Steinhausen Simone, Ommen Oliver, Antoine Sunya-Lee, Koehler Thorsten, Pfaff Holger, Neugebauer Edmund
Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Campus Cologne-Merheim, Germany.
Federal Centre for Health Education (BZgA), Cologne, Germany.
Patient Prefer Adherence. 2014 Sep 18;8:1239-53. doi: 10.2147/PPA.S62925. eCollection 2014.
To investigate accident casualties' long-term subjective evaluation of treatment outcome 6 weeks and 12 months after discharge and its relation to the experienced surgeon's empathy during hospital treatment after trauma in consideration of patient-, injury-, and health-related factors. The long-term results are compared to the 6-week follow-up outcomes.
Two hundred and seventeen surgery patients were surveyed at 6 weeks, and 206 patients at 12 months after discharge from the trauma surgical general ward. The subjective evaluation of medical treatment outcome was measured 6 weeks and 12 months after discharge with the respective scale from the Cologne Patient Questionnaire. Physician Empathy was assessed with the Consultation and Relational Empathy Measure. The correlation between physician empathy and control variables with the subjective evaluation of medical treatment outcome 12 months after discharge was identified by means of logistic regression analysis under control of sociodemographic and injury-related factors.
One hundred and thirty-six patients were included within the logistic regression analysis at the 12-month follow-up. Compared to the 6-week follow-up, the level of subjective evaluation of medical treatment outcome was slightly lower and the association with physician empathy was weaker. Compared to patients who rated the empathy of their surgeon lower than 31 points, patients with ratings of 41 points or higher had a 4.2-fold higher probability to be in the group with a better medical treatment outcome (3.5 and above) on the Cologne Patient Questionnaire scale 12 months after discharge from hospital (P=0.009, R (2)=33.5, 95% confidence interval: 1.440-12.629).
Physician empathy is the strongest predictor for a higher level of trauma patients' subjective evaluation of treatment outcome 6 weeks and 12 months after discharge from the hospital. Interpersonal factors between surgeons and their patients are possible key levers for improving patient outcomes in an advanced health system. Communication trainings for surgeons might prepare them to react appropriately to their patients' needs and lead to satisfactory outcomes for both parties.
考虑患者、损伤及健康相关因素，调查事故伤亡者出院后6周和12个月对治疗结果的长期主观评价，及其与创伤后住院治疗期间经验丰富的外科医生同理心的关系。将长期结果与6周随访结果进行比较。
对创伤外科普通病房出院后6周的217例手术患者和12个月的206例患者进行了调查。出院后6周和12个月，使用科隆患者问卷的相应量表测量对医疗治疗结果的主观评价。使用咨询与关系同理心量表评估医生的同理心。在社会人口统计学和损伤相关因素的控制下，通过逻辑回归分析确定医生同理心与控制变量与出院后12个月医疗治疗结果主观评价之间的相关性。
12个月随访时，136例患者纳入逻辑回归分析。与6周随访相比，医疗治疗结果的主观评价水平略低，与医生同理心的关联较弱。与将外科医生同理心评分低于31分的患者相比，评分41分或更高的患者在出院后12个月的科隆患者问卷量表上，处于医疗治疗结果较好组（3.5及以上）的可能性高4.2倍（P=0.009，R(2)=33.5，95%置信区间：1.440-12.629）。
医生同理心是创伤患者出院后6周和12个月对治疗结果主观评价较高水平的最强预测因素。外科医生与其患者之间的人际因素可能是先进医疗系统中改善患者预后的关键杠杆。对外科医生进行沟通培训可能使他们能够对患者的需求做出适当反应，并为双方带来满意的结果。
