Pavlova Alina, Paine Sarah-Jane, Cavadino Alana, O'Callaghan Anne, Consedine Nathan S
Department of Psychological Medicine, University of Auckland, Auckland, New Zealand.
Te Whatu Ora Counties Manukau, Auckland, New Zealand.
Br J Health Psychol. 2024 Feb;29(1):59-79. doi: 10.1111/bjhp.12687. Epub 2023 Aug 30.
To experimentally investigate whether more urgent patient presentations elicit greater compassion from health care professionals than less urgent, facilitating future research and thinking to address systemic barriers to compassion in health care.
This is a pre-registered online study with an experimental, within-subjects repeated-measure study design. Two clinical vignettes that systematically varied the urgency of patient presentation were utilized. Both vignettes depicted a patient with difficult behaviours typically associated with lower compassion.
Health care professionals (doctors, nurses and allied health practitioners) recruited from all 20 District Health Boards across Aotearoa/New Zealand completed two vignettes in a counterbalanced order. Paired-sample t-tests were used to test the effect of the presentation urgency on indices of compassion.
A total of 939 participants completed the vignettes (20% doctors, 47%, nurses and 33% allied health professionals). As expected, participants reported greater care and motivation to help the more urgent patient. However, the more urgent patient was also perceived as less difficult, and exploratory analyses showed that perceived patient difficulty was associated with lower caring and motivation to help, particularly in the less urgent patient.
This is the first work to experimentally test the relationship between the urgency of patient presentation and compassion in health care. Although the association between urgency and difficulty is complex, our findings are consonant with evolutionary views in which urgent distress elicits greater compassion. A system-wide orientation towards efficiency and urgency may exacerbate this 'bias' which must be addressed to ensure more equitable compassion in health care.
通过实验研究与不太紧急的患者相比，更紧急的患者就诊情况是否会引发医护人员更多的同情，以促进未来针对医疗保健中同情的系统性障碍进行研究和思考。
这是一项预先注册的在线研究，采用实验性的受试者内重复测量研究设计。使用了两个系统性改变患者就诊紧急程度的临床案例。两个案例均描绘了一名具有通常与较低同情心相关的困难行为的患者。
从新西兰奥特亚罗瓦所有20个地区卫生委员会招募的医护人员（医生、护士和专职医疗人员）以平衡顺序完成两个案例。配对样本t检验用于测试就诊紧急程度对同情指标的影响。
共有939名参与者完成了案例（20%为医生，47%为护士，33%为专职医疗人员）。正如预期的那样，参与者报告说对更紧急的患者有更多的关怀和帮助动机。然而，更紧急的患者也被认为不那么难相处，探索性分析表明，感知到的患者难相处程度与较低的关怀和帮助动机相关，尤其是在不太紧急的患者中。
这是第一项通过实验测试患者就诊紧急程度与医疗保健中同情之间关系的研究。尽管紧急程度和难相处程度之间的关联很复杂，但我们的研究结果与进化观点一致，即紧急困境会引发更多同情。全系统对效率和紧急程度的关注可能会加剧这种“偏见”，必须加以解决以确保医疗保健中更公平的同情。
