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Harik L, Yamamoto K, Kimura T, Rong LQ, Vogel B, Mehran R, Bairey-Merz CN, Gaudino M. Patient-physician sex concordance and outcomes in cardiovascular disease: a systematic review. Eur Heart J 2024; 45:1505-1511. [PMID: 38551446 DOI: 10.1093/eurheartj/ehae121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 05/09/2024] Open
Abstract
The sex disparity in outcomes of patients with cardiovascular disease is well-described and has persisted across recent decades. While there have been several proposed mechanisms to explain this disparity, there are limited data on female patient-physician sex concordance and its association with outcomes. The authors review the existing literature on the relationship between patient-physician sex concordance and clinical outcomes in patients with cardiovascular disease, the evidence of a benefit in clinical outcomes with female patient-physician sex concordance, and the possible drivers of such a benefit and highlight directions for future study.
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Affiliation(s)
- Lamia Harik
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Ko Yamamoto
- Department of Cardiology, Hirakata Kohsai Hospital, Osaka, Japan
| | - Takeshi Kimura
- Department of Cardiology, Hirakata Kohsai Hospital, Osaka, Japan
| | - Lisa Q Rong
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA
| | - Birgit Vogel
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Roxana Mehran
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - C Noel Bairey-Merz
- Barbara Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai, Los Angeles, CA, USA
| | - Mario Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
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Cavallo DA, Salwan JK, Doernberg M, Tetrault JM, Holt SR. Shared Medical Appointment: A Novel Model for Incorporating Group Visits Into Residency Training for Substance Use Disorders. SUBSTANCE USE & ADDICTION JOURNAL 2024:29767342241233363. [PMID: 38494709 DOI: 10.1177/29767342241233363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
BACKGROUND Shared medical appointments (SMAs) are a novel modality for treating patients with similar conditions, together, by a team of interdisciplinary providers. SMAs benefit patients with substance use disorder (SUD), but no research has focused on the feasibility of implementation of SMAs in a teaching clinic. METHODS Primary care residents rotated in a half-day ambulatory addiction clinic for 4 weeks where a third-year resident co-facilitated 4 SMAs. Confidence, knowledge, and attitudes about SUD care were assessed using web-based surveys at weeks 0, 4, and 8. Pre- and post-intervention scores were compared using a t test for paired samples. RESULTS Ten residents were included in the analyses. Using a 10-point Likert scale, confidence in SUD knowledge (7.0-8.3, P = .003), confidence in counseling patients with SUD (7.1-8.2, P = .023), and confidence in facilitating an SMA (5.7-8.3, P = .007) showed statistically significant increases from baseline following exposure to the SMAs. Confidence that counseling and other treatments will make a difference for patients with illicit drug use increased (7.1-8.0, P = .142), but did not differ statistically. Furthermore, on a 4-point Likert scale, understanding of behavioral therapies for treating and preventing the relapse of SUD (2.9-3.2, P = .180) showed a similar increase. Attitudes toward patients with SUD (42.4-42.1, P = .303) and physician empathy (119.3-119.2, P = .963) did not change from pre- to post-intervention. CONCLUSIONS SMAs are a feasible training tool in the education of primary care residents on an addiction medicine rotation. Residents develop confidence co-facilitating SMAs after 4 weeks. Overall, exposure to SMAs during residency can provide an opportunity to increase confidence in treating patients with SUD, as well as provide a training modality that may shift the way residents interact with patients receiving SUD treatment.
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Affiliation(s)
- Dana A Cavallo
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jasleen K Salwan
- Internal Medicine and Addiction Medicine, Montgomery Family Medicine Associates, Silver Spring, MD, USA
| | | | - Jeanette M Tetrault
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Stephen R Holt
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
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Ng SH, Babar MG, Ahmed SI, Hasan SS, Yang WY. Measuring empathic behaviour among undergraduate dietetics students. J Eval Clin Pract 2024; 30:153-161. [PMID: 37641432 DOI: 10.1111/jep.13913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 08/31/2023]
Abstract
AIM Empathic behaviour has a direct link to the positive clinical outcomes. Health professionals, which include dietitians, are increasingly expected to demonstrate the impact of their care on patient outcomes. To date, there is limited research exploring the empathic behaviour of dietetics students. METHODS This cross-sectional study evaluated the psychometric properties of Jefferson Scale of Empathy-Healthcare Provider Student (JSE-HPS) and empathic behaviour of dietetics students. RESULTS Undergraduate dietetics students from one private and two public universities in Malaysia participated (n = 455). Item and scale psychometric properties were examined using principal component analysis and differences in mean empathy scores for students were assessed across years of study and types of universities. A 3-factor solution emerged in the results, accounting for 26.76%, 10.75% and 6.3% of the variance. The JSE-HPS demonstrated good internal consistency (α = 0.83). Despite students enroled at public universities scoring higher mean empathy scores than students enroled at the private university, the difference was not significant. The only significant difference was between the empathy level of first and third year students (p = 0.033). CONCLUSION As empathy underpins patient-centred management in the nutrition care process, it should be well integrated into curriculum delivery so that appropriate levels of empathy can be developed to prepare work-ready healthcare professionals.
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Affiliation(s)
- Shi Hui Ng
- School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Muneer Gohar Babar
- Clinical Oral Health Sciences Division, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Syed Imran Ahmed
- School of Pharmacy, College of Health and Science, University of Lincoln, UK
| | | | - Wai Yew Yang
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
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He S, Sultana R, Anantham D, Loh HP, Zhou JX, Tang JY, Sim M, Ayre TC, Fong KY, Tan KH. Empathy Levels Among Healthcare Professionals: An Asian Multi-professional Cross-Sectional Study. Cureus 2024; 16:e53750. [PMID: 38465054 PMCID: PMC10921128 DOI: 10.7759/cureus.53750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND The aim of the study was to measure empathy in healthcare professionals in Singapore and to compare the scores between the different professions: doctors, nurses, and allied health professionals. METHODS An online survey questionnaire was conducted using the Jefferson Scale of Empathy (JSE) from July 2019 to January 2020. The total JSE score was calculated and compared among the different groups. Multiple linear regression was performed to assess predictors of total empathy scores for groups with statistically lower scores. RESULTS The survey was completed by 4,188 healthcare professionals (doctors (n=569, 13.6%), nurses (n=3032, 72.4%), and allied health professionals (n=587, 14.0%)) out of the 9,348-strong survey population, with a response rate of 44.8%. The study revealed a mean empathy score (SD) of 103.6 (15.6) for the cohort. The mean empathy score (SD) was 112.3 (14.7), 101.3 (15.2), and 107.0 (15.0), respectively for doctors, nurses, and allied health professionals. These were statistically significantly different among the groups (p< 0.0001), with nurses scoring significantly lower than either doctors (p< 0.0001) or allied health professionals (p< 0.0001). Multiple linear regression showed that age < 30 years old, male gender, Malay ethnicity, and working in a hospital setting were associated with significantly lower empathy scores in the nursing group. CONCLUSION Nurses in Singapore had significantly lower empathy scores compared to doctors and allied health professionals. Further research on the underlying causes should be undertaken and measures to improve empathy among Singapore nursing staff should be explored and implemented.
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Affiliation(s)
- Song He
- Department of Obstetrics and Gynaecology, KK (Kandang Kerbau) Women's and Children's Hospital, Singapore, SGP
| | - Rehena Sultana
- Centre for Quantitative Medicine, Duke-NUS (National University of Singapore) Medical School, Singapore, SGP
| | - Devanand Anantham
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore, SGP
| | - Huey Peng Loh
- Institute for Patient Safety & Quality, SingHealth Duke-NUS (National University of Singapore) Academic Medical Centre, Singapore, SGP
| | - Jamie X Zhou
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, SGP
| | - Joo Ying Tang
- Institute for Patient Safety & Quality, SingHealth Duke-NUS (National University of Singapore) Academic Medical Centre, Singapore, SGP
| | - Mabel Sim
- Institute for Patient Safety & Quality, SingHealth Duke-NUS (National University of Singapore) Academic Medical Centre, Singapore, SGP
| | | | - Kok Yong Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, SGP
| | - Kok Hian Tan
- Institute for Patient Safety & Quality, SingHealth Duke-NUS (National University of Singapore) Academic Medical Centre, Singapore, SGP
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Tzialla N, Boka V, Menexes G, Kotsanos N, Arapostathis K. Psychometric properties of the Greek version of the Jefferson Scale of Empathy and empathy levels in Greek dental postgraduate students. Eur Arch Paediatr Dent 2023; 24:691-700. [PMID: 37531023 DOI: 10.1007/s40368-023-00826-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE The aims of this study were to: (1) examine the psychometric properties of the Greek version of JSE-HP and (2) explore empathy among Greek dental postgraduate students. METHODS The JSE-HP scale was translated into Greek using the back translation method. The questionnaire was given to 111 dental postgraduate students between November 2017 and February 2018. A random sample of 25% was retested to assess test-retest reliability. The reliability of the Greek version of JSE-HP was measured with Cronbach's alpha (α) and Discrimination Indices (DIs). Exploratory Factor Analysis, with varimax rotation of the factorial axes, was used to examine the dimensionality and the factorial validity of the Greek version of the JSE-HP. Comparisons between groups of postgraduate students were performed as appropriate with the Kruskal-Wallis or the Mann-Whitney U test. RESULTS The response rate was 100%. The mean age was 28.9 years. The reliability, in the sense of internal consistency of the questionnaire was considered satisfactory (Cronbach's alpha: 0.76, average DI: 0.33.) The test-retest reliability was satisfactory (Pearson's r = 0.77, p < 0.001). Factor Analysis revealed 7 significant factors. No statistically significant differences in empathy scores were found among groups of postgraduate students. CONCLUSIONS The Greek version of the JSE-HP shows good psychometric properties. Empathy scores do not differ among Greek dental postgraduate students.
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Affiliation(s)
- N Tzialla
- Department of Paediatric Dentistry, Faculty of Dentistry, Aristotle University of Thessaloniki, 54636, Thessaloniki, Greece.
| | - V Boka
- Department of Paediatric Dentistry, Faculty of Dentistry, Aristotle University of Thessaloniki, 54636, Thessaloniki, Greece
| | - G Menexes
- Laboratory of Agronomy, School of Agriculture, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - N Kotsanos
- Department of Paediatric Dentistry, Faculty of Dentistry, Aristotle University of Thessaloniki, 54636, Thessaloniki, Greece
| | - K Arapostathis
- Department of Paediatric Dentistry, Faculty of Dentistry, Aristotle University of Thessaloniki, 54636, Thessaloniki, Greece
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Harz D, Begin AS, Alansari R, Esparza R, Zimmermann C, Evans BD, Eisenberg S, Katz JT. The art of empathy: Teaching empathy through art. CLINICAL TEACHER 2023; 20:e13643. [PMID: 37654209 DOI: 10.1111/tct.13643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/01/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND The instruction of empathy is challenging. Although several studies have addressed how art-based education can foster empathy, there is a need for more evidence showing its impact and students' perceptions, especially in graduate education. APPROACH We designed and implemented a virtual art-based curriculum focused on fostering empathy-The Art of Empathy. This novel curriculum used diverse art-based education methodologies to promote meticulous and collaborative observation and reflection, building on constructivism. Thirty-six interns at the Brigham and Women's Hospital were invited to participate in the curriculum, while 34 served as control. EVALUATION We used mixed methods to explore interns' perceptions of the curriculum and assess its impact on their empathy. We used two quantitative instruments with known psychometric characteristics: the Toronto Empathy Questionnaire (TEQ) and the Jefferson Scale of Physicians Empathy (JSPE), which were distributed in a survey and completed by 31/99 (31.3%). We collected qualitative data from four interns using semi-structured interviews. Thematic analysis showed how The Art of Empathy promoted interns' reflections and actions toward empathy. This was partially supported by the quantitative data that showed significantly higher scores on the 'Compassionate Care' subscale of the JSPE (p = 0.039) when compared with interns in the control group. The thematic analysis showed that interns appreciated the curriculum and valued its benefits while highlighting the limitations of the virtual delivery approach. IMPLICATIONS Our curriculum was well received by interns and showed the potential of art-based methodology to promote empathic capacities in graduate students.
