Burk Kathryn J, Stroh John J, Larkin Kelly, Chaftari Patrick, Langabeer Denise M, Menendez Jazmin R, Woodruff Jeanie F, Hargrave Jan, Zhu Hongxu, Long James P, Yeung Sai-Ching J, Alagappan Kumar, Qdaisat Aiham
Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
J Emerg Med. 2025 Jan;68:43-53. doi: 10.1016/j.jemermed.2024.08.005. Epub 2024 Aug 13.
Amidst the COVID-19 pandemic, telemedicine emerged as an important option that supports and facilitates clinical practice, however, its usefulness in emergency settings that treat patients with cancer is unclear.
To evaluate patient perception of physician empathy in an emergency oncology setting, comparing video interaction to an in-person with personal protective equipment (PPE) approach.
In this single-center, prospective, cross-sectional, survey-based randomized controlled trial, patients were randomized 1:1 for the concluding conversation done in-person which included either interacting with physicians wearing PPE or video interaction with physicians without PPE (virtual). Patients' perceptions of the physicians' relational empathy were assessed and compared for each group by using the Consultation and Relational Empathy (CARE) Measure and the Perception of Physician Compassion measure.
Patients (n = 106) in both the PPE and virtual arms provided favorable responses to all questions. The mean overall CARE scores for the PPE and virtual arms were 45.02 and 44.43, respectively (difference, 0.58 [95% CI: -2.10, 3.30]). Regarding the linear physician compassion scores, patients in the virtual arm appeared to consider physicians to be warmer (difference, -0.42 [95% CI: -0.87, 0.04]) but less pleasant (difference, 0.33 [95% CI: -0.40, 1.10]) than did patients in the PPE arm.
Cancer patients presenting to the emergency department perceive empathy and compassion equally when approached by physicians virtually without PPE or in person while wearing PPE. Virtual services for specific aspects of clinical practice during emergency department visits in an oncology setting can be implemented to ensure safer interactions between patients and physicians without compromising the physician-patient relationship.
在新型冠状病毒肺炎大流行期间，远程医疗成为支持和促进临床实践的重要选择，然而，其在治疗癌症患者的急诊环境中的作用尚不清楚。
评估在肿瘤急诊环境中患者对医生同理心的感知，比较视频互动与医生佩戴个人防护装备（PPE）的面对面交流方式。
在这项单中心、前瞻性、横断面、基于调查的随机对照试验中，患者按1:1随机分组，进行面对面的总结性谈话，其中一组是与佩戴PPE的医生互动，另一组是与不佩戴PPE的医生进行视频互动（虚拟方式）。通过使用咨询与关系同理心（CARE）量表和医生同情心感知量表，评估并比较每组患者对医生关系同理心的感知。
PPE组和虚拟组的患者（n = 106）对所有问题均给出了积极回应。PPE组和虚拟组的CARE总分均值分别为45.02和44.43（差异为0.58 [95% CI：-2.10, 3.30]）。关于医生同情心的线性评分，虚拟组患者似乎认为医生比PPE组患者更热情（差异为-0.42 [95% CI：-0.87, 0.04]），但不那么亲切（差异为0.33 [95% CI：-0.40, 1.10]）。
在肿瘤急诊就诊时，癌症患者在与不佩戴PPE的医生进行虚拟交流或与佩戴PPE的医生进行面对面交流时，对同理心和同情心的感知是相同的。在肿瘤急诊就诊期间，可实施针对临床实践特定方面的虚拟服务，以确保患者与医生之间更安全的互动，同时不损害医患关系。
