Pedersen Anette Fischer, Ingeman Mads Lind, Vedsted Peter
Research Unit for General Practice and Research Centre for Cancer Diagnosis in Primary Care (CaP), Aarhus University, Aarhus, Denmark.
Emergency Department, Aarhus University Hospital, Aarhus, Denmark.
BMJ Open. 2018 Feb 28;8(2):e020007. doi: 10.1136/bmjopen-2017-020007.
Research has suggested that physicians' gut feelings are associated with parents' concerns for the well-being of their children. Gut feeling is particularly important in diagnosis of serious low-incidence diseases in primary care. Therefore, the aim of this study was to examine whether empathy, that is, the ability to understand what another person is experiencing, relates to general practitioners' (GPs) use of gut feelings. Since empathy is associated with burn-out, we also examined whether the hypothesised influence of empathy on gut feeling use is dependent on level of burn-out.
Cross-sectional questionnaire survey. Participants completed the Jefferson Scale of Physician Empathy and The Maslach Burnout Inventory.
Primary care.
588 active GPs in Central Denmark Region (response rate=70%).
Self-reported use of gut feelings in clinical practice.
GPs who scored in the highest quartile of the empathy scale had fourfold the odds of increased use of gut feelings compared with GPs in the lowest empathy quartile (OR 3.99, 95% CI 2.51 to 6.34) when adjusting for the influence of possible confounders. Burn-out was not statistically significantly associated with use of gut feelings (OR 1.29, 95% CI 0.90 to 1.83), and no significant interaction effects between empathy and burn-out were revealed.
Physician empathy, but not burn-out, was strongly associated with use of gut feelings in primary care. As preliminary results suggest that gut feelings have diagnostic value, these findings highlight the importance of incorporating empathy and interpersonal skills into medical training to increase sensitivity to patient concern and thereby increase the use and reliability of gut feeling.
研究表明,医生的直觉与父母对子女幸福的担忧有关。直觉在基层医疗中对严重低发病率疾病的诊断尤为重要。因此,本研究的目的是探讨同理心,即理解他人经历的能力,是否与全科医生(GP)对直觉的运用有关。由于同理心与职业倦怠有关,我们还研究了同理心对直觉运用的假定影响是否取决于职业倦怠的程度。
横断面问卷调查。参与者完成了医生同理心杰斐逊量表和马氏职业倦怠量表。
基层医疗。
丹麦中部地区588名在职全科医生(回复率=70%)。
临床实践中自我报告的直觉运用情况。
在调整可能的混杂因素影响后,同理心量表得分处于最高四分位数的全科医生增加直觉运用的几率是同理心得分最低四分位数的全科医生的四倍(比值比3.99,95%置信区间2.51至6.34)。职业倦怠与直觉运用在统计学上无显著关联(比值比1.29,95%置信区间0.90至1.83),且未发现同理心与职业倦怠之间有显著的交互作用。
在基层医疗中,医生的同理心而非职业倦怠与直觉的运用密切相关。由于初步结果表明直觉具有诊断价值,这些发现凸显了将同理心和人际技能纳入医学培训以提高对患者担忧的敏感度从而增加直觉的运用和可靠性的重要性。