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Affiliation(s)
- Dominique Harz
- Dental School, Pontificia Universidad Católica de Chile, Santiago, Chile
- Harvard Medical School, Boston, Massachusetts, USA
| | - Arabella Simpkin Begin
- Harvard Medical School, Boston, Massachusetts, USA
- Lincoln College, University of Oxford, Oxford, UK
| | - Reem Alansari
- Harvard Medical School, Boston, Massachusetts, USA
- Arabian Gulf University, Manama, Bahrain
- Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts, USA
| | - Ramiro Esparza
- Harvard Medical School, Boston, Massachusetts, USA
- University of Guadalajara, Guadalajara, Mexico
| | | | | | | | - Joel T Katz
- Harvard Medical School, Boston, Massachusetts, USA
- Brigham and Women's Hospital, Boston, Massachusetts, USA
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Praharaj SK, Salagre S, Sharma PSVN. Factor structure of the Jefferson Scale for Empathy among medical undergraduates from South India. Indian J Psychiatry 2023; 65:755-759. [PMID: 37645364 PMCID: PMC10461582 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_385_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/22/2023] [Accepted: 06/24/2023] [Indexed: 08/31/2023] Open
Abstract
Background Empathy is a multidimensional construct and is considered an essential attribute among healthcare professionals. The Jefferson Scale for Empathy (JSE) is a commonly used tool to measure physician empathy and has been used in medical students as well; however, the psychometric properties have not been well studied in India. We aimed to study the factor structure of JSE among medical undergraduates. Methods This was a secondary analysis of baseline data obtained from the Stigma, Empathy and Attitude module study among medical undergraduates (N = 157). The scores obtained on the 20-item JSE Medical Student Version were subjected to principal component analysis with varimax rotation. Eigenvalues greater than unity, scree plot, and Horn's parallel analysis were used for identifying the factors. Items with loading more than 0.4 were included based on Steven's recommendation. Results The sample was adequate for factor analysis (Kaiser-Meyer-Olkin (KMO) measure 0.832). Five factors were extracted using principal component analysis, which explained 60% of the variance. The first three appeared as stable factors, and the last two factors had two items each. The first factor was the strongest (explained 18.8% of variance) with loadings from nine items. The second factor (explained 15.6% of variance) had loadings from six items, and two of the items showed correlation with the first factor. Conclusions JSE has a multidimensional structure with five factors in our sample of medical undergraduates.
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Affiliation(s)
- Samir Kumar Praharaj
- Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Santosh Salagre
- Department of Medicine, Seth GS Medical College, Mumbai, Maharashtra, India
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Raja B AJ, K S, Khandhadiya K, Guru S CS, Mahajan U. Physician empathy during crisis: A survey of doctors in COVID-19 pandemic (COPE study). Med J Armed Forces India 2022:S0377-1237(22)00142-3. [PMID: 36212186 PMCID: PMC9529356 DOI: 10.1016/j.mjafi.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 08/25/2022] [Indexed: 11/07/2022] Open
Abstract
Background There is a lack of research studies on physician empathy levels towards patients, which is a critical component of providing high-quality patient-care and satisfaction. Our study aimed at assessing the physician-reported empathy levels towards patients during a crisis like the ongoing COVID-19 pandemic. Methods Cross-sectional online-based survey was conducted among 409 practicing doctors from varied healthcare levels during the pandemic. We used a validated Jefferson Physician's Empathy (JPE) - Health Professional (HP) version questionnaire. Empathy score was expressed as a median and interquartile range, and the analysis was done in STATA 12.1 (StataCorp LP, Texas, USA). Results Among the survey respondents, 55% were between 26-35 years, 56% were from the government health sector, and 57% were male doctors. Overall physicians' empathy score was 100 (89, 113). The empathy score among physicians engaged in OPD duty was significantly higher (p = 0.022). A total of 70.0% of physicians consulting more than 50 patients/day reported a score ≤105 (p = 0.035). Physicians aged more than 40 years (AOR = 2.545, 95% CI = 1.1133, 5.8184) and those working in government healthcare centers (AOR = 2.711, 95% CI = 1.1372, 6.4616) were about three times more likely to have a score >105 compared to younger physicians (p = 0.027) and private practitioners (p = 0.024). Conclusion Physician-reported empathy scores during the COVID pandemic were high. Middle-aged physicians involved in OPD consultation and those working in government healthcare recorded good scores. However, reporting lower empathy scores when the patient load increases highlights the need for administrative and medical education interventions.
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Affiliation(s)
- Antonieo Jude Raja B
- Assistant Professor (Paediatrics), Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Sriambika K
- Associate Professor (Anatomy), Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Ketki Khandhadiya
- Professor (Biochemistry), Heritage Institute of Medical Sciences, Varanasi, India
| | - Chandra Sekara Guru S
- Assistant Professor (Sports Medicine), Wg Cdr MS (IT & Trg), Dte Gen Medical Services (Air), Air HQ (RKP), New Delhi, India
| | - Uma Mahajan
- Former Biostatistician, Army Sports Institute, Pune, India
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Kristensen T, Ejersted C, Ahnfeldt-Mollerup P, Søndergaard J, Charles JA. Profiles of GPs with high and low self-reported physician empathy—personal, professional, and antibiotic prescribing characteristics. BMC PRIMARY CARE 2022; 23:243. [PMID: 36127665 PMCID: PMC9487092 DOI: 10.1186/s12875-022-01847-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 09/01/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
General Practitioners’ (GPs) professional empathy has been hypothesized to have substantial impact on their healthcare delivery and medication prescribing patterns. This study compares profiles of personal, professional, and antibiotic prescribing characteristics of GPs with high and low empathy.
Methods
We apply an extreme group approach to a unique combined set of survey and drug register data. The survey included questions about demographic, professional, and antibiotic prescribing characteristics, as well as the Jefferson Scale of Empathy for Health Professionals (JSE-HP) to assess self-reported physician empathy. It was sent to a stratified sample of 1,196 GPs comprising 30% of the Danish GP population of whom 464 (38.8%) GPs responded. GPs in the top and bottom decile of empathy levels were identified. All intra- and inter-profile descriptive statistics and differences were bootstrapped to estimate the variability and related confidence intervals.
Results
61% of GPs in the top decile of the empathy score were female. GPs in this decile reported the following person-centered factors as more important for their job satisfaction than the bottom decile: The Patient-physician relationship, interaction with colleagues, and intellectual stimulation. High-empathy scoring GPs prescribed significantly less penicillin than the low-empathy GPs. This was true for most penicillin subcategories. There were no significant differences in age, practice setting (urban vs. rural), practice type (partnership vs. single-handed), overall job satisfaction, or GP’s value of prestige and economic profit for their job satisfaction. The intra profile variation index and confidence intervals show less prescribing uncertainty among GPs with high empathy.
Conclusions
This study reveals that high empathy GPs may have different personal, professional, and antibiotic prescribing characteristics than low empathy GPs and have less variable empathy levels as a group. Furthermore, person-centered high empathy GPs on average seem to prescribe less penicillins than low empathy GPs.
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Voultsos P, Chatzinikolaou F, Papana A, Deliligka A. Reliability of Greek version of the Toronto empathy questionnaire in medical students and associations with sociodemographic and lifestyle factors. BMC Psychol 2022; 10:113. [PMID: 35501889 PMCID: PMC9063083 DOI: 10.1186/s40359-022-00824-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 04/26/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Empathy is an important key driver of any therapeutic relationship. It is beneficial for both physicians and patients. Enhancing physician's empathy should be an important goal of medical education. As there was a literature gap regarding the topic of empathy among medical students in Greece, this study aimed to contribute to filling this gap. METHODS A cross-sectional study was conducted. A socio-demographic questionnaire and the 52-item Greek version of the Toronto composite empathy scale (TCES) for measuring the cognitive and emotional aspects of empathy in both personal and professional life was administered to all the medical students in the Aristotle University of Thessaloniki, in Greece. Descriptive statistics were displayed for demographics. The associations of the variables were quantified by Chi-2 independence tests and Pearson's Correlation Coefficient. The reliability and validity of the questionnaire was determined by Cronbach's α, Hotelling's T-Squared Test, and Pearson correlation. Paired and Independent Sample T-Tests and One-way ANOVAs indicated statistically significant mean differences among the variables or subgroups of the variables. RESULTS The 52-item TCES, 26 for the personal (Per) setting and another 26 for professional (Pro) life, equally divided into cognitive (Cog) and emotional (Emo) empathy in each case. The overall reliability of the TCES questionnaire was found to be high (Cronbach's α = 0.895, significant positive correlations between the subscales). The mean total score of empathy showed that students had a moderately high empathy. Further, there was a statistically significant difference in means between the Per-Cog and Per-Emo settings (p < 0.001), the Pro-Cog and Pro-Emo (p < 0.001), the Per-Cog and Pro-Cog (p = 0.004), and the Per-Emo and Pro-Emo (p < 0.001). Females had significantly higher empathy scores (mean score 208.04) than males (192.5) on the Per-Cog, Per-Emo and Pro-Emo subscales. Furthermore, a positive correlation was found between empathy and factors such as love for animals, interest in medical ethics, belief in God, having an ill person in the family, class year or carrier intention. CONCLUSIONS The TCES is applicable to medical students. For the most part our findings were consistent with previous literature. However, we identified some nuances that might draw researchers' attention. The results of this study may contribute to plan interventions in the curriculum to enhance empathy in the medical students.
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Affiliation(s)
- Polychronis Voultsos
- Laboratory of Forensic Medicine and Toxicology (Medical Law and Ethics), School of Medicine, Faculty of Health Sciences, Aristotle University, University Campus, 541 24, Thessaloniki, Greece.
| | - Fotios Chatzinikolaou
- Laboratory of Forensic Medicine and Toxicology (Medical Law and Ethics), School of Medicine, Faculty of Health Sciences, Aristotle University, University Campus, 541 24, Thessaloniki, Greece
| | - Angeliki Papana
- Department of Economics, School of Economics and Regional Studies, University of Macedonia, Egnatia Str 156, 546 36, Thessaloniki, Greece
| | - Aspasia Deliligka
- AHEPA University Hospital, Kiriakidi Str 1, 546 21, Thessaloniki, Greece
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Role of Empathy and Lifelong Learning Abilities in Physicians and Nurses Who Work in Direct Contact with Patients in Adverse Working Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053012. [PMID: 35270702 PMCID: PMC8910215 DOI: 10.3390/ijerph19053012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/27/2022] [Accepted: 03/01/2022] [Indexed: 01/17/2023]
Abstract
Empathy and lifelong learning are two professional competencies that depend on the four principles of professionalism: humanism, altruism, excellence, and accountability. In occupational health, there is evidence that empathy prevents work distress. However, in the case of lifelong learning, the evidence is still scarce. In addition, recent studies suggest that the development of lifelong learning varies in physicians and nurses and that it is sensitive to the influence of cultural stereotypes associated with professional roles. This study was performed with the purpose of determining the specific role that empathy and lifelong learning play in the reduction in occupational stress. This study included a sample composed by 40 physicians and 40 nurses with high dedication to clinical work in ambulatory consultations from a public healthcare institution in Paraguay. Somatization, exhaustion, and work alienation, described as indicators of occupational stress, were used as dependent variables, whereas empathy, lifelong learning, gender, discipline, professional experience, civil status, and family burden were used as potential predictors. Three multiple regression models explained 32% of the variability of somatization based on a linear relationship with empathy, lifelong learning, and civil status; 73% of the variability of exhaustion based on a linear relationship with empathy, somatization, work alienation, and discipline; and 62% of the variability of work alienation based on a linear relationship with lifelong learning, exhaustion, and discipline. These findings indicate that empathy and lifelong learning play important roles in the prevention of work distress in physicians and nurses. However, this role varies by discipline.
