Yuguero Oriol, Marsal Josep Ramon, Buti Miquel, Esquerda Montserrat, Soler-González Jorge
Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.
Faculty of Medicine, University of Lleida, Lleida, Spain.
BMC Med Ethics. 2017 Sep 26;18(1):54. doi: 10.1186/s12910-017-0214-9.
The doctor-patient relationship is a crucial aspect of primary-care practice Research on associations between quality of care provision and burnout and empathy in a primary care setting could improve this relationship.
Cross-sectional study of family physicians (108) and nurses (112) of twenty-two primary care centers in the health district of Lleida, Spain. Empathy and burnout were measured using the Jefferson Physician Empathy Scale and the Maslach Burnout Inventory, while quality of care delivery was evaluated using Quality Standard Indicator scores. JPSE and MBI results were grouped into low, medium, and high scores to analyze associations with QSI scores and sociodemographic variables.
The mean QSI score recorded for the family physicians and nurses was 665 (out of a total of 1000). Higher, albeit insignificant, QSI scores were observed for practitioners with high burnout. No differences were observed according to level of empathy (p > 0.05). The differences with respect to sex, age, and area of practice (urban vs rural center) were not significant. Practitioners with low empathy had higher QSI scores than those with high empathy (672.8 vs. 654.4) while those with high burnout had higher scores than those with low burnout (702 vs. 671).
Burnout and empathy did not significantly influence quality of care delivery scores in 22 primary care centers. More studies, however, are needed to investigate the unexpected trend observed that suggests that physicians and nurses with higher levels of burnout provide higher quality care.
医患关系是初级保健实践的一个关键方面。对初级保健环境中护理质量与职业倦怠和同理心之间关联的研究可以改善这种关系。
对西班牙莱里达健康区22个初级保健中心的108名家庭医生和112名护士进行横断面研究。使用杰斐逊医生同理心量表和马氏职业倦怠量表测量同理心和职业倦怠，同时使用质量标准指标得分评估护理质量。将杰斐逊医生同理心量表和马氏职业倦怠量表的结果分为低分、中分和高分，以分析与质量标准指标得分和社会人口统计学变量的关联。
家庭医生和护士的平均质量标准指标得分为665分（满分1000分）。职业倦怠程度高的从业者的质量标准指标得分较高，尽管不显著。根据同理心水平未观察到差异（p>0.05）。在性别、年龄和执业领域（城市中心与农村中心）方面的差异不显著。同理心低的从业者的质量标准指标得分高于同理心高的从业者（672.8对654.4），而职业倦怠程度高的从业者的得分高于职业倦怠程度低的从业者（702对671）。
职业倦怠和同理心对22个初级保健中心的护理质量得分没有显著影响。然而，需要更多的研究来调查观察到的意外趋势，即职业倦怠程度较高的医生和护士提供更高质量的护理。
