基于巴林特小组的适当培训可以提高医学生的共情能力：一项初步研究。

Appropriate training based on Balint groups can improve the empathic abilities of medical students: a preliminary study.

作者信息

Airagnes Guillaume, Consoli Silla M, De Morlhon Olivier, Galliot Anne-Marie, Lemogne Cédric, Jaury Philippe

机构信息

Paris Descartes University, Sorbonne Paris Cité, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Ouest, Service universitaire de Psychiatrie de l'adulte et du sujet âgé, Paris, France.

出版信息

J Psychosom Res. 2014 May;76(5):426-9. doi: 10.1016/j.jpsychores.2014.03.005. Epub 2014 Mar 28.

DOI:10.1016/j.jpsychores.2014.03.005

PMID:24745786

Abstract

OBJECTIVE

Although empathy is critical in a doctor-patient relationship, empathic abilities seem to decline throughout medical school. This study aimed at examining changes in empathic abilities of fourth-year medical students who participated in an optional certificate based on Balint groups.

METHODS

Thirty-four students were included in the "Balint group" certificate and compared with 129 participating in other certificates. Before the training sessions and 4 months later, they filled up the interpersonal reactivity index (IRI) and were asked to rate their emotional reactions in response to two case-reports: the first described a woman with diabetes, borderline- personality traits and a history of childhood trauma; the second, a woman with histrionic traits suffering from multiple sclerosis and hospitalized for functional symptoms. A principal component analysis extracted four factors from the 8 questions asked: empathic-approach (e.g. finding the patient touching), rejecting-attitude, intellectual-interest and fear of emotion contagion.

RESULTS

At baseline, there were no socio-demographic or psychological differences between groups. At follow-up, an increase of IRI fantasy-scale (p=0.02) and a decrease of IRI empathic-concern (p=0.006) were observed, regardless of the group. Empathic-approach only increased in the "Balint group" and for the first case-report (p=0.023), with a difference between the groups at follow-up (p=0.003).

CONCLUSION

Results suggest that Balint groups may enable medical students to better handle difficult clinical situations such as those presented by borderline personalities. Our findings encourage assessing training initiatives designed at helping young medical students to take into account the emotional component of a doctor-patient relationship.

摘要

目的

尽管同理心在医患关系中至关重要，但在整个医学院学习过程中，同理心能力似乎会下降。本研究旨在考察参加基于巴林特小组的选修证书课程的四年级医学生同理心能力的变化。

方法

34名学生参加了“巴林特小组”证书课程，并与129名参加其他证书课程的学生进行比较。在培训课程前和4个月后，他们填写了人际反应指数（IRI），并被要求对两个病例报告的情绪反应进行评分：第一个病例描述了一名患有糖尿病、边缘性人格特质且有童年创伤史的女性；第二个病例是一名患有表演型人格特质、患有多发性硬化症并因功能症状住院的女性。主成分分析从所问的8个问题中提取了4个因素：同理心方法（如发现患者令人感动）、拒绝态度、求知兴趣和对情绪感染的恐惧。

结果：在基线时，两组之间在社会人口统计学或心理方面没有差异。在随访时，无论哪一组，IRI幻想量表得分增加（p = 0.02），IRI同理心关注得分降低（p = 0.006）。仅在“巴林特小组”中，针对第一个病例报告，同理心方法有所增加（p = 0.023），随访时两组之间存在差异（p = 0.003）。