测量医学生的同理心：探索五个国家中两种广泛使用的自我报告工具的潜在结构及两者之间的关联。

Measuring Medical Students' Empathy: Exploring the Underlying Constructs of and Associations Between Two Widely Used Self-Report Instruments in Five Countries.

作者信息

Costa Patrício, de Carvalho-Filho Marco Antonio, Schweller Marcelo, Thiemann Pia, Salgueira Ana, Benson John, Costa Manuel João, Quince Thelma

机构信息

P. Costa is assistant professor, School of Health Sciences, and researcher in medical education, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal. M.A. de Carvalho-Filho is professor of medicine, Department of Emergency Medicine, Faculty of Medical Sciences, University of Campinas (Unicamp), Campinas, Brazil. M. Schweller is emergency medicine physician and preceptor, Faculty of Medical Sciences, University of Campinas (Unicamp), Campinas, Brazil. P. Thiemann is research assistant, Palliative Care Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. A. Salgueira is a PhD student, School of Health Sciences, and researcher in medical education, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal. J. Benson is senior lecturer, General Practice, and director, General Practice Education Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. M.J. Costa is associate professor, School of Health Sciences, and researcher in medical education, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal. T. Quince is medical educational research associate, Primary Care Unit, Department of Public Health and Primary Care and School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.

出版信息

Acad Med. 2017 Jun;92(6):860-867. doi: 10.1097/ACM.0000000000001449.

DOI:10.1097/ACM.0000000000001449

PMID:28557952

Abstract

PURPOSE

Understanding medical student empathy is important to future patient care; however, the definition and development of clinical empathy remain unclear. The authors sought to examine the underlying constructs of two of the most widely used self-report instruments-Davis's Interpersonal Reactivity Index (IRI) and the Jefferson Scale of Empathy version for medical students (JSE-S)-plus, the distinctions and associations between these instruments.

METHOD

Between 2007 and 2014, the authors administered the IRI and JSE-S in three separate studies in five countries, (Brazil, Ireland, New Zealand, Portugal, and the United Kingdom). They collected data from 3,069 undergraduate medical students and performed exploratory factor analyses, correlation analyses, and multiple linear regression analyses.

RESULTS

Exploratory factor analysis yielded identical results in each country, confirming the subscale structures of each instrument. Results of correlation analyses indicated significant but weak correlations (r = 0.313) between the total IRI and JSE-S scores. All intercorrelations of IRI and JSE-S subscale scores were statistically significant but weak (range r = -0.040 to 0.306). Multiple linear regression models revealed that the IRI subscales were weak predictors of all JSE-S subscale and total scores. The IRI subscales explained between 9.0% and 15.3% of variance for JSE-S subscales and 19.5% for JSE-S total score.

CONCLUSIONS

The IRI and JSE-S are only weakly related, suggesting that they may measure different constructs. To better understand this distinction, more studies using both instruments and involving students at different stages in their medical education, as well as more longitudinal and qualitative studies, are needed.

摘要

目的

了解医学生的同理心对未来的患者护理很重要；然而，临床同理心的定义和发展仍不明确。作者试图研究两种最广泛使用的自我报告工具——戴维斯人际反应指数（IRI）和医学生杰斐逊同理心量表（JSE-S）的潜在结构，以及这些工具之间的区别和关联。

方法

在2007年至2014年期间，作者在五个国家（巴西、爱尔兰、新西兰、葡萄牙和英国）的三项独立研究中对IRI和JSE-S进行了施测。他们收集了3069名本科医学生的数据，并进行了探索性因素分析、相关性分析和多元线性回归分析。

结果

探索性因素分析在每个国家都得出了相同的结果，证实了每种工具的子量表结构。相关性分析结果表明，IRI总分与JSE-S总分之间存在显著但较弱的相关性（r = 0.313）。IRI和JSE-S子量表分数的所有相互相关性在统计学上均显著但较弱（范围r = -0.040至0.306）。多元线性回归模型显示，IRI子量表是所有JSE-S子量表和总分的弱预测指标。IRI子量表解释了JSE-S子量表9.0%至15.3%的方差变异，以及JSE-S总分19.5%的方差变异。