Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Division of General Internal Medicine and Geriatrics, Oregon Health and Science University, Portland, OR, USA; Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA.
Patient Educ Couns. 2020 Sep;103(9):1745-1751. doi: 10.1016/j.pec.2020.04.016. Epub 2020 Apr 19.
To understand whether clinicians' empathic concern and perspective-taking traits are associated with their response to patient emotions.
We audio-recorded 41 HIV clinician interactions with 342 patients at two academic medical centers. We assessed clinicians' self-reported empathic concern and perspective-taking traits using the Interpersonal Reactivity Index and coded emotional communication using the Verona Coding Definitions of Emotional Sequences. We used random effects models to assess associations between clinician traits and clinician responses to patients' negative emotions, accounting for clustering of emotions within encounters and patients within clinicians.
Clinicians with more self-reported empathic concern received fewer emotional expressions from their patients (β -0.06; 95% CI -0.10, -0.01) and had greater odds of responding to emotions by giving information/advice (OR 1.10; 95% CI 1.01, 1.20). There were no associations between empathic concern or perspective-taking and any other clinician responses.
Clinicians with higher levels of empathic concern respond to patient emotions by giving information and advice, a response traditionally thought of as a missed empathic opportunity, not by exploring emotions or providing empathy. Whether this is helpful to patients is unknown.
Clinicians should be aware of their tendency to give information to patients with emotional distress, and consider whether this response is helpful to patients.
了解临床医生的同理心关怀和换位思考特质是否与其对患者情绪的反应有关。
我们在两所学术医疗中心对 41 名 HIV 临床医生与 342 名患者的 41 次互动进行了录音。我们使用人际反应指数评估了临床医生的自我报告同理心关怀和换位思考特质,并使用维罗纳编码情感序列定义对情感沟通进行了编码。我们使用随机效应模型评估了临床医生特质与临床医生对患者负面情绪的反应之间的关联,同时考虑了情绪在互动中以及患者在临床医生中的聚类。
自我报告同理心关怀程度较高的临床医生从患者那里获得的情感表达较少(β -0.06;95%置信区间 -0.10,-0.01),并且更有可能通过提供信息/建议来回应情绪(OR 1.10;95%置信区间 1.01,1.20)。同理心关怀或换位思考与任何其他临床医生反应之间均无关联。
同理心关怀程度较高的临床医生通过提供信息和建议来回应患者的情绪,这种反应传统上被认为是错失了同理心的机会,而不是通过探索情绪或提供同理心来回应。这对患者是否有帮助尚不清楚。
临床医生应该意识到自己在患者情绪困扰时倾向于向患者提供信息,并考虑这种反应是否对患者有帮助。