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食管癌和胃癌患者的医疗和手术并发症严重程度与对外科医生同理心的感知之间的关联。

Associations between the severity of medical and surgical complications and perception of surgeon empathy in esophageal and gastric cancer patients.

机构信息

SCALab UMR CNRS 9193, University of Lille, Villeneuve D'AscqCedex, Rue du Barreau BP 60149, Lille, France.

Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, F-59000, Lille, France.

出版信息

Support Care Cancer. 2021 Dec;29(12):7551-7561. doi: 10.1007/s00520-021-06257-y. Epub 2021 Jun 10.

Abstract

OBJECTIVE

To assess the impact of global physician empathy and its three subdimensions (establishing rapport, emotional and cognitive processes) on the severity of postoperative complications in a sample of cancer patients.

METHODS

We retrospectively analyzed data on 256 patients with esogastric cancer from the French national FREGAT database. Empathy and its subdimensions were assessed using the patient-reported CARE scale and the severity of medical and surgical complications was reported with the Clavien-Dindo classification system. The usual covariates were included in multinomial logistic regression analyses.

RESULTS

Physician empathy predicted the odds of reporting major complications. When patients perceived high empathy, they were less likely to report major complications compared to no complications (OR = .95, 95% CI = [.91-.99], p = .029). Among the three dimensions, only "establishing rapport" (OR = .84, 95% CI = [.73-.98], p = .019) and the "emotional process" (OR = .85, 95% CI = [.74-.98], p = .022) predicted major complications.

CONCLUSIONS

Physician empathy is essential before surgery. Further research is needed to understand the mechanisms associating empathy with health outcomes in cancer. Physicians should be trained to establish good rapport with patients, especially in the preoperative period.

摘要

目的

评估全球医生同理心及其三个亚维度(建立融洽关系、情感和认知过程)对癌症患者样本中术后并发症严重程度的影响。

方法

我们回顾性分析了来自法国国家 FREGAT 数据库的 256 例胃食管交界癌患者的数据。使用患者报告的 CARE 量表评估同理心及其亚维度,使用 Clavien-Dindo 分类系统报告医疗和手术并发症的严重程度。通常的协变量包括在多项逻辑回归分析中。

结果

医生同理心预测报告重大并发症的几率。当患者感知到高度同理心时,与无并发症相比,他们报告重大并发症的可能性较小(OR=0.95,95%CI[0.91-0.99],p=0.029)。在三个维度中,只有“建立融洽关系”(OR=0.84,95%CI[0.73-0.98],p=0.019)和“情感过程”(OR=0.85,95%CI[0.74-0.98],p=0.022)预测重大并发症。

结论

手术前同理心至关重要。需要进一步研究以了解同理心与癌症患者健康结果之间的关联机制。应培训医生与患者建立良好的融洽关系,特别是在术前期间。

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