护人员共情技能的选拔和培训工作。概述了未来研究的一些领域，包括个体医生在共情各组成部分上的差异影响、医患二元组中的共情兼容性、长期护理期间医生共情水平的波动、传达共情的具体医生行为，以及患者满意度因素与共情理解感知之间的关系。
