Lelorain Sophie, Brédart Anne, Dolbeault Sylvie, Cano Alejandra, Bonnaud-Antignac Angélique, Cousson-Gélie Florence, Sultan Serge
Univ Lille Nord de France, Department of Psychology, Lille, France; UDL3, SCALab UMR CNRS 9193, Villeneuve d'Ascq, France.
Institut Curie, Psycho-oncology Unit, Paris, France; Paris Descartes University, LPPS EA 4057-IUPDP, Boulogne-Billancourt, France.
Patient Educ Couns. 2015 Jun;98(6):734-41. doi: 10.1016/j.pec.2015.03.002. Epub 2015 Mar 18.
Unmet supportive care needs of patients decrease patient perception of physician empathy (PE). We explored whether the accurate physician understanding of a given patient's unmet needs (AU), could buffer the adverse effect of these unmet needs on PE.
In a cross-sectional design, 28 physicians and 201 metastatic cancer patients independently assessed the unmet supportive care needs of patients. AU was calculated as the sum of items for which physicians correctly rated the level of patient needs. PE and covariates were assessed using self-reported questionnaires. Multilevel analyses were carried out.
AU did not directly affect PE but acted as a moderator. When patients were highly expressive and when physicians perceived poor rapport with the patient, a high AU moderated the adverse effect of patient unmet needs on PE.
Physician AU has the power to protect the doctor-patient relationship in spite of high patient unmet needs, but only in certain conditions.
Physicians should be encouraged toward AU but warned that high rapport and patient low emotional expression may impede an accurate reading of patients. In this latter case, they should request a formal assessment of their patients' needs.
患者未满足的支持性护理需求会降低患者对医生同理心（PE）的感知。我们探讨了医生对特定患者未满足需求的准确理解（AU）是否能够缓冲这些未满足需求对PE的不利影响。
采用横断面设计，28名医生和201名转移性癌症患者分别评估患者未满足的支持性护理需求。AU计算为医生正确评定患者需求水平的项目总和。使用自我报告问卷评估PE和协变量。进行多水平分析。
AU并未直接影响PE，但起到了调节作用。当患者表达性很强且医生感觉与患者关系不融洽时，高AU可缓和患者未满足需求对PE的不利影响。
尽管患者有大量未满足的需求，但医生的AU有能力保护医患关系，但仅在某些情况下如此。
应鼓励医生做到AU，但要提醒他们，关系融洽度高以及患者情绪表达少可能会妨碍对患者的准确判断。在后一种情况下，他们应要求对患者需求进行正式评估。
