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在社区慢性疼痛患者样本中,治疗满意度在感知医生同理心和心理困扰之间起中介作用。

Treatment satisfaction mediates the association between perceived physician empathy and psychological distress in a community sample of individuals with chronic pain.

机构信息

Department of Psychoeducation and Psychology, Université du Québec en Outaouais Gatineau, Québec, Canada.

出版信息

Patient Educ Couns. 2021 May;104(5):1213-1221. doi: 10.1016/j.pec.2020.09.004. Epub 2020 Sep 8.

DOI:10.1016/j.pec.2020.09.004
PMID:33059949
Abstract

OBJECTIVE

While the benefits of patient-centered care have been consistently demonstrated in the health literature, there exists a dearth of pathway research within health outcome research, especially within the chronic pain context. This study examined the relationship between perceived physician empathy and patient psychological distress and its underlying mechanism.

METHODS

A community sample of 259 adults with chronic pain completed online questionnaires measuring patient-perceived physician empathy, treatment satisfaction, depressive and anxiety symptoms. Analyses were conducted using correlational and mediation analyses.

RESULTS

Results revealed perceived empathy to be positively and strongly correlated with treatment satisfaction (r = .72, p < .001). A significant negative correlation was also demonstrated between perceived empathy and depressive symptoms (r = -.13, p < .05), but not between perceived empathy and anxious symptoms (r = .03, p = .65). Results revealed significant mediation models between perceived empathy and patient depressive symptoms (indirect effect: B = -.19, SE =.06, 95 % CI [-.31, -.09]) and anxious symptoms (indirect effect: B = -.24, SE = .06, 95 % CI [-.35, -.14]), via treatment satisfaction as mediator and including covariates.

CONCLUSION

Chronic pain patients who perceive greater levels of physician empathy experience fewer depressive and anxious symptoms, as mediated by treatment satisfaction.

PRACTICE IMPLICATIONS

Clinical training and practice should promote empathetic components of health communication within chronic pain treatment.

摘要

目的

虽然患者为中心的护理的益处已在健康文献中得到一致证明,但在健康结果研究中,特别是在慢性疼痛背景下,路径研究却很少。本研究检验了患者感知医生同理心与患者心理困扰之间的关系及其潜在机制。

方法

一个由 259 名慢性疼痛成年人组成的社区样本完成了在线问卷调查,测量了患者感知医生同理心、治疗满意度、抑郁和焦虑症状。使用相关分析和中介分析进行分析。

结果

结果显示,感知同理心与治疗满意度呈正相关且高度相关(r =.72,p <.001)。感知同理心与抑郁症状之间也存在显著负相关(r = -.13,p <.05),但与焦虑症状之间无显著相关(r =.03,p =.65)。结果显示,感知同理心与患者抑郁症状(中介效应:B = -.19,SE =.06,95 % CI [-.31,-.09])和焦虑症状(中介效应:B = -.24,SE =.06,95 % CI [-.35,-.14])之间存在显著的中介模型,通过治疗满意度作为中介,包括协变量。

结论

感知到更高水平医生同理心的慢性疼痛患者,通过治疗满意度的中介作用,经历较少的抑郁和焦虑症状。

实践意义

临床培训和实践应在慢性疼痛治疗中促进健康沟通中同理心的成分。

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