Pain Clinic, Complejo Hospitalario Universitario de Ourense (CHUO), Ourense, Spain.
Pain Clinic, Hospital Universitario 12 de Octubre, Madrid, Spain.
Pain Med. 2018 Jul 1;19(7):1304-1314. doi: 10.1093/pm/pnx160.
To assess the impact of the empathy of physicians, perceived by patients with chronic pain, regarding pain relief and health-related quality of life (HR-QoL).
A prospective noninterventional study was conducted in 2,898 patients with moderate to severe chronic pain who were referred to pain clinics. The same physician visited each patient at baseline and after one and three months. Study questionnaires included the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), the Life Orientation Test-Revised (LOT-R), the Pain Coping Questionnaire (CAD-R), the Brief Pain Inventory Short Form (BPI-SF), and the EuroQol-5D (EQ-5D). Regression analyses were used to evaluate the independent contribution of the changes in perceived empathy over pain intensity and improvement of HR-QoL.
BPI-SF scores for pain intensity, rated as worst, least, average, and current pain, decreased significantly (P < 0.001) from baseline to month 3, with reductions of 33.7%, 42.5%, 40.0%, and 46.9%, respectively. Pain intensity decreased from 6.3 ± 1.5 at baseline to 4.7 ± 1.8 at one month and 3.8 ± 1.9 at three months (P < 0.050). Significant (P < 0.001) improvements in the EQ-5D tariff (+37.1%) and EQ-5D VAS (+26.7%) were also recorded. In the linear regression analysis, JSPPPE and LOT-R, but not CAD-R, were significantly associated with pain relief and HR-QoL.
Physicians' empathy and patients' dispositional optimism have a role in determining positive outcomes in patients with chronic pain. Physicians' empathy may therefore be a suitable, yet relatively unexplored, target for intervention.
评估患者感知到的医生同理心对慢性疼痛患者的疼痛缓解和健康相关生活质量（HR-QoL）的影响。
这是一项前瞻性非干预性研究，共纳入 2898 名中重度慢性疼痛患者，这些患者被转诊至疼痛诊所。同一名医生在基线、1 个月和 3 个月时分别对每位患者进行了访视。研究问卷包括杰斐逊患者感知医生同理心量表（JSPPPE）、生活取向测验修订版（LOT-R）、疼痛应对问卷（CAD-R）、简明疼痛量表（BPI-SF）和欧洲五维健康量表（EQ-5D）。回归分析用于评估感知同理心变化对疼痛强度和 HR-QoL 改善的独立贡献。
BPI-SF 评分中疼痛强度的最差、最轻、平均和当前疼痛评分从基线到第 3 个月显著降低（P<0.001），分别降低了 33.7%、42.5%、40.0%和 46.9%。疼痛强度从基线时的 6.3±1.5 降低到 1 个月时的 4.7±1.8 和 3 个月时的 3.8±1.9（P<0.050）。EQ-5D 量表评分（+37.1%）和 EQ-5D 视觉模拟评分（+26.7%）也有显著改善（P<0.001）。线性回归分析显示，JSPPPE 和 LOT-R，但不是 CAD-R，与疼痛缓解和 HR-QoL 显著相关。
医生的同理心和患者的性格乐观与慢性疼痛患者的积极结果有关。因此，医生的同理心可能是一个合适的、但尚未被充分探索的干预目标。
