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患者关怀中的同理心:从“临床同理心”到“共情关怀”。

Empathy in patient care: from 'Clinical Empathy' to 'Empathic Concern'.

机构信息

University of Groningen, Groningen, The Netherlands.

出版信息

Med Health Care Philos. 2021 Dec;24(4):573-585. doi: 10.1007/s11019-021-10033-4. Epub 2021 Jul 1.

Abstract

As empathy gains importance within academia, we propose this review as an attempt to bring clarity upon the diverse and widely debated definitions and conceptions of empathy within the medical field. In this paper, we first evaluate the limits of the Western mainstream medical culture and discuss the origins of phenomena such as dehumanization and detached concern as well as their impacts on patient care. We then pass on to a structured overview of the debate surrounding the notion of clinical empathy and its taxonomy in the medical setting. In particular, we present the dichotomous conception of clinical empathy that is articulated in the debate around cognitive empathy and affective empathy. We thus consider the negative impacts that this categorization brings about. Finally, we advocate for a more encompassing, holistic conception of clinical empathy; one that gives value to a genuine interest in welcoming, acknowledging and responding to the emotions of those suffering. Following this line of reasoning, we advance the notion of 'empathic concern', a re-conceptualization of clinical empathy that finds its source in Halpern in Med Health Care Philos (2014) 17:301-311 engaged curiosity. We ultimately advance Narrative Medicine as an approach to introduce, teach and promote such an attitude among medical trainees and practitioners.

摘要

随着同理心在学术界的重要性日益凸显,我们提出这篇综述,旨在厘清医学领域同理心的多样性和广泛争议的定义和概念。在本文中,我们首先评估了西方主流医学文化的局限性,并讨论了去人性化和冷漠关注等现象的起源及其对患者护理的影响。然后,我们对围绕临床同理心概念及其在医学环境中的分类的争论进行了结构化概述。特别是,我们提出了临床同理心的二分概念,这种概念在认知同理心和情感同理心的争论中得到了体现。因此,我们考虑了这种分类所带来的负面影响。最后,我们主张采用更全面、更整体的临床同理心概念;重视真正关注、承认和回应患者情感的理念。基于这种推理,我们提出了“同理心关怀”的概念,这是对临床同理心的重新概念化,其根源可以追溯到 Halpern 在 Med Health Care Philos (2014) 17:301-311 中提出的“共情好奇心”。我们最终提出叙事医学作为一种方法,在医学培训生和从业者中引入、教授和促进这种态度。

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