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医生同理心与医生特征和患者体验标准化衡量指标之间的关联。

Associations Between Physician Empathy, Physician Characteristics, and Standardized Measures of Patient Experience.

机构信息

A. Chaitoff is a third-year medical student, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio. B. Sun is a third-year medical student, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio. A. Windover is director of curriculum and faculty development, Center for Excellence in Healthcare Communication, Cleveland Clinic, Cleveland, Ohio. D. Bokar is an analyst, Center for Excellence in Healthcare Communication, Cleveland Clinic, Cleveland, Ohio. J. Featherall is a third-year medical student, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio. M.B. Rothberg is vice chair for research, Medical Institute, and director, Center for Value-Based Care Research, Cleveland Clinic, Cleveland, Ohio. A.D. Misra-Hebert is a staff physician, Center for Value-Based Care Research, Cleveland Clinic, and assistant professor of medicine, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio.

出版信息

Acad Med. 2017 Oct;92(10):1464-1471. doi: 10.1097/ACM.0000000000001671.

Abstract

PURPOSE

To identify correlates of physician empathy and determine whether physician empathy is related to standardized measures of patient experience.

METHOD

Demographic, professional, and empathy data were collected during 2013-2015 from Cleveland Clinic Health System physicians prior to participation in mandatory communication skills training. Empathy was assessed using the Jefferson Scale of Empathy. Data were also collected for seven measures (six provider communication items and overall provider rating) from the visit-specific and 12-month Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS) surveys. Associations between empathy and provider characteristics were assessed by linear regression, ANOVA, or a nonparametric equivalent. Significant predictors were included in a multivariable linear regression model. Correlations between empathy and CG-CAHPS scores were assessed using Spearman rank correlation coefficients.

RESULTS

In bivariable analysis (n = 847 physicians), female sex (P < .001), specialty (P < .01), outpatient practice setting (P < .05), and DO degree (P < .05) were associated with higher empathy scores. In multivariable analysis, female sex (P < .001) and four specialties (obstetrics-gynecology, pediatrics, psychiatry, and thoracic surgery; all P < .05) were significantly associated with higher empathy scores. Of the seven CG-CAHPS measures, scores on five for the 583 physicians with visit-specific data and on three for the 277 physicians with 12-month data were positively correlated with empathy.

CONCLUSIONS

Specialty and sex were independently associated with physician empathy. Empathy was correlated with higher scores on multiple CG-CAHPS items, suggesting improving physician empathy might play a role in improving patient experience.

摘要

目的

确定医生同理心的相关因素,并确定医生同理心是否与患者体验的标准化测量有关。

方法

在 2013 年至 2015 年期间,克利夫兰诊所医疗系统的医生在参加强制性沟通技巧培训之前,收集了人口统计学、专业和同理心数据。同理心使用杰斐逊同理心量表进行评估。还从特定就诊和 12 个月的消费者评估医疗保健提供者和系统临床医生和小组(CG-CAHPS)调查中收集了七个措施(六个提供者沟通项目和整体提供者评分)的数据。通过线性回归、方差分析或非参数等效方法评估同理心与提供者特征之间的关联。将显著的预测因子纳入多变量线性回归模型。使用 Spearman 等级相关系数评估同理心与 CG-CAHPS 评分之间的相关性。

结果

在双变量分析(n = 847 名医生)中,女性(P <.001)、专业(P <.01)、门诊实践环境(P <.05)和 DO 学位(P <.05)与较高的同理心评分相关。在多变量分析中,女性(P <.001)和四个专业(妇产科、儿科、精神病学和胸外科;均 P <.05)与较高的同理心评分显著相关。在 583 名有特定就诊数据的医生中,有七个 CG-CAHPS 测量中的五个测量值,在 277 名有 12 个月数据的医生中,有三个测量值与同理心呈正相关。

结论

专业和性别与医生同理心独立相关。同理心与 CG-CAHPS 多项评分较高相关,这表明提高医生同理心可能在改善患者体验方面发挥作用。

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