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Predictors of Physician Compassion, Empathy, and Related Constructs: a Systematic Review. J Gen Intern Med 2022; 37:900-911. [PMID: 34545471 PMCID: PMC8452146 DOI: 10.1007/s11606-021-07055-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/20/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Compassion in healthcare provides measurable benefits to patients, physicians, and healthcare systems. However, data regarding the factors that predict care (and a lack of care) are scattered. This study systematically reviews biomedical literature within the Transactional Model of Physician Compassion and synthesizes evidence regarding the predictors of physician empathy, compassion, and related constructs (ECRC). METHODS A systematic literature search was conducted in CENTRAL, MEDLINE, PsycINFO, EMBASE, CINAHL, AMED, OvidJournals, ProQuest, Web of Science, and Scopus using search terms relating to ECRC and its predictors. Eligible studies included physicians as participants. Methodological quality was assessed based on the Cochrane Handbook, using ROBINS-I risk of bias tool for quantitative and CASP for qualitative studies. Confidence in findings was evaluated according to GRADE-CERQual approach. RESULTS One hundred fifty-two included studies (74,866 physicians) highlighted the diversity of influences on compassion in healthcare (54 unique predictors). Physician-related predictors (88%) were gender, experience, values, emotions and coping strategies, quality of life, and burnout. Environmental predictors (38%) were organizational structure, resources, culture, and clinical environment and processes. Patient-related predictors (24%) were communication ease, and physicians' perceptions of patients' motives; compassion was also less forthcoming with lower SES and minority patients. Evidence related to clinical predictors (15%) was scarce; high acuity presentations predicted greater ECRC. DISCUSSION The growth of evidence in the recent years reflects ECRC's ongoing importance. However, evidence remains scattered, concentrates on physicians' factors that may not be amenable to interventions, lacks designs permitting causal commentary, and is limited by self-reported outcomes. Inconsistent findings in the direction of the predictors' effects indicate the need to study the relationships among predictors to better understand the mechanisms of ECRCs. The current review can guide future research and interventions.
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Doctor-Patient Relationship in Synchronous/Real-time Video-Consultations and In-Person Visits: An Investigation of the Perceptions of Young People with Type 1 Diabetes and Their Parents During the COVID-19 Pandemic. Int J Behav Med 2022; 29:638-647. [PMID: 35076861 PMCID: PMC8788397 DOI: 10.1007/s12529-021-10047-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 12/21/2022]
Abstract
Background Given that the widely acknowledged influence of the doctor-patient relationship on objective health parameters and treatment adherence in chronic illnesses, this study sought to explore how patients perceived the patient-doctor relationship across virtual and in-person contexts. Methods Parents’ and patients’ perceptions of doctor-patient relationship were evaluated in 610 children and adolescents (12.17 ± 4.19 years, 50.9% girls) with type 1 diabetes who visited via video-conferencing or in person during the COVID-19 pandemic. Results No differences were found between video consultations and in-person visits in terms of care satisfaction (p > .05), doctor-patient relationship—for the dimensions agreement on tasks (p = .506) and bond (p = .828)—as perceived by parents and physician empathy as perceived by patients (p = .096). Parents rated patient-doctor agreement on explicit goals of treatment higher in video consultation than in person (p = .009, d = .211). Agreement on goals (β = − .180, p = .016) and bond with doctor (β = − .160, p = .034) were negatively and significantly associated with HbA1c values, but only in participants who visited in person. Conclusions Parents’ care satisfaction and perceptions of doctor-patient relationship, along with patients’ perceptions of physician empathy, did not substantially differ between visits carried out in person or via video consultations. Given the high risk of psychological problems described in young people with diabetes, video consultation can be considered a useful opportunity to maintain access to a healthcare provider in a challenging time, such as the COVID-19 pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s12529-021-10047-5.
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Fineschi D, Acciai S, Napolitani M, Scarafuggi G, Messina G, Guarducci G, Nante N. Game of Mirrors: Health Profiles in Patient and Physician Perceptions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031201. [PMID: 35162218 PMCID: PMC8834689 DOI: 10.3390/ijerph19031201] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/05/2022] [Accepted: 01/19/2022] [Indexed: 02/04/2023]
Abstract
The relationship between general practitioners and patients is privileged. The aim of this study was to assess the concordance between the health profile perceived by the patient and the one described by the doctor. We conducted a cross-sectional study between 2019–2020. Patients completed the 5d-5L (EQ-p) and clinicians completed it “from the patient’s perspective” (EQ-d), also consulting the clinical diary. Statistical analysis was performed using Stata 14 (Cohen’s kappa; Fisher’s exact test). The sample consisted of 423 patients. The mean age was 56.7 ± 19.2. There were significant differences by gender in usual activities, pain, and anxiety/depression (74.6% of men had no limitation in usual activities versus 64.5% of women (p < 0.01), 53.9% of men had no pain versus 38.5% of women (p < 0.01), and 60.3% of men had no anxiety/depression versus 38.5% of women (p < 0.01)). Physicians did not detect these differences. The concordance between EQ-p and EQ-d was substantial for mobility (k = 0.62; p < 0.01), moderate for self-care (k = 0.48; p < 0.01) and usual activities (k = 0.50; p < 0.01). Concordance was fair for pain/discomfort (k = 0.32; p < 0.01), anxiety/depression (k = 0.38; p < 0.01), and EQ Index (k = 0.21; p < 0.01). There was greater agreement for “objective “dimensions (mobility, self-care, and usual activities). A good doctor, to be considered as such, must try to put himself in the “patient’s pajamas” to feel his feelings and be on the same wavelength.
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Affiliation(s)
- Daniele Fineschi
- Local Health Unit Tuscany South-East, 53100 Siena, Italy; (D.F.); (S.A.)
| | - Sofia Acciai
- Local Health Unit Tuscany South-East, 53100 Siena, Italy; (D.F.); (S.A.)
| | - Margherita Napolitani
- Post Graduate School of Public Health, University of Siena, 53100 Siena, Italy; (M.N.); (G.M.); (G.G.)
| | - Giovanni Scarafuggi
- Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy;
| | - Gabriele Messina
- Post Graduate School of Public Health, University of Siena, 53100 Siena, Italy; (M.N.); (G.M.); (G.G.)
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Giovanni Guarducci
- Post Graduate School of Public Health, University of Siena, 53100 Siena, Italy; (M.N.); (G.M.); (G.G.)
| | - Nicola Nante
- Post Graduate School of Public Health, University of Siena, 53100 Siena, Italy; (M.N.); (G.M.); (G.G.)
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
- Correspondence:
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Saha S, Narang R, Aggarwal VP, Brinda GS, Kavita D. Comparison of Self-Reported Empathy Levels among Dental Undergraduate Students in Northern India: A Questionnaire-Based Cross-Sectional Study. Contemp Clin Dent 2021; 12:255-258. [PMID: 34759682 PMCID: PMC8525808 DOI: 10.4103/ccd.ccd_744_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/29/2020] [Accepted: 12/14/2020] [Indexed: 12/30/2022] Open
Abstract
Context: Empathy is one of the fundamentals of communication relevant within the practice of dentistry, and the research is limited in this field. Aims: The present study was conducted to assess the self-reported empathy levels among dental undergraduate students in Lucknow city of Northern India. Settings and Design: A descriptive cross-sectional study was conducted among three dental colleges of Lucknow city during July 2019–September 2019. Subjects and Methods: E-survey link was circulated among 790 students through e-mails. It has two parts. The first part included sociodemographic information, wherein the second part, the empathy level of students was assessed using the Jefferson Scale of Physician Empathy-Health Profession Students Version Questionnaire. The possible score range is 20–140: the higher the mean score, the higher the self-reported empathy level. Statistical Analysis Used: The data collected were analyzed using SPSS software version 24. Chi-square test was used to test gender distribution differences among different years. One-way analysis of variance including post hoc tests was used to compare the differences between study variables. Results: The mean ± standard deviation empathy score was 92.55 ± 11.85, 91.85 ± 12.23, 93.25 ± 11.24, 93.37 ± 12.31, and 88.34 ± 12.01 among the first-year, second-year, third-year, final-year, and interns' students, respectively, with a statistically significant difference. Conclusion: It can be concluded from the results of the present study that the mean empathy score was highest among final-year students which is suggestive of the impact of education in behavioral sciences.
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Affiliation(s)
- Sonali Saha
- Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ridhi Narang
- Department of Public Health Dentistry, Adesh Institute of Dental Sciences and Research, Bathinda, Punjab, India
| | - Vikram Pal Aggarwal
- Department of Public Health Dentistry, Surendra Dental College and Research Institute, Sri Ganganagar, Rajasthan, India
| | - Godhi S Brinda
- Department of Pedodontics and Preventive Dentistry, JSS Dental College and Hospital, Mysore, Karnataka, India
| | - Dhinsa Kavita
- Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
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Bukowski H, Ahmad Kamal NF, Bennett D, Rizzo G, O'Tuathaigh C. Association between dispositional empathy and self-other distinction in Irish and Belgian medical students: a cross-sectional analysis. BMJ Open 2021; 11:e048597. [PMID: 34521665 PMCID: PMC8442071 DOI: 10.1136/bmjopen-2020-048597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Physicians' cognitive empathy is associated with improved diagnosis and better patient outcomes. The relationship between self-reported and performance-based measures of cognitive empathic processes is unclear. DESIGN Cross-sectional analysis of the association between medical students' empathy scale scores and their empathic performance in a visuospatial perspective-taking (VPT) task. PARTICIPANTS Undergraduate medical students across two European medical schools (n=194). PRIMARY AND SECONDARY OUTCOME MEASURES Two self-report empathy and one performance-based perspective-taking outcome: Jefferson Scale of Physician Empathy (JSPE); Empathy Quotient (EQ); Samson's level-1 VPT task. RESULTS Higher scores on the 'standing in patient's shoes' subscale of the JSPE were associated with a lower congruency effect (as well as lower egocentric and altercentric biases) in the VPT (B=-0.007, 95% CI=-0.013 to 0.002, p<0.05), which reflects an association with better capacity to manage conflicting self-other perspectives, also known as self-other distinction. Lower egocentric bias was also associated with higher scores on the 'social skills' EQ subscale (B=-10.17, 95% CI=-17.98 to 2.36, p<0.05). Additionally, selection of a 'technique-oriented' clinical specialty preference was associated with a higher self-perspective advantage in the VPT, reflecting greater attentional priority given to the self-perspective. CONCLUSIONS We show that self-assessment scores are associated with selected performance-based indices of perspective taking, providing a more fine-grained analysis of the cognitive domain of empathy assessed in medical student empathy scales. This analysis allows us to generate new critical hypotheses about the reasons why only certain self-report empathy measures (or their subscales) are associated with physicians' observed empathic ability.
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Affiliation(s)
- Henryk Bukowski
- Psychological Sciences Research Institute, Universite catholique de Louvain, Louvain-la-Neuve, Walloon Brabant, Belgium
| | | | - Deirdre Bennett
- Medical Education Unit, School of Medicine, University College Cork, Cork, Ireland
| | - Gabriella Rizzo
- Department of Medicine, Cork University Hospital, Cork, Ireland
| | - Colm O'Tuathaigh
- Medical Education Unit, School of Medicine, University College Cork, Cork, Ireland
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Lamiani G, Mistraletti G, Moreschi C, Andrighi E, Vegni E. Cultivating Empathy and Soft Skills Among Intensive Care Residents: Effects of a Mandatory, Simulation-Based, Experiential Training. Ann Transplant 2021; 26:e931147. [PMID: 34385409 PMCID: PMC8369950 DOI: 10.12659/aot.931147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Communication with families is crucial in ICU care. However, only a few residency programs include communication and relationship training in their curricula. This study aimed to assess the impact of a communication-skill course on residents’ empathy and self-reported skills. Material/Methods A single-center, observational study was conducted. Since 2017, the 4th-year residents of the Anaesthesia and Intensive Care School, University of Milan attended the mandatory “Program to Enhance Relational and Communication Skills in ICU (PERCS-ICU)”. PERCS-ICU lasted 10 hours and involved small groups of residents. The course was articulated around the simulation and debriefing of 3 difficult conversations with trained actors. Before and after the course, residents completed the Jefferson Scale of Empathy and a questionnaire measuring self-assessed preparation, communication skills, relational skills, confidence, anxiety, emotional awareness, management of emotions, and self-reflection when conducting difficult conversations. The quality and usefulness of the course and the case scenario were assessed on a 5-point Likert scales. Results Between 2017 and 2019, 6 PERCS-ICU courses were offered to 71 residents, 69 of whom completed the questionnaires. After the course, residents reported improvements in empathy (p<.05), preparation (p<.001), communication skills (p<.005), confidence (p<.001), self-reflection (p<.001), and emotional awareness (p<.001). Residents perceived the course as very useful (mean=4.79) and high-quality (mean=4.58). The case scenario appeared very realistic (mean=4.83) and extremely useful (mean=4.91). All residents recommended the course to other colleagues. Conclusions PERCS-ICU proved to be a well-received and effective course to improve residents’ empathy and some self-reported skills. The long-term effects remain to be investigated.
