Univ. Lille, CNRS, CHU Lille, UMR 9193, SCALab, Cognitive and Affective Sciences, Lille, France; SIRIC (French comprehensive cancer center), ONCOLille, France.
Univ. Lille, Department of Digestive Diseases, Claude Huriez University Hospital, Lille, France.
Patient Educ Couns. 2018 Jul;101(7):1216-1222. doi: 10.1016/j.pec.2018.01.023. Epub 2018 Feb 1.
In cancer settings, physician empathy is not always linked to a better patient emotional quality of life quality of life (eQoL). We tested two possible moderators of the inconsistent link: type of consultation (bad news versus follow-up) and patient emotional skills (emoSkills, i.e., the way patients process emotional information).
In a cross-sectional design, 296 thoracic and digestive tract cancer patients completed validated questionnaires to assess their physician empathy, their emoSkills and eQoL. Moderated multiple regressions were performed.
In follow-up consultations, physician empathy was associated with a better eQoL in patients with low or average emotional skills. Those with high emotional skills did not benefit from physician empathy. Their eQoL was nonetheless very good. In bad news consultations, the pattern was reversed: only patients with average or high emotional skills benefited from physician empathy. Those with low emotional skills were not sensitive to it and presented a poor eQoL.
Medical empathy is important in all consultations. However, in bad news consultations, patients with low emoSkills are at risk of psychological distress even with an empathetic doctor.
Accordingly, physicians should be trained to detect patients with low emoSkills in order to refer them to supportive care.
在癌症环境中，医生的同理心并不总是与更好的患者情感生活质量相关。我们测试了两个可能调节这种不一致联系的因素：咨询类型（坏消息咨询和随访咨询）和患者的情感技能（即患者处理情感信息的方式）。
在一项横断面设计中，296 名胸部和消化系统癌症患者完成了经过验证的问卷，以评估他们的医生同理心、情感技能和情感生活质量。进行了有调节的多元回归分析。
在随访咨询中，医生同理心与低或平均情感技能的患者的情感生活质量较好相关。那些具有高情感技能的患者则不会从医生同理心中受益。但他们的情感生活质量仍然很好。在坏消息咨询中，模式发生了逆转：只有具有平均或高情感技能的患者才会从医生同理心中受益。那些情感技能低的患者对此不敏感，表现出较差的情感生活质量。
在所有咨询中，医学同理心都很重要。然而，在坏消息咨询中，即使有同理心的医生，情感技能低的患者仍有心理困扰的风险。
因此，医生应该接受培训，以发现情感技能低的患者，以便将他们转介至支持性护理。
