Keshtkar Leila, Madigan Claire D, Ward Andy, Ahmed Sarah, Tanna Vinay, Rahman Ismail, Bostock Jennifer, Nockels Keith, Wang Wen, Gillies Clare L, Howick Jeremy
Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester, Leicester, United Kingdom (L.K., A.W., I.R., J.H.).
Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (C.D.M.).
Ann Intern Med. 2024 Feb;177(2):196-209. doi: 10.7326/M23-2168. Epub 2024 Jan 30.
Practitioners who deliver enhanced empathy may improve patient satisfaction with care. Patient satisfaction is associated with positive patient outcomes ranging from medication adherence to survival.
To evaluate the effect of health care practitioner empathy on patient satisfaction, using a systematic review of randomized trials.
Ovid MEDLINE, CINAHL, PsycInfo, Cochrane Central Register of Controlled Trials, and Scopus to 23 October 2023.
Randomized trials published in any language that evaluated the effect of empathy on improving patient satisfaction as measured on a validated patient satisfaction scale.
Data extraction, risk-of-bias assessments, and strength-of-evidence assessments were done by 2 independent reviewers. Disagreements were resolved through consensus.
Fourteen eligible randomized trials (80 practitioners; 1986 patients) were included in the analysis. Five studies had high risk of bias, and 9 had some concerns about bias. The trials were heterogeneous in terms of geographic locations (North America, Europe, Asia, and Africa), settings (hospital and primary care), practitioner types (family and hospital physicians, anesthesiologists, nurses, psychologists, and caregivers), and type of randomization (individual patient or clustered by practitioner). Although all trials suggested a positive change in patient satisfaction, inadequate reporting hindered the ability to draw definitive conclusions about the overall effect size.
Heterogeneity in the way that empathy was delivered and patient satisfaction was measured and incomplete reporting leading to concerns about the certainty of the underpinning evidence.
Various empathy interventions have been studied to improve patient satisfaction. Development, testing, and reporting of high-quality studies within well-defined contexts is needed to optimize empathy interventions that increase patient satisfaction.
Stoneygate Trust. (PROSPERO: CRD42023412981).
表现出更强同理心的从业者可能会提高患者对医疗服务的满意度。患者满意度与从药物依从性到生存率等积极的患者预后相关。
通过对随机试验的系统评价,评估医疗从业者的同理心对患者满意度的影响。
截至2023年10月23日的Ovid MEDLINE、CINAHL、PsycInfo、Cochrane对照试验中央注册库和Scopus。
以任何语言发表的随机试验,这些试验评估了同理心对通过经过验证的患者满意度量表测量的提高患者满意度的影响。
数据提取、偏倚风险评估和证据强度评估由2名独立 reviewers 完成。分歧通过共识解决。
分析纳入了14项符合条件的随机试验(80名从业者;1986名患者)。5项研究存在高偏倚风险,9项研究存在一些偏倚问题。这些试验在地理位置(北美、欧洲、亚洲和非洲)、环境(医院和初级保健)、从业者类型(家庭医生和医院医生、麻醉师、护士、心理学家和护理人员)以及随机化类型(个体患者或按从业者聚类)方面存在异质性。尽管所有试验都表明患者满意度有积极变化,但报告不充分阻碍了就总体效应大小得出明确结论的能力。
同理心的传递方式和患者满意度的测量方法存在异质性,以及报告不完整导致对基础证据的确定性存在担忧。
已经研究了各种同理心干预措施以提高患者满意度。需要在明确界定的背景下开展、测试和报告高质量研究,以优化提高患者满意度的同理心干预措施。
斯托尼盖特信托基金。(国际前瞻性系统评价注册库:CRD42023412981)