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Affiliation(s)
- Giulia Lamiani
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Giovanni Mistraletti
- Unit of Anesthesia and Intensive Care, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | | - Elisa Andrighi
- Unit of Clinical Psychology, ASST Santi Paolo e Carlo, Milan, Italy
| | - Elena Vegni
- Department of Health Sciences, University of Milan, Milan, Italy.,Unit of Clinical Psychology, ASST Santi Paolo e Carlo, Milan, Italy
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Yu J, Parsons GS, Lancastle D, Tonkin ET, Ganesh S. "Walking in Their Shoes": The effects of an immersive digital story intervention on empathy in nursing students. Nurs Open 2021; 8:2813-2823. [PMID: 33743185 PMCID: PMC8363366 DOI: 10.1002/nop2.860] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 02/05/2021] [Accepted: 02/19/2021] [Indexed: 12/30/2022] Open
Abstract
Aim To evaluate the effects of a novel, immersive digital story intervention on empathy. Design A randomized trial with three phases. Results A total of 238 2nd year nursing students were recruited between May 2018 and December 2019. At baseline, no significant differences in empathy between the groups were found (p = .760). However, at post‐test, empathy was significantly higher in the intervention group (M: 118.76, SD: 10.65) than it was in the control group (M: 114.60, SD: 15.40) (p = .012). At follow‐up, there were no significant differences in empathy between the groups (p = .364). Conclusion The intervention resulted in an immediate increase in empathy in nursing students. However, further development of effective intervention delivery modes and fundamental redesign of the intervention itself would be needed to sustain this improvement over the long term.
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Affiliation(s)
- Juping Yu
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Gareth S Parsons
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Deborah Lancastle
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Emma T Tonkin
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Siva Ganesh
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
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Rashid Z, Sharif I, Khushk IA, Raja AA. Evaluation of empathy and fatigue among physicians and surgeons in tertiary care hospitals of Rawalpindi. Pak J Med Sci 2021; 37:663-667. [PMID: 34104144 PMCID: PMC8155429 DOI: 10.12669/pjms.37.3.1973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background and Objectives: Clinicians need to build an astute doctor-patient relationship. The term clinical empathy is the ability of doctor to cognitively appreciate a patient’s perspective, experiences, and deliver such an understanding back to patient. Studies associate high physician empathy with improved patient trust and clinical outcomes. In Pakistan, there is paucity of research data on this relationship. This study assessed the empathy and its relation to fatigue levels among physicians and surgeons. Methods: This was a cross-sectional analytical study involving 262 Physicians and Surgeons (1:1) chosen by convenience sampling method. Physicians and Surgeons were included from three hospitals in Rawalpindi from September 2017 to February 2018 and RAO soft sample calculator was used. The Jefferson Scale for Physician empathy (JSPE) (score range 20-140) and Multidimensional Fatigue Inventory (MFI-20) (score range 20-100) were used as data collection tools. The data was analyzed using SPSS version 23. Statistical tests including T-test and Pearson Correlation were used. Results: Overall, mean score of empathy was found to be 98.8±21.9 (range; 46-138). The empathy in Physicians (106.8±18.3) was found to be greater than Surgeons (89.4±22.1) and the difference was statistically significant (p value <0.01). Mean score of fatigue was 50.6±16.0. The fatigue level in Surgeons was greater than Physicians and the difference was found to be statistically significant (p value < 0.01). Strong negative correlation was observed between empathy and fatigue (r= -0.5, p=<0.01) using Pearson correlation. Conclusion: Overall, physicians had better empathy than surgeons, while fatigue scores were higher among surgeons. Fatigue is associated with empathy decay. This research provides an understanding of empathy deterioration and other factors responsible for it.
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Affiliation(s)
- Zubaida Rashid
- Zubaida Rashid, Community Medicine Department, AMC, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Imtenan Sharif
- Imtenan Sharif, Community Medicine Department, AMC, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Imdad Ali Khushk
- Imdad Ali Khushk, Pakistan Medical and Dental Council, Islamabad, Pakistan
| | - Abdullah Anis Raja
- Abdullah Raja, Community Medicine Department, AMC, National University of Medical Sciences, Rawalpindi, Pakistan
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Park J, Blatt B, Greenberg L. Does Medical Students' High Expression of Empathy Correlate with Their Choice of Primary Care Residencies? South Med J 2021; 114:8-12. [PMID: 33398353 DOI: 10.14423/smj.0000000000001192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES There are many factors that influence medical students' (MS) decisions when choosing a career. Some prominent factors include life-work balance, indebtedness, and flexibility of work hours. Whereas the expression of empathy has many positive correlates with a trusting and meaningful physician-patient interaction, only a few studies have analyzed the association of MS empathy expression and primary care residency selection. The results of these studies about the relationship of MS expression of empathy and their selection of primary care specialties have been conflicting, depending on the empathy instrument used. In addition, there have been other variables that have affected career decision making in more recent years not previously encountered. The objectives of our study were to analyze the association of The George Washington University School of Medicine and Health Sciences (GWU) MS Interpersonal Reactivity Index (IRI) scores and their residency selection, to compare our results with previous studies to determine whether the IRI provided more definitive relationships between empathy and career choice, and to assess whether our results confirmed the theoretical construct linking empathy with primary care physicians. METHODS GWU third-year MS (MS3s), representing the classes of 2008-2011, completed the perspective taking and empathy subscales of the IRI, which measure cognitive and affective empathy, respectively. MS empathy scores for individual specialty were compared to those scores in internal medicine (IM) using a linear regression model. Empathy scores for patient-oriented versus technology-oriented specialties and primary versus surgical specialties were compared using the independent t test. RESULTS A total of 593 (77.5%) MS3s had mean IRI scores of 45.1 (standard error 4.8), higher than a recent study involving MS. There were no significant differences between patient- and technology-oriented specialties (-0.65 to 0.88), primary care versus surgical residencies (-0.87 to 1.4), and women versus men (-0.20 to 1.4). Our study did not clarify previous conflicting studies in the literature. CONCLUSIONS There are no significant differences in expression of empathy in GWU students who chose patient- versus technology-oriented and primary care versus surgical residencies. The authors can only speculate why students' high expression of empathy was not associated with selecting primary care residencies, namely, women are outnumbering men entering medicine and are selecting technology-related specialties previously identified predominantly with men, and millennials have specific traits inherent in their generation that can affect their specialty choice. The results of our study shed doubt that the theoretical construct linking MS high empathy expression and choice of primary care careers is valid today.
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Affiliation(s)
- Joseph Park
- From The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Benjamin Blatt
- From The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Larrie Greenberg
- From The George Washington University School of Medicine and Health Sciences, Washington, DC
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Lwow M, Canetti L, Muszkat M. Gender differences in the effect of medical humanities program on medical students' empathy: a prospective longitudinal study. BMC MEDICAL EDUCATION 2020; 20:413. [PMID: 33167937 PMCID: PMC7653998 DOI: 10.1186/s12909-020-02333-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 10/28/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Previous studies have suggested that Medical students' empathy declines during medical school, especially during the clinical studies. The aim of this study was to examine. Changes in medical students' empathy during their first clinical experience, and to determine the impact of gender and humanities curriculum on empathy changes. METHODS In this prospective longitudinal study, 262 4th year students from three consecutive classes were assessed. Empathy was assessed before and at 4th-year-end, using the Jefferson Scale of Physician Empathy-Student Version (JSPE-S). The three classes differed in humanities curriculum [limited Medical Humanities (MH(lim)) vs. extended Medical Humanities (MH(ext))], and in admission system [Personal Interview (PI) vs. multiple mini interviews (MMI)]. RESULTS Overall, there was a small but significant decrease in JSPE-S during the fourth year (114.40 ± 11.32 vs. 112.75 ± 14.19, p = 0.034). Among men there was a statistically significant decline in JSPE-S during the fourth year, and the MH(ext) (but not the MH(lim)) was associated with the decline (t(35) = 2.38, p = 0.023). Women students showed no decline in empathy during the fourth-year of studies, regardless of type of humanities program. In addition, women who participated in MH(ext) had a higher JSPE-S scores during the 4th -year as compared to women who participated in MH(lim). CONCLUSION Pre-clinical humanities program was associated with a decline in empathy among men medical students during the fourth-year of medical studies. Gender differences in response to medical humanities programs require further study.
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Affiliation(s)
- Michal Lwow
- Department of Medicine, Hadassah Medical Center, Mount Scopus, POB 24035, 91240 Jerusalem, Israel
| | - Laura Canetti
- Department of Psychology, Hebrew University of Jerusalem, Mount Scopus, 91905 Jerusalem, Israel
- Department of Psychiatry, Hadassah Medical Center, POB 24035, 91240 Jerusalem, Israel
| | - Mordechai Muszkat
- Department of Medicine, Hadassah Medical Center, Mount Scopus, POB 24035, 91240 Jerusalem, Israel
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Aziz AB, Ali SK. Relationship between level of empathy during residency training and perception of professionalism climate. BMC MEDICAL EDUCATION 2020; 20:320. [PMID: 32957975 PMCID: PMC7507236 DOI: 10.1186/s12909-020-02231-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Empathy is one of the vital personality attributes for all physicians. It is essential for establishing general interpersonal relationships among doctors and patients. Unfortunately, there is evidence for the decline of physician's empathy during the clinical training phase and is a major concern for medical educators worldwide. One of the major factors reported for the decline of this trait is an unprofessional learning environment. OBJECTIVE This study examines the relationship between empathy level and perception of climate of professionalism among residents. METHOD The study participants included 70 residents of Obstetrics & Gynecology and Pediatrics departments of a private sector tertiary care hospital in Karachi, Pakistan. Two self-administered internet based surveys - Jefferson Scale of Physician Empathy (JSPE) and "Professionalism Climate Instrument"(PCI) - were administered to assess the level of empathy among the participants and their perception of professionalism in the learning environment. The relationship between the level of empathy and professionalism was analyzed using Spearman rank correlation. RESULTS The overall response rate was 81.4% with mean empathy level of 103 ± 13. The internal consistency of each scale measured by Cronbach's coefficient α was 0.76 for JSPE and 0.65 for PCI. No significant difference was observed in the mean empathy scores between senior and junior residents of both specialties. Statistically significant difference in empathy scores existed between female and male residents (p = 0.012; 95% CI, 2.27 to 17.59). The mean PCI score was 106 + 8.88 with no significant difference among residents of two specialties. Professionalism score was not found to vary with either the year of residency or gender. Empathy score and professionalism climate were not found to be correlated (rs = 0.56, p = 0.64). CONCLUSION The findings suggested that empathy is a relatively stable trait that remains unchanged during residency training programs. Female residents had higher empathic concern than the male trainees, however, the empathy level of the participants was not found to be influenced by the climate of professionalism.
