Ardenghi Stefano, Russo Selena, Bani Marco, Rampoldi Giulia, Strepparava Maria Grazia
Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
Department of Mental Health, Clinical Psychology Unit, San Gerardo Hospital, ASST-Monza, Monza, Italy.
Psychol Health Med. 2023 Jun;28(5):1215-1229. doi: 10.1080/13548506.2021.2001549. Epub 2021 Nov 9.
While empathy and patient-centeredness (PC) are considered core variables in high-quality healthcare education and care, research suggests that empathy and PC decrease during the clinical years of study and that impairments in empathy and PC may be related to difficulties in emotion regulation. There is a growing interest in identifying the psycho-social variables that sustain and foster empathy and PC in medical students throughout their education. This study explored whether and to what extent emotion dysregulation predicted empathy and PC in medical students controlling for gender. Three hundred ninety-eight pre-clinical medical students enrolled at a university in northern Italy completed the Difficulties in Emotion Regulation Scale (DERS), the Interpersonal Reactivity Index (IRI) and the Patient-Practitioner Orientation Scale - 8 Items - Italian version (PPOS-8-IT). All statistically significant correlation coefficients between DERS, IRI and PPOS-8-IT scores were negative (s from -.130 to -.336, s ≤ 01), except for IRI Personal Distress and IRI Fantasy Scale that were mainly positively related to DERS scores (s from .130 to .305, s ≤ .01). Hierarchical multiple-regression analyses showed that DERS scores accounted for a significant amount of additional variance in both IRI and PPOS-8-IT components above and beyond gender. Emotion dysregulation was positively associated with Personal Distress (s from .135 to .250, s ≤ .007), whereas Empathic Concern, Perspective Taking, and the PC components were negatively predicted by emotion regulation difficulties (s from -.131 to -.309, s ≤ .005). Female students showed higher levels of all empathy and PC measures than males (s from -3.49 to -5.54, s ≤ 001) except for Perspective Taking. Tailored educational approaches that provide medical students with emotion regulation strategies implemented along the pre-clinical curriculum may sustain empathy and PC and equip students to appropriately and functionally face the emotional and interpersonal aspects of the clinical internship experience.
虽然同理心和以患者为中心（PC）被视为高质量医疗教育和护理的核心变量，但研究表明，在临床学习期间，同理心和PC会下降，而且同理心和PC的损害可能与情绪调节困难有关。越来越多的人关注识别在医学生整个教育过程中维持和培养同理心及PC的心理社会变量。本研究探讨了情绪失调在控制性别的情况下，对医学生的同理心和PC预测的程度。意大利北部一所大学的398名临床前医学生完成了情绪调节困难量表（DERS）、人际反应指数（IRI）和患者-从业者取向量表-8项-意大利语版（PPOS-8-IT）。DERS、IRI和PPOS-8-IT分数之间所有具有统计学意义的相关系数均为负（范围从-.130至-.336，p≤.01），但IRI个人痛苦和IRI幻想量表主要与DERS分数呈正相关（范围从.130至.305，p≤.01）。分层多元回归分析表明，DERS分数在性别之外，在IRI和PPOS-8-IT的两个组成部分中都解释了大量额外的方差。情绪失调与个人痛苦呈正相关（范围从.135至.250，p≤.007），而同理心关注、观点采择和PC组成部分则被情绪调节困难负向预测（范围从-.131至-.309，p≤.005）。除观点采择外，女生在所有同理心和PC测量指标上的得分均高于男生（范围从-3.49至-5.54，p≤.001）。为医学生提供沿临床前课程实施的情绪调节策略的定制教育方法，可能会维持同理心和PC，并使学生能够适当地且有效地面对临床实习经历中的情感和人际方面。
