Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas.
J Bone Joint Surg Am. 2019 Feb 20;101(4):296-301. doi: 10.2106/JBJS.18.00372.
Perceived physician empathy is a strong driver of patient satisfaction. We assessed the influence of wait time, time spent with the surgeon, and surgeon stress level on the way patients rated surgeon empathy.
One hundred and fourteen patients visiting 1 of 6 participating surgeons were prospectively enrolled in the study. We recorded patient demographics and assessed the patient rating of perceived physician empathy. Time waiting for the surgeon and time spent with the surgeon were measured with use of ambulatory tracking systems and by research assistants with stopwatches outside the patient rooms. Patient ratings of surgeon empathy were assessed with use of the Jefferson Scale of Patient's Perceptions of Physician Empathy (JSPPPE), and surgeon stress level was assessed with use of the Perceived Stress Score short form. The mean wait time was 30 ± 18 minutes, and the mean time spent with the surgeon was 8.7 ± 5.3 minutes. Two separate multilevel linear regression models were used to compare factors associated with the JSPPPE and time spent with the surgeon.
Neither time spent with the surgeon nor wait time was independently associated with perceived physician empathy; being male, having at least a post-college graduate degree, and higher self-reported surgeon stress levels were independently associated with less perceived empathy. More time spent with the surgeon was independently associated with lower self-reported surgeon stress levels; follow-up visits and visits for a traumatic condition were independently associated with less time spent with the surgeon.
The results of the present study show that improved communication strategies, rather than shorter wait time or increased time spent with the patient, may increase patient satisfaction. This should be a focus of future research.
患者感知到的医生同理心是患者满意度的重要驱动因素。我们评估了等待时间、与外科医生相处的时间以及外科医生的压力水平对患者评价外科医生同理心的影响。
114 名前往 6 名参与外科医生之一处就诊的患者前瞻性地入组本研究。我们记录了患者的人口统计学数据，并评估了患者感知到的医生同理心的评分。使用活动跟踪系统和研究助理在患者室外使用秒表来测量患者等待外科医生的时间和与外科医生相处的时间。使用杰斐逊患者感知医生同理心量表（JSPPPE）评估患者对外科医生同理心的评分，使用简易压力量表评估外科医生的压力水平。平均等待时间为 30 ± 18 分钟，与外科医生相处的平均时间为 8.7 ± 5.3 分钟。使用两个单独的多层线性回归模型比较与 JSPPPE 和与外科医生相处时间相关的因素。
与外科医生相处的时间和等待时间均与感知到的医生同理心无独立相关性；男性、至少具有大学学历以及自我报告的外科医生压力水平较高与感知到的同理心较低独立相关。与外科医生相处的时间越长与自我报告的外科医生压力水平越低独立相关；随访就诊和创伤性疾病就诊与与外科医生相处的时间较短独立相关。
本研究结果表明，改善沟通策略，而不是缩短等待时间或增加与患者相处的时间，可能会提高患者满意度。这应该是未来研究的重点。