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Affiliation(s)
- Aliya B. Aziz
- Department of Obstetrics and Gynaecology, Aga Khan university Hospital, Stadium Road, P.O. Box 3500, Karachi, Pakistan
| | - Syeda Kauser Ali
- Department of educational development, Aga Khan university Hospital, Stadium Road, P.O. Box 3500, Karachi, Pakistan
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Williams B, Beovich B. A systematic review of psychometric assessment of the Jefferson Scale of Empathy using the COSMIN Risk of Bias checklist. J Eval Clin Pract 2020; 26:1302-1315. [PMID: 31742843 DOI: 10.1111/jep.13293] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 07/01/2019] [Accepted: 07/06/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Empathic communication in health care may enhance positive patient and health care professional relationships, patient satisfaction and can buffer professional burnout. The Jefferson Scale of Empathy (JSE) was developed based on the need to quantitatively measure levels of empathy, particularly in health care settings. Evaluating the utility of empathy is underpinned by the psychometric rigour of the instruments used to measure it. The aim of this study was to critically evaluate the current evidence on the measurement properties of the JSE. METHODS Two reviewers independently searched six databases for papers describing psychometric assessment of the JSE from January 2000 to July 2018 inclusive. The studies were independently assessed for methodological quality using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist. RESULTS The search strategy resulted in the retrieval of 985 papers, of which 59 were included in this study. The majority of papers reported on measures of structural validity and internal consistency, and it was in these areas which the highest quality of reporting was demonstrated. Additionally, there was a generally very good quality in reporting of convergent validity. Reliability, measurement error, cross-cultural validity were reported with less than optimum quality. CONCLUSION The JSE demonstrates robust structural validity, internal consistency, and convergent validity. These measurement properties are generally well reported in the literature in studies of good methodological quality, and thus may be interpreted with relative confidence when used in empathy research. However, current evidence is limited for the properties of reliability, measurement error, and cross-cultural validity. Thus, a degree of caution should be considered in drawing conclusions when using the JSE with regard to these properties. It is recommended that future examinations of the JSE refer to the COSMIN guidelines to ensure complete and well-reported psychometric data are included.
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Affiliation(s)
- Brett Williams
- Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Victoria, Australia
| | - Bronwyn Beovich
- Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Victoria, Australia
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The Role of Empathy in Health and Social Care Professionals. Healthcare (Basel) 2020; 8:healthcare8010026. [PMID: 32019104 PMCID: PMC7151200 DOI: 10.3390/healthcare8010026] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/23/2020] [Accepted: 01/25/2020] [Indexed: 12/17/2022] Open
Abstract
The current article is an integrative and analytical literature review on the concept and meaning of empathy in health and social care professionals. Empathy, i.e., the ability to understand the personal experience of the patient without bonding with them, constitutes an important communication skill for a health professional, one that includes three dimensions: the emotional, cognitive, and behavioral. It has been proven that health professionals with high levels of empathy operate more efficiently as to the fulfillment of their role in eliciting therapeutic change. The empathetic professional comprehends the needs of the health care users, as the latter feel safe to express the thoughts and problems that concern them. Although the importance of empathy is undeniable, a significantly high percentage of health professionals seem to find it difficult to adopt a model of empathetic communication in their everyday practice. Some of the factors that negatively influence the development of empathy are the high number of patients that professionals have to manage, the lack of adequate time, the focus on therapy within the existing academic culture, but also the lack of education in empathy. Developing empathetic skills should not only be the underlying objective in the teaching process of health and social care undergraduate students, but also the subject of the lifelong and continuous education of professionals.
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Mistraletti G, Mezzetti A, Anania S, Ionescu Maddalena A, Del Negro S, Giusti GD, Gili A, Iacobone E, Pulitanò SM, Conti G, Bocci MG. Improving communication toward ICU families to facilitate understanding and reduce stress. Protocol for a multicenter randomized and controlled Italian study. Contemp Clin Trials 2019; 86:105847. [PMID: 31525488 DOI: 10.1016/j.cct.2019.105847] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/25/2019] [Accepted: 09/10/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Families of ICU patients have a pressing need for information: they find themselves suddenly in a complex technical environment often because of a life-threatening illness of a loved one. Some evidence suggests that specific communication tools (like websites or brochures) could improve the experience of ICU families. DESIGN Randomized, multicenter, stepped wedge trial for large-scale assessment of the effectiveness of a multitasking intervention to improve communication with families of critically ill patients. MAIN OUTCOME correct understanding of the prognosis. SECONDARY OUTCOMES correct understanding of medical treatments, prevalence of anxiety, depression and post-traumatic stress symptoms in the first ICU week. Prevalence of PTSD 6 months from ICU discharge. Empathy and burnout among ICU staff. Prevalence of refusals for tissues/organ donation, and medical claims. SUBJECTS 2100 ICU relatives of critically ill patients. INTERVENTIONS The intervention employs specific tools especially designed to raise the correctness of information and to improve the quality of communication: a website presenting the ICU world and justifying the relatives' emotions, with a webpage specifically dedicated to each participating ICU; a standard brochure; eight posters for the families' waiting room and a signboard for the ICU door. MEASUREMENTS AND MAIN RESULTS The study plans to assess these materials in up to 300 Italian ICUs that will participate, according to a five waves program, each one with randomized starting order. This way the effect of the intervention will be evaluated simultaneously. CONCLUSION This is an educational study, aiming to spread good medical practices, while also verifying their real effectiveness in a large number of ICUs. TRIAL REGISTRATION NUMBER NCT03438175.
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Affiliation(s)
- Giovanni Mistraletti
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Italy; SC Anestesia e Rianimazione, ASST Santi Paolo e Carlo, Ospedale San Paolo - Polo Universitario, Milano, Italy.
| | - Andrea Mezzetti
- AUSL Toscana Centro, SOS 118 Emergenza Territoriale, Empoli, Italy
| | - Stefania Anania
- SC Anestesia e Rianimazione, ASST Santi Paolo e Carlo, Ospedale San Paolo - Polo Universitario, Milano, Italy
| | - Alessandra Ionescu Maddalena
- Istituto di Anestesiologia e Rianimazione, Università Cattolica del Sacro Cuore, Roma, Italy; Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Silvia Del Negro
- SC Anestesia e Rianimazione, ASST Santi Paolo e Carlo, Ospedale San Paolo - Polo Universitario, Milano, Italy
| | | | - Alessio Gili
- Dipartimento di Medicina Sperimentale, Università degli Studi di Perugia, Italy
| | - Emanuele Iacobone
- SAR, Dipartimento Emergenza-Urgenza, AV3 Ospedale di Macerata, ASUR Marche, Italy
| | - Silvia Maria Pulitanò
- Istituto di Anestesiologia e Rianimazione, Università Cattolica del Sacro Cuore, Roma, Italy; Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Giorgio Conti
- Istituto di Anestesiologia e Rianimazione, Università Cattolica del Sacro Cuore, Roma, Italy; Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Maria Grazia Bocci
- Istituto di Anestesiologia e Rianimazione, Università Cattolica del Sacro Cuore, Roma, Italy; Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
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Cai F. Can I Get a Suggestion? Medical Improv as a Tool for Empathy Training in Obstetrics and Gynecology Residents. J Grad Med Educ 2019; 11:597-600. [PMID: 31636832 PMCID: PMC6795330 DOI: 10.4300/jgme-d-19-00185.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/06/2019] [Accepted: 07/29/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Physician empathy is associated with improved patient outcomes. No studies have examined the outcomes of medical improvisational (improv) training on empathy. OBJECTIVE Our aims were to determine whether an improv workshop is an effective tool to deliver empathy training for obstetrics and gynecology (OB-GYN) residents, and whether that effect is sustained over time. METHODS We conducted a prospective cohort study of OB-GYN residents undergoing empathy training through 4 improv games in a 1-hour session. Empathy surveys (score range 20-140) with validity evidence were administered 2 weeks prior to empathy training, immediately after, and 1, 3, and 6 months later. Fisher's exact test, Student's t test, and Wilcoxon rank sum test were used to compare statistical differences at each post-intervention assessment. RESULTS All 22 invited residents participated in empathy training. Empathy scores improved immediately after (120.0 ± 9.8 versus 113.1 ± 10.6, P = .026), though they regressed toward baseline through 6 months (116.3 ± 11.0 versus 113.1 ± 10.6, P = .43). When asked on a scale of 1-5 how much the workshop would impact their work, there was an increase in scores both immediately after (mean 3.5 versus 4.6, P < .001) and 1 month later (mean 3.5 versus 4.1, P = .039), but this difference disappeared at 6 months. CONCLUSIONS Using improv comedy to deliver empathy training is associated with a minor improvement in empathy scores in OB-GYN residents, which decreased at 6 months. Residents found the activity to be acceptable and reported the training would impact their clinical practice.
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Wahjudi JW, Findyartini A, Kaligis F. The relationship between empathy and stress: a cross-sectional study among undergraduate medical students. KOREAN JOURNAL OF MEDICAL EDUCATION 2019; 31:215-226. [PMID: 31455051 PMCID: PMC6715901 DOI: 10.3946/kjme.2019.132] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 07/03/2019] [Accepted: 07/22/2019] [Indexed: 05/28/2023]
Abstract
PURPOSE Empathy is critical for medical doctors, as it enables them to conduct good patient-centred care. Medical students are expected to learn this ability as part of their education and training. METHODS Using a cross-sectional design, the present study was conducted to identify whether the empathy levels of medical students are affected by their stress levels. A translated version of the Perceived Stress Scale-10 was used to measure the students' stress levels, while the Jefferson Scale of Physician Empathy was used to measure their empathy levels. RESULTS A total of 464 students from one medical school in Indonesia participated in the study. Stress levels among medical students peak in their first year of study and maintain a downward trend over the following years. The students' empathy levels increased during their first 3 years, declined significantly upon entering the first clinical year, and increased during the second clinical year. However, no correlations were found between stress level and empathy level. CONCLUSION These findings suggest that there may be other underlying factors that contribute to empathy decline among medical students upon entering their first clinical year. Further research should be conducted to identify these factors. The bounced-back of empathy level to a higher level in the second year highlights the importance of student adaptation in the clinical learning environment and the support system.
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Affiliation(s)
- James Wiguna Wahjudi
- Undergraduate Medical Program, Indonesia Medical Education and Research Institute (IMERI), Indonesia
| | - Ardi Findyartini
- Department of Medical Educationr, Indonesia Medical Education and Research Institute (IMERI), Indonesia
- Medical Education Center, Indonesia Medical Education and Research Institute (IMERI), Indonesia
| | - Fransiska Kaligis
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Indonesia
- Department of Psychiatry, Dr. Cipto Mangunkusumo Hospital, Central Jakarta, Indonesia
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Acquati A, Uberti S, Aquino A, Cerasetti E, Castagna C, Rovere-Querini P, Pisa V. Do empathic osteopaths achieve better clinical results? An observational feasibility study. INT J OSTEOPATH MED 2019. [DOI: 10.1016/j.ijosm.2019.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Yu J, Chung Y, Lee JE, Suh DH, Wie JH, Ko HS, Park IY, Shin JC. The Educational Effects of a Pregnancy Simulation in Medical/Nursing Students and Professionals. BMC MEDICAL EDUCATION 2019; 19:168. [PMID: 31126341 PMCID: PMC6534918 DOI: 10.1186/s12909-019-1589-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 05/02/2019] [Indexed: 05/19/2023]
Abstract
BACKGROUND The objective of this study was to investigate whether a pregnancy experience program (PREP) simulating physical changes in a mother during the last trimester of pregnancy could increase empathy, understanding, and positive attitude of medical/nursing students and their professional counterparts. METHODS This was a prospective observational study on medical/nursing students and their professional counterparts. Jefferson Scale of Physician Empathy (JSPE), physical difficulty and positive attitude score, and perceived effectiveness scores prior to PREP were compared to those after PREP. RESULTS A total of 189 participants completed PREP and questionnaires both prior to and after PREP. Mean JSPE score, physical difficulty score, and positive attitude scores were significantly increased following PREP (p<0.001, all). Perceived effectiveness scores about awareness, empathy, and understanding after PREP were significantly high in the professional group than in the student group (p=0.004, p=0.01, and p=0.017, respectively). Multiple stepwise linear regression analysis revealed that major in medicine (p = 0.014), health care professionals (nurse or physician) (p<0.001), and marriage experience (p < 0.001) were significant predictors of increasing empathy, difficulty feelings and effectiveness scores, respectively. CONCLUSION PREP is an effective simulation program that can improve empathy, positive attitude, and awareness in medical/nursing students as well as their professional counterparts.
