医生自我评估的同理心水平与患者的评估不相关。

Physicians' self-assessed empathy levels do not correlate with patients' assessments.

机构信息

Radiology Department-Faculty of Medicine-Catholic University of São Paulo-Sorocaba-São Paulo-Brazil.

Center for Educational Development Innovation and Research-University Medical Center-University of Groningen-Groningen-The Netherlands.

出版信息

PLoS One. 2018 May 31;13(5):e0198488. doi: 10.1371/journal.pone.0198488. eCollection 2018.

DOI:10.1371/journal.pone.0198488

PMID:29852021

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5979004/

Abstract

BACKGROUND

Empathy is a fundamental humanistic component of patient care which facilitates efficient and patient-centered clinical encounters. Despite being the principal recipient of physician empathy little work on how patients perceive/report receiving empathy from their physicians has been undertaken. In the context of doctor-patient interactions, knowledge about empathy has mostly originated from physicians' perspectives and has been developed from studies using self-assessment instruments. In general, self-assessment may not correlate well with the reality observed by others.

OBJECTIVES

To investigate: 1-the relationship between physicians' self-assessed empathy and patients' measures of physicians' empathy; 2 -Environmental factors that could influence patients' perceptions; and 3 -the correlation between two widely used psychometric scales to measure empathy from the perspective of patients.

METHODS

This is an observational study which enrolled 945 patients and 51 physicians from radiology, clinical, and surgical specialties. The physicians completed the Jefferson Scale of Physician Empathy (JSE) and the International Reactivity Index (IRI), and patients completed the Consultation and Relational Empathy scale (CARE), and the Jefferson Scale of Patient's Perceptions of Physician Empathy (JSPPPE).

RESULTS

We did not observe any significant correlation between total self-assessed empathy and patients' perceptions. We observed a small correlation (r = 0,3, P<0,05) between the sub-dimension Perspective Taking-JSE and JSPPPE. JSPPPE and CARE had a positive and moderate correlation (0,56; p<0,001). Physicians' gender and sector influenced the JSPPPE score. Sector, medical specialty and the nature of the appointment (initial versus subsequent) influenced the CARE measure.

CONCLUSIONS

The lack of correlation between self-assessed empathy levels and patients' perceptions suggests patients be included in the process of empathy evaluation.

PRACTICE IMPLICATIONS

Training strategies aiming the development of empathy should include patients' evaluations and perspectives.

摘要

背景

同理心是患者护理的一个基本人文组成部分，它促进了高效和以患者为中心的临床接触。尽管同理心是医生的主要接受者，但很少有关于患者如何感知/报告从医生那里获得同理心的工作。在医患互动的背景下，关于同理心的知识主要来自医生的观点，并从使用自我评估工具的研究中发展而来。一般来说，自我评估可能与他人观察到的现实不太相关。

目的

调查：1-医生自我评估的同理心与患者衡量医生同理心之间的关系；2-影响患者感知的环境因素；3-从患者角度衡量同理心的两种广泛使用的心理计量学量表之间的相关性。

方法

这是一项观察性研究，共纳入 945 名患者和 51 名来自放射科、临床和外科专业的医生。医生完成了杰斐逊医生同理心量表（JSE）和国际反应指数（IRI），患者完成了咨询和关系同理心量表（CARE）以及杰斐逊患者对医生同理心感知量表（JSPPPE）。

结果

我们没有观察到总自我评估同理心与患者感知之间存在任何显著相关性。我们观察到同理心的观点采择子维度-JSE 与 JSPPPE 之间存在较小的相关性（r = 0.3，P<0.05）。JSPPPE 和 CARE 之间存在正相关和中度相关性（0.56；p<0.001）。医生的性别和科室影响 JSPPPE 评分。科室、医学专业和预约性质（初次就诊与后续就诊）影响 CARE 测量。