Patient- and hospital-related determinants on subjective evaluation of medical treatment outcome of severely injured patients

Physician empathy and subjective evaluation of medical treatment outcome in trauma surgery patients

OBJECTIVE

To analyze whether patients' perception of their medical treatment outcome is higher among patients who experienced a higher empathy by trauma surgeons during their stay in hospital.

METHODS

127 patients were surveyed six weeks after discharge from the trauma surgical general ward. Subjective evaluation of medical treatment outcome was measured with the corresponding scale from the Cologne Patient Questionnaire. Clinical empathy was assessed by using the CARE measure. The influence of physician empathy and control variables on a dichotomized index of subjective evaluation of medical treatment outcome was identified with a logistic regression.

RESULTS

120 patients were included in the logistic regression analysis. Compared to patients with physician empathy ratings of less than 30 points, patients with ratings of 41 points or higher have a 20-fold higher probability to be in the group with a better medical treatment outcome on the CPQ-scale (α-level<.001, R(2) 46.9).

CONCLUSION

Findings emphasize the importance of a well-functioning relationship between physician and patient even in a surgical setting where the focus is mostly on the bare medical treatment.

PRACTICE IMPLICATIONS

Communication trainings i.e. in surgical education can be an effective way to improve the ability to show empathy with patients' concerns.

Pre-traumatic, trauma- and treatment-related determinants of self-rated health after a severe trauma

BACKGROUND

This analysis examines the relationship between different pre-traumatic, trauma and treatment related factors and self-rated health of heavily injured patients after a severe trauma.

MATERIALS & METHODS

A written questionnaire was sent to 121 seriously injured patients who were predominantly hurt by traffic or work related accidents and were treated between june 1996 and july 2000 in two hospitals in North Rhine-Westphalia. Information regarding age, gender, education, occupation, income, injury severity, injury of extremities, state anxiety, date of discharge and taking part in a cognitive behavioural intervention were gathered during the inpatient stage, information about self-rated health, patients subjective evaluation of medical treatment outcome and shared decision making with physicians were gathered about four years after trauma.

RESULTS

Results of a multivariate stepwise linear regression show that poor self-rated health is significantly associated with a negative subjective evaluation of medical treatment outcome, less shared decision making behaviour of physician, low socio-economic status and older age.

CONCLUSIONS

Treatment but not trauma related factors and socio-economic and demographic characteristics of patients are significantly associated with self-rated health of severely injured patients. It seems to be important for long-term health to take into account: 1.) patient reported outcomes e.g. subjective evaluation of medical treatment outcome, 2.) shared decision making behaviour of physicians and 3.) to be aware of patients with low socio-economic status or 4.) older age as a high risk population.