Department of General Medicine, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba, Japan.
Department of General Medicine, Sanmu Medical Center, Chiba, Japan.
J Gen Intern Med. 2023 Jun;38(8):1843-1847. doi: 10.1007/s11606-022-07936-0. Epub 2022 Nov 16.
Physicians frequently experience patients as difficult. Our study explores whether more empathetic physicians experience fewer patient encounters as difficult.
To investigate the association between physician empathy and difficult patient encounters (DPEs).
Cross-sectional study.
Participants were 18 generalist physicians with 3-8 years of experience. The investigation was conducted from August-September 2018 and April-May 2019 at six healthcare facilities.
Based on the Jefferson Scale of Empathy (JSE) scores, we classified physicians into low and high empathy groups. The physicians completed the Difficult Doctor-Patient Relationship Questionnaire-10 (DDPRQ-10) after each patient visit. Scores ≥ 31 on the DDPRQ-10 indicated DPEs. We implemented multilevel mixed-effects logistic regression models to examine the association between physicians' empathy and DPE, adjusting for patient-level covariates (age, sex, history of mental disorders) and with physician-level clustering.
The median JSE score was 114 (range: 96-126), and physicians with JSE scores 96-113 and 114-126 were assigned to low and high empathy groups, respectively (n = 8 and 10 each); 240 and 344 patients were examined by physicians in the low and high empathy groups, respectively. Among low empathy physicians, 23% of encounters were considered difficulty, compared to 11% among high empathy groups (OR: 0.37; 95% CI = 0.19-0.72, p = 0.004). JSE scores and DDPRQ-10 scores were negatively correlated (r = -0.22, p < 0.01).
Empathetic physicians were less likely to experience encounters as difficult. Empathy appears to be an important component of physician perception of encounter difficulty.
医生经常觉得患者很难相处。我们的研究探讨了更有同理心的医生是否会遇到较少的困难患者遭遇。
调查医生同理心与困难患者遭遇（DPE）之间的关系。
横断面研究。
18 名具有 3-8 年经验的普通科医生。调查于 2018 年 8 月至 9 月和 2019 年 4 月至 5 月在六家医疗机构进行。
根据杰斐逊同理心量表（JSE）评分，我们将医生分为低同理心组和高同理心组。医生在每次就诊后完成困难医患关系问卷-10（DDPRQ-10）。DDPRQ-10 得分≥31 表示存在 DPE。我们实施了多水平混合效应逻辑回归模型，以调整患者水平的协变量（年龄、性别、精神障碍史）并考虑医生水平的聚类，来检验医生同理心与 DPE 之间的关联。
JSE 评分中位数为 114（范围：96-126），JSE 评分 96-113 和 114-126 的医生分别被分到低和高同理心组（n = 8 和 10）；低和高同理心组的医生分别检查了 240 名和 344 名患者。在低同理心医生中，23%的就诊被认为是困难的，而高同理心组中这一比例为 11%（OR：0.37；95%CI=0.19-0.72，p=0.004）。JSE 评分和 DDPRQ-10 评分呈负相关（r=-0.22，p<0.01）。
有同理心的医生不太可能遇到困难的就诊。同理心似乎是医生感知就诊困难的一个重要组成部分。
