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临床同理心是什么?社区成员、大学生、癌症患者和医生的观点。

What is clinical empathy? Perspectives of community members, university students, cancer patients, and physicians.

机构信息

Department of Psychology, Northeastern University, Boston, MA, USA.

Stanford University School of Medicine, Stanford, CA, USA.

出版信息

Patient Educ Couns. 2021 May;104(5):1237-1245. doi: 10.1016/j.pec.2020.11.001. Epub 2020 Nov 9.

Abstract

OBJECTIVES

To explore what undergraduates, community members, oncology patients, and physicians consider empathic behavior in a physician.

METHODS

150 undergraduates, 152 community members, 95 physicians, and 89 oncology patients rated 49 hypothetical physician behaviors for how well they fit their personal definition of physician empathy. Dimensions of empathy were explored and compared across groups.

RESULTS

Three dimensions of empathy were Conscientious and Reassuring, Relationship Oriented, and Emotionally Involved. Relationship Oriented was the most strongly endorsed, followed by Emotionally Involved, with Conscientious and Reassuring coming in last. There were no group differences for Conscientious and Reassuring, but the Relationship Oriented factor was more endorsed by the clinical groups (physicians and patients) than the non-clinical groups. The Emotionally Involved factor was endorsed by physicians notably more than by patients.

CONCLUSION

What is considered clinical empathy is not the same across individuals and stakeholder groups.

PRACTICE IMPLICATIONS

Physicians and patients differ in how much they include the physicians' emotionality and emotion-related actions in their definition of empathy. Communication training for physicians that emphasizes behaviors associated with empathy (listening, understanding a person's feelings and perspectives, and showing interest in and concern for the whole person) may enhance patients' perception of clinical empathy.

摘要

目的

探讨医学生、社区成员、肿瘤患者和医生对医生共情行为的看法。

方法

150 名医学生、152 名社区成员、95 名医生和 89 名肿瘤患者对 49 种假设的医生行为进行了评分,以评估这些行为与他们个人对医生同理心的定义的契合程度。探讨并比较了同理心的各个维度在不同群体中的差异。

结果

同理心的三个维度分别是:认真负责和安慰、以关系为导向、情感投入。以关系为导向的维度最受认可,其次是情感投入,而认真负责和安慰的维度则排名最后。在认真负责和安慰维度上,不同群体之间没有差异,但临床群体(医生和患者)比非临床群体更认可以关系为导向的因素。情感投入维度则是医生比患者更认可。

结论

不同个体和利益相关者群体对临床同理心的看法并不相同。

实践意义

医生和患者在同理心的定义中对医生的情感和与情感相关的行为的重视程度存在差异。为医生提供强调同理心相关行为(倾听、理解他人的感受和观点,以及对整个人表现出兴趣和关心)的沟通培训,可能会增强患者对临床同理心的感知。

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