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Affiliation(s)
- Jeeyoon Yu
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoohyun Chung
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
| | - Jung Eum Lee
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
| | - Dae Hun Suh
- Department of dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong Ha Wie
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
| | - Hyun Sun Ko
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
| | - In Yang Park
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
| | - Jong Chul Shin
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
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Uziel N, Meyerson J, Giryes R, Eli I. Empathy in dental care - the role of vicarious trauma. Int Dent J 2019; 69:348-353. [PMID: 31102260 DOI: 10.1111/idj.12487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES In health care, empathy is associated with compassion, thoughtfulness, attentiveness and caring. While empathy is perceived as desirable and positive, it can potentially be associated with negative aspects, such as secondary traumatic stress or vicarious trauma (VT). VT addresses the secondary vicarious influences of patients' pain and discomfort on clinicians. Dentists are routinely exposed to patients' anxiety, pain and discomfort. These may lead to VT, which in turn can affect empathy. The objectives of the present study were to examine the existence of VT among dentists and its association with their empathic approach. MATERIALS AND METHODS Two-hundred and fifty dentists were approached personally and by mail, and asked to complete: (i) the Jefferson Scale of Physician Empathy - Health Professionals; (ii) the Vicarious Trauma Scale; and (iii) demographic, personal and professional data, including age, definition of professional speciality, number of working hours per week and number of sleeping hours per night. RESULTS A total of 200 dentists responded (80% response rate). No differences were found between genders regarding empathy or VT. Dentists who have been accredited as a specialist in one of the dental fields (dental specialists) presented higher empathy scores than general practitioners. VT correlated positively with number of working hours per week and negatively with empathy. The best predictor of empathy was number of sleeping hours per night, followed by VT and age. CONCLUSIONS Empathy in the clinical setting is closely associated with secondary VT among dentists. Decreasing dentists' VT may benefit dentists' empathy and through this lead to better clinical outcomes.
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Affiliation(s)
- Nir Uziel
- Department of Oral Rehabilitation, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Joseph Meyerson
- Department of Oral Rehabilitation, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rami Giryes
- School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ilana Eli
- Department of Oral Rehabilitation, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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O’Tuathaigh CMP, Nadhirah Idris A, Duggan E, Costa P, Costa MJ. Medical students' empathy and attitudes towards professionalism: Relationship with personality, specialty preference and medical programme. PLoS One 2019; 14:e0215675. [PMID: 31048851 PMCID: PMC6497245 DOI: 10.1371/journal.pone.0215675] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 04/05/2019] [Indexed: 12/30/2022] Open
Abstract
Background Existing research has suggested that self-reported empathy in medical students is moderated by personality traits and diverse demographic and educational factors including age, gender, nationality, career aspirations, as well as year of curriculum. It is unclear how empathy, personality, and background factors might impact on students’ attitudes towards professionalism in medicine. Methods A cross-sectional questionnaire-based study was conducted in first and final year medical students at an Irish medical school. The following instruments were administered: (a) Jefferson Scale of Empathy; (b) NEO Five-Factor Inventory (NEO-FFI-3); (c) Attitudes towards Professionalism Scale. Demographic and educational variables were also measured. Descriptive and correlational analysis was conducted to examine the association between empathy, personality, professionalism-related attitudes and additional measures. Regression analysis was used to examine determinants of attitudes towards professional behaviour. Results Both selected NEO-FFI personality traits and empathy were independently associated with distinct categories of professional behaviour. Specifically, Openness to Experience was associated with higher empathy scores, and higher ‘Social responsibility’. Extraversion was linked with higher scores on the “Personal characteristics” and “Interactions with team” categories, while Conscientiousness was also positively associated with “Personal characteristics”. In agreement with previous studies, the personality traits most associated empathy were Agreeableness and Openness to Experience. Empathy did not vary according to programme year or career specialty preference. Conclusions This study is the first to show that empathy and personality factors may act as determinants of students’ attitudes towards medical professionalism in a manner which is dependent upon category of professional behaviour.
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Affiliation(s)
- Colm M. P. O’Tuathaigh
- Medical Education Unit, School of Medicine, University College Cork, Cork, Ireland
- * E-mail:
| | | | - Eileen Duggan
- Medical Education Unit, School of Medicine, University College Cork, Cork, Ireland
| | - Patricio Costa
- Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Braga, Portugal
| | - Manuel João Costa
- Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Braga, Portugal
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Emergency physician empathy does not explain variation in admission rates. Am J Emerg Med 2019; 37:767-768. [DOI: 10.1016/j.ajem.2018.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 08/07/2018] [Accepted: 08/07/2018] [Indexed: 11/18/2022] Open
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Guilera T, Batalla I, Forné C, Soler-González J. Empathy and big five personality model in medical students and its relationship to gender and specialty preference: a cross-sectional study. BMC MEDICAL EDUCATION 2019; 19:57. [PMID: 30764878 PMCID: PMC6376790 DOI: 10.1186/s12909-019-1485-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 02/04/2019] [Indexed: 06/01/2023]
Abstract
BACKGROUND Given the influence that personality can have on empathy, this study explores the relationship between empathy and personality, using three different measures of empathy, and taking into account gender and specialty preference. METHODS Cross-sectional study. One hundred and ten medical students completed the Jefferson Scale of Physician Empathy, the Interpersonal Reactivity Index, the Empathy Quotient, and the NEO-FFI Big Five personality model. Multivariable linear regression was performed to assess the association between personality traits and empathy. RESULTS Empathy scales showed weak and moderate correlation with personality. The strongest correlations were observed between IRI-Fantasy and Openness, and between IRI-Personal Distress and Neuroticism. Gender and specialty preference can modify this relationship. The extreme groups of Empathy Quotient had significant differences in most personality traits. CONCLUSIONS This study confirmed that empathy is related to personality. Using three empathy scales allows personalizing the evaluation of different empathy models and its relation with personality. These results can help to design programs to study if some personalized intervention strategies could improve the empathy in medical students.
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Affiliation(s)
- Teresa Guilera
- Psychiatry Service, Santa Maria University Hospital, Rovira Roure Avenue, 44, 25198 Lleida, Spain
- Institute for Biomedical research in Lleida Dr. Pifarré Foundation (IRBLleida), Lleida, Spain
| | - Iolanda Batalla
- Psychiatry Service, Santa Maria University Hospital, Rovira Roure Avenue, 44, 25198 Lleida, Spain
- Institute for Biomedical research in Lleida Dr. Pifarré Foundation (IRBLleida), Lleida, Spain
- Department of Medicine, Faculty of Medicine, University of Lleida, Lleida, Spain
| | - Carles Forné
- Department of Basic Medical Sciences, University of Lleida, Lleida, Spain
- Biostatistics Unit, Institute for Biomedical Research in Lleida Dr. Pifarré Foundation (IRBLleida), Lleida, Spain
| | - Jorge Soler-González
- Institute for Biomedical research in Lleida Dr. Pifarré Foundation (IRBLleida), Lleida, Spain
- Department of Medicine, Faculty of Medicine, University of Lleida, Lleida, Spain
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Charitou A, Fifli P, Vivilaki VG. Is empathy an important attribute of midwives and other health professionals?: A review. Eur J Midwifery 2019; 3:4. [PMID: 33537583 PMCID: PMC7839101 DOI: 10.18332/ejm/100612] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 12/09/2018] [Accepted: 12/09/2018] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION This paper is a report of a systematic review to identify and analyze studies of the measurement of empathy in midwives and other health professionals. Empathy has been recognized as an important factor in patient care, with positive outcomes for both patients and health professionals. There is a debate on the definition of empathy, on its measurement and on the possibility of improvement. METHODS Searches were made of the CINAHL, SCOPUS, PubMed and PsychINFO databases using the terms empathy, clinical, midwifery, nursing, medical students, measurement, and health professionals, singly or in combination, to identify literature published in English between 2002-2015. The included papers were critically reviewed and a narrative synthesis was conducted. RESULTS In all, 22 papers met the inclusion criteria by studies that were conducted to measure the levels of empathy in a variety of health professionals and students. Their scores were analyzed in correlation with their sociodemographic factors. CONCLUSIONS Despite numerous studies, many correlations but also differences exist, indicating the complexity of empathy and the need to further study it.
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Affiliation(s)
| | - Polyxeni Fifli
- Department of Midwifery, University of West Attica, Athens, Greece
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Hojat M, DeSantis J, Shannon SC, Mortensen LH, Speicher MR, Bragan L, LaNoue M, Calabrese LH. The Jefferson Scale of Empathy: a nationwide study of measurement properties, underlying components, latent variable structure, and national norms in medical students. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2018; 23:899-920. [PMID: 29968006 PMCID: PMC6245107 DOI: 10.1007/s10459-018-9839-9] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 06/18/2018] [Indexed: 05/22/2023]
Abstract
The Jefferson Scale of Empathy (JSE) is a broadly used instrument developed to measure empathy in the context of health professions education and patient care. Evidence in support of psychometrics of the JSE has been reported in health professions students and practitioners with the exception of osteopathic medical students. This study was designed to examine measurement properties, underlying components, and latent variable structure of the JSE in a nationwide sample of first-year matriculants at U.S. colleges of osteopathic medicine, and to develop a national norm table for the assessment of JSE scores. A web-based survey was administered at the beginning of the 2017-2018 academic year which included the JSE, a scale to detect "good impression" responses, and demographic/background information. Usable surveys were received from 6009 students enrolled in 41 college campuses (median response rate = 92%). The JSE mean score and standard deviation for the sample were 116.54 and 10.85, respectively. Item-total score correlations were positive and statistically significant (p < 0.01), and Cronbach α = 0.82. Significant gender differences were observed on the JSE scores in favor of women. Also, significant differences were found on item scores between top and bottom third scorers on the JSE. Three factors of Perspective Taking, Compassionate Care, and Walking in Patient's Shoes emerged in an exploratory factor analysis by using half of the sample. Results of confirmatory factor analysis with another half of the sample confirmed the 3-factor model. We also developed a national norm table which is the first to assess students' JSE scores against national data.
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Affiliation(s)
- Mohammadreza Hojat
- Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, 1015 Walnut Street, Suite 320, Philadelphia, PA, 19107, USA.
| | - Jennifer DeSantis
- Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, 1015 Walnut Street, Suite 320, Philadelphia, PA, 19107, USA
| | - Stephen C Shannon
- American Association of Colleges of Osteopathic Medicine, Bethesda, MD, USA
| | - Luke H Mortensen
- American Association of Colleges of Osteopathic Medicine, Bethesda, MD, USA
| | - Mark R Speicher
- American Association of Colleges of Osteopathic Medicine, Bethesda, MD, USA
| | - Lynn Bragan
- American Association of Colleges of Osteopathic Medicine, Bethesda, MD, USA
| | - Marianna LaNoue
- Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, 1015 Walnut Street, Suite 320, Philadelphia, PA, 19107, USA
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Haque M, Sa B, Majumder MAA, Islam MZ, Othman NSAB, Lutfi SNNB, Kibria GM, Salam A, Ismail MH, Abdullah SL. Empathy among undergraduate medical students: A cross-sectional study in one Malaysian public medical school. Ann Afr Med 2018; 17:183-188. [PMID: 30588931 PMCID: PMC6330787 DOI: 10.4103/aam.aam_57_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Empathy is one of the cardinal components for physician-patient relationships, optimal outcomes in patient care, improved patient satisfaction, greater adherence to therapy, and lower malpractice liability. It is also considered an essential quality for health-care professionals to practice medicine. The aim of the present study was to assess the empathy level of medical students of Universiti Pertahanan Nasional Malaysia (UPNM) National Defense University of Malaysia, Kuala Lumpur, Malaysia. Methods This was a cross-sectional study conducted in 2017 which recruited medical students of UPNM. The Empathy Quotient, a self-reported questionnaire, was utilized for data collection. The total empathy score of the questionnaire is 80. Results Majority of the respondents were male (60.9%), year-V students (26.6%), Malay (70.5%), and cadet officer (69.6%). The overall mean score achieved by the respondents was 36.76 ± 9.18, and 74.4% of the respondents scored more than 30. The empathy scores of the students were significantly affected by the gender (t = 2.371; df = 205; P < 0.05), year of study (F = 2.553; df = 4/202; P < 0.05), and examination grades (F = 3.488; df = 2/204; P < 0.05). The findings showed that female students are more empathetic than their male counterparts. Further, the post hoc Tukey test analysis revealed that Year-V students are more empathetic than their junior counterparts and students who got highest grade are more empathetic. Conclusions To improve the empathy level of the UPNM medical students, appropriate educational strategies and interventions should be designed and implemented in the curriculum to inculcate, maintain, and enhance empathy.
