From the Cognitive Brain Research Unit, Faculty of Medicine (Martikainen, Falcon, Wikström, Saarikivi), University of Helsinki; and Mehiläinen Oy (Peltola), Helsinki, Finland.
Psychosom Med. 2022 May 1;84(4):513-521. doi: 10.1097/PSY.0000000000001055. Epub 2022 Jan 28.
Medical doctors' empathy is known to support patients' health status after face-to-face clinical visits. However, the role of doctors' empathy in chat-based encounters is not yet well understood. This study investigates whether patients' evaluations of doctors' empathy are associated with their health perceptions after a meeting at an online clinic and whether experiences of empathy could be enhanced by augmenting an automated anamnesis questionnaire completed before the visit.
A total of 209 adult patients agreed to participate in the study. First 103 patients filled out the regular version of the questionnaire (June-August 2019) and then 106 filled out the augmented version of the online anamnesis questionnaire (August-November 2019). Patients' perceptions of doctors' empathy were measured with the Consultation and Relational Empathy questionnaire. Patients' self-perceived health status, potential confounders, and demographic background information were measured via questionnaires.
Patients' perceptions of doctors' empathy during a chat-based encounter were associated with patients being less concerned about their symptoms (estimated odds ratios varied between 0.45 and 0.55 depending on the model, p values < .003) and considering their symptoms as less severe (estimated odds ratios = 0.54-0.61, p values < .007), as well as a higher probability of alleviation of symptoms as rated by the patients (estimated odds ratios = 2.16-2.24, p values < .001). Augmenting the anamnesis questionnaire did not affect patient reports on doctors' overall empathy, but it did have positive effects on specific areas of doctors' empathy covered by the questionnaire.
These results show that patients' experience of doctors' empathy not only is important during face-to-face encounters but also supports patients' perceptions of health when the interaction is text based. The results also encourage further development of means to support patients' experiences of empathy during online interaction with medical doctors.
医生的同理心已知可以支持患者在面对面临床就诊后的健康状况。然而，医生同理心在基于聊天的交流中的作用尚不清楚。本研究调查了患者对医生同理心的评价是否与他们在在线诊所就诊后的健康感知有关，以及在访问前增强自动病史问卷是否可以增强同理心体验。
共有 209 名成年患者同意参与研究。前 103 名患者填写了常规版本的问卷（2019 年 6 月至 8 月），然后 106 名患者填写了增强版的在线病史问卷（2019 年 8 月至 11 月）。使用咨询和关系同理心问卷测量患者对医生同理心的感知。患者自我感知的健康状况、潜在混杂因素和人口统计学背景信息通过问卷进行测量。
基于聊天的医患交流中，患者对医生同理心的感知与患者对症状的关注度降低有关（取决于模型，估计比值比在 0.45 到 0.55 之间，p 值均<0.003），并认为症状的严重程度降低（估计比值比=0.54-0.61，p 值均<0.007），以及患者自评症状缓解的可能性更高（估计比值比=2.16-2.24，p 值均<0.001）。增强病史问卷并未影响患者对医生总体同理心的报告，但对问卷涵盖的医生同理心的特定领域有积极影响。
这些结果表明，患者对医生同理心的体验不仅在面对面交流中很重要，而且在基于文本的交流中也支持患者的健康感知。结果还鼓励进一步开发支持在线与医生互动时患者同理心体验的方法。
