The Intricate Relationship Between Client Perceptions of Physician Empathy and Physician Self-Assessment: Lessons for Reforming Clinical Practice

Women's Relationships With Healthcare and Providers: The Role of Weight Stigma in Healthcare and Weight Bias Internalization

BACKGROUND

Weight stigma (devaluation due to body weight) in healthcare is common and influences one's engagement in healthcare, health behaviors, and relationship with providers. Positive patient-provider relationships (PPR) are important for one's healthcare engagement and long-term health.

PURPOSE

To date, no research has yet investigated whether weight bias internalization (self-stigma due to weight; WBI) moderates the effect of weight stigma on the PPR. We predict that weight stigma in healthcare is negatively associated with (i) trust in physicians, (ii) physician empathy, (iii) autonomy and competence when interacting with physicians, and (iv) perceived physician expertise. We also predict that those with high levels of WBI would have the strongest relationship between experiences of weight stigma and PPR outcomes.

METHODS

We recruited women (N = 1,114) to complete a survey about weight stigma in healthcare, WBI and the previously cited PPR outcomes.

RESULTS

Weight stigma in healthcare and WBI were associated with each of the PPR outcomes when controlling for age, BMI, education, income, race, and ethnicity. The only exception was that WBI was not associated with trust in physicians. The hypothesis that WBI would moderate the effect of weight stigma in healthcare on PPR outcomes was generally not supported.

CONCLUSIONS

Overall, this research highlights how weight stigma in healthcare as well as one's own internalization negatively impact PPRs, especially how autonomous and competent one feels with their provider which are essential for one to take an active role in their health and healthcare.

Potential and Risks Behind the National Transformation Program in Saudi Arabia

Saudi Arabia guarantees citizens the right to receive medical care and treatment during emergencies or sickness and aging. However, with the consistent increase in expenditure and inability to provide access, the transformation was an unavoidable action. Therefore, this paper aims to address the potential and risks behind the National Transformation Program (NTP) in Saudi Arabia through the lens of the Value Transformation Framework. Multiple research databases (PubMed, Web of Science, UpToDate, Google Scholar, and Summon) were searched between 2016 and 2024. Relevant articles were selected by scanning the title and abstract, yielding 34 references after the screening, exclusion, and inclusion criteria were met. Citation software was used to identify additional sources as analysis proceeded, in accordance with the hermeneutic approach in mapping and classification. The most cited concerns were the sustainability and workforce of the healthcare system. In terms of care delivery, the literature was extensive. In contrast, insufficient studies have been conducted on infrastructure and people. Furthermore, limited information is available on how to assess the transformation, which remains an unaddressed research question. NTP could meet several hurdles. However, through the measurement, assessment phases, and development tracking, success could be achieved.

Physician empathy during crisis: A survey of doctors in COVID-19 pandemic (COPE study)

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.

Empathy among Saudi Residents at a Tertiary Academic Center during the COVID-19 Pandemic and Its Association with Perceived Stress

Background and Objectives: Empathy is an important attribute of a healthy doctor−patient relationship. Although multiple studies have assessed empathy in different countries, little is known about its levels among Saudi residents and its association with perceived stress. Objectives: To assess the levels of empathy and to identify if there is an association with stress in general and across the demographic and training characteristics of residents. Materials and Methods: A cross-sectional questionnaire-based study was carried out from December 2020 to March 2021 among residents training at a tertiary academic center in Riyadh, Saudi Arabia. Empathy and perceived stress were measured using the Jefferson Scale of Empathy (JSE) and the Perceived Stress Scale (PSS). Results: A total of 229 residents participated. The mean JSE score was 105.25 ± 15.35. The mean JSE scores were significantly higher among residents training in pediatrics (mean difference (MD) = 17.35, p < 0.001), family medicine (MD = 12.24, p = 0.007), and medical specialties (MD = 11.11, p = 0.012) when compared with surgical specialties and anesthesia. In addition, residents who worked 1−4 on-calls per month had a higher mean JSE score (MD = 11.23, p = 0.028) compared with those who worked 7 or more on-calls. Lastly, no correlation between empathy and perceived stress was detected in the whole sample (r = −0.007, p = 0.913); however, there was a correlation among residents training in medical specialties (r = −0.245, p = 0.025). Conclusion: Residents in our study had empathy levels comparable with Asian but lower than Western residents. We recommend qualitative studies that explore potential factors that might affect empathy among residents and studying the association between empathy and perceived stress among medical residents. Postgraduate curricula should incorporate interventions that foster a more empathetic doctor−patient relationship.

Sense of Coherence as a Mediator in the Association Between Empathy and Moods in Healthcare Professionals: The Moderating Effect of Age

While empathy is considered a critical determinant of the quality of medical care, growing evidence suggests it may be associated with both one’s own positive and negative moods among healthcare professionals. Meanwhile, sense of coherence (SOC) plays an essential role in the improvement of both psychological and physical health. Reportedly, individual SOC reaches full stability after around age 30. The aim of this study was first to evaluate the mediatory role of SOC on the association between empathy and individual moods among 114 healthcare professionals in a general hospital, and then to examine the moderating effect of age on this association. Participants completed a range of self-report demographic questionnaires, Empathy Process Scale (EPS), the 13-item Antonovsky’s SOC, and Profile of Mood States (POMS). Findings showed that SOC mediated the relations between empathy (EPS) and both POMS-Vigor (POMS-V: self-vigor mood) and POMS-Depression (POMS-D: self-depression mood). Notably, moderated mediation analysis revealed that there was a significant interaction (age × SOC) on self-vigor mood (POMS-V) in healthcare professionals. The indirect effect of empathy (EPS) on self-vigor mood (POMS-V) through SOC was significant at over mean age “32.83.” Although there was no significant interaction with age regarding the indirect effect of empathy (EPS) on self-depression mood (POMS-D), in the sub-category level analysis of empathy (EPS), we found a significant interaction item [age × empathy for other’s negative affect (EPS-N)] on SOC. This indirect effect was also significant at over mean age “32.83.” Taken, together, the current study highlighted the significant mediator of SOC on that empathy amplifies self-vigor mood and attenuates self-depression mood as a protective factor among the Japanese healthcare professionals. Some components of these processes may depend on the moderating role of age, indicating that we may need to consider the SOC development with age for more effective empathy performance interventions among healthcare professionals.