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Affiliation(s)
- Mainul Haque
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, (National Defence University of Malaysia), Kem Perdana Sungai Besi, 57000 Kuala Lumpur, Malaysia
| | - Bidyadhar Sa
- The Centre for Medical Sciences Education, Faculty of Medical Sciences, The University of the West Indies, St Augustine Campus, Trinidad and Tobago, West Indies, Trinidad and Tobago
| | - Md. Anwarul Azim Majumder
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Barbados, West Indies
| | - Md. Zakirul Islam
- The Department of Pharmacology, Eastern Medical College, Comilla, Kabila, Dhaka-Chittagong Highway, Burichang 3520, Bangladesh
| | - Nur Syamirah Aishah Binti Othman
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, (National Defence University of Malaysia), Kem Perdana Sungai Besi, 57000 Kuala Lumpur, Malaysia
| | - Siti Nur Najihah Binti Lutfi
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, (National Defence University of Malaysia), Kem Perdana Sungai Besi, 57000 Kuala Lumpur, Malaysia
| | - Golam Mohammad Kibria
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, (National Defence University of Malaysia), Kem Perdana Sungai Besi, 57000 Kuala Lumpur, Malaysia
| | - Abdus Salam
- Medical Education and Quality Assurance, Asia Metropolitan University, No.6, Jalan Lembah Bandar Seri Alam, 81750 Johor Bahru, Malaysia
| | - Mohd Hafizi Ismail
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, (National Defence University of Malaysia), Kem Perdana Sungai Besi, 57000 Kuala Lumpur, Malaysia
| | - Shahidah Leong Abdullah
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, (National Defence University of Malaysia), Kem Perdana Sungai Besi, 57000 Kuala Lumpur, Malaysia
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Biswas B, Haldar A, Dasgupta A, Mallick N, Karmakar A. An Epidemiological Study on Empathy and its Correlates: A Cross-sectional Assessment among Medical Students of a Government Medical College of India. Indian J Psychol Med 2018; 40:364-369. [PMID: 30093748 PMCID: PMC6065120 DOI: 10.4103/ijpsym.ijpsym_109_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Empathy is a desirable quality in every clinician. It is a crucial determinant of patient-physician communication and relation. There are very few existent Indian studies on empathy of medical students and its correlates. AIM The aim of the study was to assess empathy level of medical students and its correlates. METHODOLOGY It was a cross-sectional, hospital-based, analytical observational study conducted from July to November 2017. In total, 249 undergraduate medical students of a medical college of Kolkata were interviewed with a structured schedule. The schedule comprised of the sociodemographic questionnaire, career satisfaction, future career choice, and Jefferson Scale of Empathy. RESULTS The mean empathy score was 98.5 ± 12.5. Third-semester students had higher empathy scores (102.4 ± 12.4) compared to fifth (97.2 ± 12.9) and seventh semester (95.0 ± 10.9) students. The difference between the mean scores of different semesters was statistically significant. Female students were more empathic than male students. In the multivariable linear regression model, sex, semester, residence, career satisfaction, future career choice, and current place of living were significant predictors of empathy scores. CONCLUSION Empathy level of medical students of our study was quite low compared to other studies conducted outside India. Empathy eroded with semester, which supports earlier pieces of evidence in this regard.
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Affiliation(s)
- Bijit Biswas
- Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
| | - Anima Haldar
- Department of Community Medicine, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India
| | - Aparajita Dasgupta
- Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
| | - Nazrul Mallick
- Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
| | - Anubrata Karmakar
- Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
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Spivak B, Batagol B, Sifris A, Williams B. Measuring empathy in undergraduate law students: Examining the factorial validity of the Jefferson Scale of Empathy - Law Students (JSE-LS). INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2018; 58:143-149. [PMID: 29853004 DOI: 10.1016/j.ijlp.2018.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 01/09/2018] [Accepted: 01/25/2018] [Indexed: 06/08/2023]
Abstract
Several scholars have hypothesised a link between empathy and a range of important outcomes for law students including well-being, mental health and the development of effective client-lawyer relationships. However, few studies have examined these claims empirically. Empirical investigation of empathy among law students requires effective methods of measuring empathy. The present study sought to examine an instrument designed specifically to measure empathy among law students - the Jefferson Empathy Scale - Law Students (JSE-LS). The study involved examining the internal consistency and factor structure of the instrument using a sample of 276 Australian undergraduate law students. The study found that a four-factor solution was optimal for the dataset. Two of the factors were readily interpretable with previous literature, however the remaining two factors were unstable, suggesting the need for further revision of the instrument. Recommendations for revising the JSE-LS to better measure empathy are discussed.
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Affiliation(s)
- Benjamin Spivak
- Centre for Forensic Behavioural Sciences, Swinburne University of Technology, 505 Hoddle street, Clifton Hill, Victoria, Australia.
| | | | | | - Brett Williams
- Department of Community Emergency Health and Paramedic Practice, Monash University, Australia; Division of Paramedicine, School of Medicine, University of Tasmania, Australia
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Empathy Variation in General Practice: A Survey among General Practitioners in Denmark. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15030433. [PMID: 29498682 PMCID: PMC5876978 DOI: 10.3390/ijerph15030433] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 02/07/2018] [Accepted: 02/28/2018] [Indexed: 12/30/2022]
Abstract
Background: Previous studies have demonstrated that high levels of physician empathy may be correlated with improved patient health outcomes and high physician job satisfaction. Knowledge about variation in empathy and related general practitioner (GP) characteristics may allow for a more informed approach to improve empathy among GPs. Objective: Our objective is to measure and analyze variation in physician empathy and its association with GP demographic, professional, and job satisfaction characteristics. Methods: 464 Danish GPs responded to a survey containing the Danish version of the Jefferson Scale of Empathy for Health Professionals (JSE-HP) and questions related to their demographic, professional and job satisfaction characteristics. Descriptive statistics and a quantile plot of the ordered empathy scores were used to describe empathy variation. In addition, random-effect logistic regression analysis was performed to explore the association between empathy levels and the included GP characteristics. Results: Empathy scores were negatively skewed with a mean score of 117.9 and a standard deviation of 10.1 within a range from 99 (p5) to 135 (p95). GPs aged 45–54 years and GPs who are not employed outside of their practice were less likely to have high empathy scores (≥120). Neither gender, nor length of time since specialization, length of time in current practice, practice type, practice location, or job satisfaction was associated with odds of having high physician empathy. However, odds of having a high empathy score were higher for GPs who stated that the physician-patient relationship and interaction with colleagues has a high contribution to job satisfaction compared to the reference groups (low and medium contribution of these factors). This was also the trend for GPs who stated a high contribution to job satisfaction from intellectual stimulation. In contrast, high contribution of economic profit and prestige did not contribute to increased odds of having a high empathy score. Conclusions: Albeit generally high, we observed substantial variation in physician empathy levels among this population of Danish GPs. This variation is positively associated with values of interpersonal relationships and interaction with colleagues, and negatively associated with middle age (45–54 years) and lack of outside employment. There is room to increase GP physician empathy via educational and organizational interventions, and consequently, to improve healthcare quality and outcomes.
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Abstract
The aim of this study was to report the most frequent psychosocial difficulties (PSDs) in patients with Parkinson disease (PD), to explore the relationship between PSDs, disability and quality of life (QoL), and to address the predictors of PSDs. Patients with PD were interviewed using a protocol composed of a questionnaire investigating PSDs (PARADISE 24), QoL, disability, comorbidity, and social support questionnaires, scales on resilience, personality traits, and empathy in physician. Most frequent PSDs were reported. Spearman's correlation was used to address the relationship between PARADISE 24 and QoL and disability measures. Multiple linear regression was performed to investigate predictors of PARADISE 24. Eighty patients were enrolled: 40% women, mean age 61.2 years. The most frequent PSDs were related to cognitive and motor slowness, tiredness, sleeping, facing all things to do, depressive mood, and anxiety. PARADISE 24 were correlated with disability (ρ=0.831) and QoL (ρ=-0.685). Lower QoL, higher disability, early age at onset, and shorter disease duration were significant predictors of PSDs (adjusted R=0.762). PARADISE 24 is an easy to use questionnaire that could contribute toward describing the impact of PD on patients' life more extensively, thus helping to define more tailored interventions.
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Lee PT, Loh J, Sng G, Tung J, Yeo KK. Empathy and burnout: a study on residents from a Singapore institution. Singapore Med J 2017; 59:50-54. [PMID: 29022041 DOI: 10.11622/smedj.2017096] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Empathy and burnout are two entities that are important in a physician's career. They are likely to relate to each other and can be heavily influenced by surrounding factors, such as medical education, local practices and cultural expectations. To our knowledge, empathy and burnout studies have not been performed in Singapore. This study was designed to evaluate empathy and burnout levels using the Jefferson Scale of Physician Empathy (JSPE) and Maslach Burnout Inventory (MBI) among residents in Singapore, and compare them with the United States (US) literature. METHODS The JSPE, MBI and a self-designed questionnaire were completed by 446 trainees at a residency-sponsoring institution in Singapore. RESULTS Residents in Singapore had lower empathy and higher rates of burnout compared to US literature. Physician empathy was associated with burnout: residents with higher empathy scores had higher personal accomplishment (p < 0.001, r = 0.477, r2 = 0.200); and lower emotional exhaustion (p < 0.001, r = 0.187, r2 = 0.035) and depersonalisation (p < 0.001, r = 0.321, r2 = 0.103) scores. CONCLUSION Residents in Singapore had lower empathy and higher burnout scores compared to the US literature. Further research into the underlying cause is imperative to guide intervention.
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Affiliation(s)
- Phong Teck Lee
- Department of Cardiology, National Heart Centre Singapore, Singapore
| | - Julian Loh
- Department of Cardiology, National Heart Centre Singapore, Singapore
| | - Gerald Sng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joshua Tung
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Khung Keong Yeo
- Department of Cardiology, National Heart Centre Singapore, Singapore.,Duke-NUS Medical School, Singapore
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Tariq N, Rasheed T, Tavakol M. A Quantitative Study of Empathy in Pakistani Medical Students: A Multicentered Approach. J Prim Care Community Health 2017; 8:294-299. [PMID: 28645236 PMCID: PMC5932734 DOI: 10.1177/2150131917716233] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To examine the empathy level of undergraduate medical students in Pakistan. Three hypotheses are developed based on the literature review. (1) Female medical students have a higher level of empathy than do male students. (2) Empathy scores vary during the medical school years in Pakistani students. (3) Medical students interested in people-oriented specialties would score higher than the students interested in technology-oriented specialties. METHODS This is a quantitative inquiry approach using a cross-sectional design of 1453 students from 8 Pakistani medical schools, both private and state. The sample consists of 41.1% (n = 597) male students and 58.9% (n = 856) female students. Empirical data are collected using the Jefferson Scale of Physician Empathy (JSPE), a well-validated self-administered questionnaire. RESULTS The mean empathy score among students is 4.77 with a standard deviation of 0.72. The results show that there is no statistically significant association between the empathy scores and gender, t(1342.36) = -0.053, P = .95). There is a statistically significant difference between the empathy scores and the years of medical school, F(14, 1448) = 4.95, P = .01. Concerning the specialty interests, there is no statistically significant difference between the empathy score and specialty interests. CONCLUSION The findings of this study showed that in Western countries, medical students performed better than Pakistani medical students on the empathy scale. This finding has important implications for Pakistani medical educators to improve the interpersonal skills of medical students in the context of patient care. Inconsistent with our expectations and experiences, our findings do not support that female medical students scored better than their male counterparts on the empathy scale. Because of the nature of a cross-sectional study, it is impossible to argue the decline of empathy during medical school training.
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Affiliation(s)
- Nabia Tariq
- Shifa College of Medicine Islamabad, Islamabad, Pakistan
| | - Tariq Rasheed
- Social Security Hospital Rawalpindi, Islamabad, Pakistan
| | - Mohsen Tavakol
- The University of Nottingham, Nottingham, Nottinghamshire, UK
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Chaitoff A, Sun B, Windover A, Bokar D, Featherall J, Rothberg MB, Misra-Hebert AD. Associations Between Physician Empathy, Physician Characteristics, and Standardized Measures of Patient Experience. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:1464-1471. [PMID: 28379929 DOI: 10.1097/acm.0000000000001671] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE To identify correlates of physician empathy and determine whether physician empathy is related to standardized measures of patient experience. METHOD Demographic, professional, and empathy data were collected during 2013-2015 from Cleveland Clinic Health System physicians prior to participation in mandatory communication skills training. Empathy was assessed using the Jefferson Scale of Empathy. Data were also collected for seven measures (six provider communication items and overall provider rating) from the visit-specific and 12-month Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS) surveys. Associations between empathy and provider characteristics were assessed by linear regression, ANOVA, or a nonparametric equivalent. Significant predictors were included in a multivariable linear regression model. Correlations between empathy and CG-CAHPS scores were assessed using Spearman rank correlation coefficients. RESULTS In bivariable analysis (n = 847 physicians), female sex (P < .001), specialty (P < .01), outpatient practice setting (P < .05), and DO degree (P < .05) were associated with higher empathy scores. In multivariable analysis, female sex (P < .001) and four specialties (obstetrics-gynecology, pediatrics, psychiatry, and thoracic surgery; all P < .05) were significantly associated with higher empathy scores. Of the seven CG-CAHPS measures, scores on five for the 583 physicians with visit-specific data and on three for the 277 physicians with 12-month data were positively correlated with empathy. CONCLUSIONS Specialty and sex were independently associated with physician empathy. Empathy was correlated with higher scores on multiple CG-CAHPS items, suggesting improving physician empathy might play a role in improving patient experience.
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Affiliation(s)
- Alexander Chaitoff
- A. Chaitoff is a third-year medical student, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio. B. Sun is a third-year medical student, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio. A. Windover is director of curriculum and faculty development, Center for Excellence in Healthcare Communication, Cleveland Clinic, Cleveland, Ohio. D. Bokar is an analyst, Center for Excellence in Healthcare Communication, Cleveland Clinic, Cleveland, Ohio. J. Featherall is a third-year medical student, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio. M.B. Rothberg is vice chair for research, Medical Institute, and director, Center for Value-Based Care Research, Cleveland Clinic, Cleveland, Ohio. A.D. Misra-Hebert is a staff physician, Center for Value-Based Care Research, Cleveland Clinic, and assistant professor of medicine, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
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Díez-Goñi N, Rodríguez-Díez MC. Why teaching empathy is important for the medical degree. Rev Clin Esp 2017; 217:332-335. [PMID: 28237408 DOI: 10.1016/j.rce.2017.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 11/12/2016] [Accepted: 01/08/2017] [Indexed: 12/30/2022]
Abstract
Empathy is a basic skill in the exercise of medicine and increases patient and physician satisfaction and improves clinical results. However, the teaching of empathy is poorly covered in the teaching plans. A number of studies have observed a reduction in empathy during the final training courses. The reasons for this decline include, the students' excessive academic workload, the prioritisation of acquiring medical expertise over humanistic knowledge, the patient load in hospitals and health centres and the physicians' need to distance themselves from their patients. Nevertheless, intervention studies through simulation with standardised patients have shown an increase in empathy in students, which can be evaluated through the Jefferson scales: JSE-S and JSPPPE. The teaching of empathy to medical students is an important commitment in the curricular programs of medical schools.
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Affiliation(s)
- N Díez-Goñi
- Unidad de Educación Médica, Facultad de Medicina, Universidad de Navarra, Pamplona, España.
| | - M C Rodríguez-Díez
- Unidad de Educación Médica, Facultad de Medicina, Universidad de Navarra, Pamplona, España
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Validity and Reliability of the Jefferson Scale of Empathy, Nursing Student Version R in a Sample of Iranian Oncology Nurses. Nurs Midwifery Stud 2016. [DOI: 10.5812/nmsjournal.39505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Quintas R, Cerniauskaite M, Giovannetti AM, Schiavolin S, Raggi A, Covelli V, Villani F, Didato G, Deleo F, Franceschetti S, Binelli S, Canafoglia L, Casazza M, Leonardi M. PARADISE 24 instrument: An observational study on psychosocial difficulties, quality of life, and disability levels in patients with epilepsy. Epilepsy Behav 2016; 64:160-165. [PMID: 27743548 DOI: 10.1016/j.yebeh.2016.08.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 08/16/2016] [Accepted: 08/19/2016] [Indexed: 11/30/2022]
Abstract
AIM The aim of this observational study was to test the effectiveness of the PARADISE 24 instrument in describing the psychosocial difficulties (PSDs) reported by people with epilepsy, their relation with disability, and quality-of-life (QoL) levels and, overall, to explore a horizontal epidemiology methodology applied to a sample of patients with epilepsy. METHODS A convenience sample of 80 adult patients with epilepsy was included in this cross-sectional study. Patients were interviewed using a structured protocol composed of demographic, clinical, and patient-reported outcome measures to collect PSDs associated with epilepsy. RESULTS There were 80 patients, 40 females; mean age was 41.2years; mean disease duration was 18.7years; and mean number of AED was 2.09. Moderate severity rating according to clinicians' rating scale, low impact of comorbidities (mean: 2.36, SD: 2.97), high levels of QoL (mean: 30.00, SD: 4.4), medium levels of resilience (mean: 13.56, SD: 2.66), high levels of perceived empathy (mean: 15.05, SD: 4.74), poor or moderate perceived social support, and low levels of disability (mean: 10.85, SD: 10.05) were observed. The most frequently reported PSDs were related to tiredness (80%), emotional problems (73.75%), anxiety (68.75%), depressive mood (66.25%), and driving problems (61.25%). The EUROHIS-QOL (p=.003) had a negative significant relationship with PARADISE 24 while WHODAS-12 (p=.000) and CRS (p=.027) had a positive significant relationship with PARADISE 24. CONCLUSIONS The PARADISE 24 permits data comparison and the creation of a complete description of a person's functioning and of all of his/her PSDs and allows better and more tailored interventions.
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Affiliation(s)
- Rui Quintas
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy; Division of Clinical Epileptology and Experimental Neurophysiology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy.
| | - Milda Cerniauskaite
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy; Neurosurgery Department, Radiotherapy Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Ambra Mara Giovannetti
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy; Department of Neuroimmunology and Neuromuscular Diseases, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Silvia Schiavolin
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Alberto Raggi
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Venusia Covelli
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy; e-Campus University, Novedrate, Como, Italy
| | - Flavio Villani
- Division of Clinical Epileptology and Experimental Neurophysiology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Giuseppe Didato
- Division of Clinical Epileptology and Experimental Neurophysiology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Francesco Deleo
- Division of Clinical Epileptology and Experimental Neurophysiology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Silvana Franceschetti
- Division of Neurophysiology and Diagnostic Epileptology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Simona Binelli
- Division of Neurophysiology and Diagnostic Epileptology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Laura Canafoglia
- Division of Neurophysiology and Diagnostic Epileptology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Marina Casazza
- Division of Neurophysiology and Diagnostic Epileptology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
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Sedaghati Kesbakhi M, Rohani C, Mohtashami J, Nasiri M. Validity and Reliability of the Jefferson Scale of Empathy, Nursing Student Version R in a Sample of Iranian Oncology Nurses. Nurs Midwifery Stud 2016. [DOI: 10.17795/nmsjournal39505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Psychosocial difficulties of individuals with multiple sclerosis: the PARADISE-24 questionnaire. Int J Rehabil Res 2016; 39:339-345. [PMID: 27631722 DOI: 10.1097/mrr.0000000000000194] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study is to identify the most relevant psychosocial difficulties (PSDs) experienced by persons with multiple sclerosis (PwMS); to evaluate the relation between an overall level of PSDs measured with the PARADISE-24 and other variables; to assess which factors may predict PARADISE-24 overall score. Adults PwMS were consecutively enrolled and completed a battery of eight self-reported instruments (i.e. SCQ, EUROHIS-QOL 8, BRS, BFI-10, JSPE, OSS-3, WHODAS-12, PARADISE-24). A clinical evaluation was performed for each patient and the Expanded Disability Status Scale (EDSS) score was determined by neurologists. A total of 80 PwMS, mean age 41.0, 65% women, 62% married, and 76.3% working, 86.3% relapsing-remitting MS, with an EDSS median score of 1.5, took part in the study. The mean disease duration was 7.7 years. The most frequently reported PSDs involved motor and emotional functioning. Free of charge access to medicines; health treatments and family, friends and health professionals' assistance represented the most important facilitators. WHODAS-12 and EUROHIS-QOL 8 were excluded from regression because of their strong correlation with PARADISE-24. EDSS, BRS, OSS-3, and neuroticism were the main predictors of the PARADISE-24 score. Despite MS heterogeneity, a common pattern of PSDs can be observed among PwMS. The level of physical impairment and personal resilience were the main predictors of the overall level of PSDs in PwMS, with a lower but significant additional role played by social support and personality traits. Attention to PSDs and their predictors, using PARADISE-24, can help clinicians to plan tailored and personalized rehabilitation programs.
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Ferreira-Valente A, Costa P, Elorduy M, Virumbrales M, Costa MJ, Palés J. Psychometric properties of the Spanish version of the Jefferson Scale of Empathy: making sense of the total score through a second order confirmatory factor analysis. BMC MEDICAL EDUCATION 2016; 16:242. [PMID: 27647296 PMCID: PMC5028960 DOI: 10.1186/s12909-016-0763-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 09/06/2016] [Indexed: 05/06/2023]
Abstract
BACKGROUND Empathy is a key aspect of the physician-patient interactions. The Jefferson Scale of Empathy (JSE) is one of the most used empathy measures of medical students. The development of cross-cultural empathy studies depends on valid and reliable translations of the JSE. This study sought to: (1) adapt and assess the psychometric properties in Spanish students of the Spanish JSE validated in Mexican students; (2) test a second order latent factor model. METHODS The Spanish JSE was adapted from the Spanish JSE-S, resulting in a final version of the measure. A non-probabilistic sample of 1104 medical students of two Spanish medical schools completed a socio-demographic and the Spanish JSE-S. Descriptive statistics, along with a confirmatory factor analysis, the average variance extracted (AVE), Cronbach's alphas and composite reliability (CR) coefficients were computed. An independent samples t-test was performed to access sex differences. RESULTS The Spanish JSE-S demonstrated acceptable to good sensitivity (individual items - except for item 2 - and JSE-S total score: -2.72 < Sk < 0.35 and -0.77 < Ku < 7.85), convergent validity (AVE: between 0.28 and 0.45) and reliability (Cronbach's alphas: between 0.62 and 0.78; CR: between 0.62 and 0.87). The confirmatory factor analysis supported the three-factor solution and the second order latent factor model. CONCLUSIONS The findings provide support for the sensitivity, construct validity and reliability of the adapted Spanish JSE-S with Spanish medical students. Data confirm the hypothesized second order latent factor model. This version may be useful in future research examining empathy in Spanish medical students, as well as in cross-cultural studies.
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Affiliation(s)
- Alexandra Ferreira-Valente
- University of Minho, School of Health Sciences, Life and Health Sciences Research Institute, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Patrício Costa
- University of Minho, School of Health Sciences, Life and Health Sciences Research Institute, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Marta Elorduy
- Universitat Internacional de Catalunya, School of Medicine and Health Sciences, Josep Trueta s/n 08165 Sant Cugat del Vallès, Barcelona, Spain
| | - Montserrat Virumbrales
- Universitat Internacional de Catalunya, School of Medicine and Health Sciences, Josep Trueta s/n 08165 Sant Cugat del Vallès, Barcelona, Spain
| | - Manuel J. Costa
- University of Minho, School of Health Sciences, Life and Health Sciences Research Institute, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Jorge Palés
- University of Barcelona, School of Medicine, Casanova 143, 08036 Barcelona, Spain
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