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Wang Y, Zhai S, Liu L, Qu B, Wang Z. Effect of empathy nursing combined with SBAR communication system on the negative emotions and nursing quality of children with tracheotomy. Technol Health Care 2024; 32:369-378. [PMID: 37393456 DOI: 10.3233/thc-230231] [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] [Indexed: 07/03/2023]
Abstract
BACKGROUND Situation, Background, Assessment, and Recommendation (SBAR) is a structured method for communicating critical information that requires immediate attention and action. OBJECTIVE To study the effects of empathy nursing combined with the SBAR communication system on the negative emotions and nursing quality of children undergoing tracheotomy. METHODS This is a clinical observational study. A total of 100 tracheotomy patients who were cared for in the pediatric intensive care unit (subsequent treatment in the tracheotomy clinic or otolaryngology ward) of our hospital from September 2021 to June 2022 were recruited and assigned at a ratio of 1:1 either into a control group (empathic care) or an observation group (empathic care combined with SBAR) using a randomized method. Further, the postoperative anxiety self-rating scale scores, negative emotions, hope index, and nursing quality were compared between the two groups. RESULTS After nursing, the psychological resilience scale score of the observation group was higher than that of the control group, whereas the anxiety self-rating scale score was significantly lower than that of the control group (all P< 0.05). Basic and special nursing, knowledge awareness, and safety management of the two groups of patients improved significantly, with higher results in the observation group than in the control group (P< 0.05). CONCLUSION Empathy nursing combined with the SBAR communication system considerably improves postoperative negative emotions and enhances the quality of nursing care for patients undergoing tracheotomy.
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Affiliation(s)
- Yanan Wang
- Department of Otorhinolaryngology Head and Neck Surgery, National Center for Children's Health (NCCH), Beijing Children's Hospital, Beijing, China
| | - Shifen Zhai
- Department of Otorhinolaryngology Head and Neck Surgery, National Center for Children's Health (NCCH), Beijing Children's Hospital, Beijing, China
| | - Lili Liu
- Nursing Department, National Center for Children's Health (NCCH), Beijing Children's Hospital, Beijing, China
| | - Bin Qu
- Nursing Department, National Center for Children's Health (NCCH), Beijing Children's Hospital, Beijing, China
| | - Ziqian Wang
- Department of Otorhinolaryngology Head and Neck Surgery, National Center for Children's Health (NCCH), Beijing Children's Hospital, Beijing, China
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Viana DSL, Kawagoe JY. Emergency units and COVID-19: Burnout, and empathy reported by nursing professionals and perceived by patients. Rev Bras Enferm 2023; 76:e20210869. [PMID: 38055466 DOI: 10.1590/0034-7167-2021-0869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/29/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE To investigate Burnout Syndrome and empathy self-reported by the nursing staff and empathy perceived by the patient. METHOD Cross-sectional study in a public emergency unit in São Paulo (from October/2020 to March/2021). The nursing staff answered the Maslach Burnout Inventory and the Consultation and Relational Empathy Measure-Nurses (Brazilian version), whereas adult patients answered the Consultation and Relational Empathy Measure (Brazilian version). Descriptive and inferential analysis, with a 5% significance level. RESULTS A total of 92 professionals and 271 patients participated. Most professionals reported impact of COVID-19 (80; 86.96%) and, among them, increased Burnout Syndrome (93; 75%), but with low emotional exhaustion (71; 74%), low depersonalization (59; 78%) and high level of professional accomplishment (72; 83%). Most reported impact and increased empathy, and the results reported by professionals and patients (mean and standard deviation) were: 39.89 (6.44) and 38.25 (9.45), respectively. CONCLUSION The professionals reported a low level of Burnout Syndrome and a high level of empathy in pandemic.
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Affiliation(s)
| | - Julia Yaeko Kawagoe
- Faculdade Israelita de Ciências da Saúde Albert Einstein. São Paulo, São Paulo, Brazil
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Sattar K, Yusoff MSB, Arifin WN, Mohd Yasin MA, Mat Nor MZ. A scoping review on the relationship between mental wellbeing and medical professionalism. MEDICAL EDUCATION ONLINE 2023; 28:2165892. [PMID: 36621960 PMCID: PMC9833410 DOI: 10.1080/10872981.2023.2165892] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 08/01/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Mental wellbeing issues among medical students are common, and their relationship to medical professionalism is debated. Few studies have attempted to link such issues with undergraduate medical education. This review aimed to advance the knowledge on this matter by exploring the relationship between mental wellbeing and medical professionalism in undergraduate medical education. METHODS We collected the literature about mental wellbeing and medical professionalism (published from 1 January 1986 to 31 March 2021) from the Web of Science, PubMed, Scopus and ScienceDirect databases using the search terms 'mental wellbeing' and 'medical professionalism'.We included all peer-reviewed articles in which mental wellbeing and medical professionalism in the undergraduate medical education context were the central topics regardless of the age range, nationality, race and gender of the participants. RESULTS From the 13,076 Iinitially found articles, 16 were included. These 16 articles were from nine countries in four different continents, which all together helped us find answer to our research question using extracted points relating to the main study themes (mental wellbeing and medical professionalism). Under theme 1 (mental wellbeing), six subthemes emerged: burnout, stress, depression, disappointment, depersonalisation and conscientiousness. Theme 2 (medical professionalism), on the other hand, had five subthemes: empathy, academic performance, compassion, unprofessional behaviour and professionalism. A significant inverse association was found between empathy and burnout. Academic performance was also related to burnout. At the same time, empathy was found to have a varied association with stress. Moreover, compassion was found to alleviate burnout and nurture professional gratification. CONCLUSION The medical professionalism attributes were found to deteriorate as the mental wellbeing issues grow. This can harm medical students' overall health, current learning abilities and future attitudes towards their patients. Explicit primary research is thus required to examine and intervene in the cause-effect relationship between medical professionalism and mental wellbeing.
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Affiliation(s)
- Kamran Sattar
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Muhamad Saiful Bahri Yusoff
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Wan Nor Arifin
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Mohd Azhar Mohd Yasin
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Mohd Zarawi Mat Nor
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Ghazwani S, Alshowkan A, AlSalah N. A study of empathy levels among nursing interns: a cross-sectional study. BMC Nurs 2023; 22:226. [PMID: 37391749 DOI: 10.1186/s12912-023-01381-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 06/14/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Empathy is one of the therapeutic communication techniques used to help the client feel better. However, there are a few studies have investigated level of empathy among enrollers at nursing colleges. The aim was to examine the level of self-reported empathy among nursing interns. METHODS The study was a descriptive, cross-sectional in nature. A total of 135 nursing interns fill in the Interpersonal Reactivity Index from August to October 2022. Data was analyzed through the SPSS program. An independent -sample t-test and one way- ANOVA was used to explore differences in the degree of empathy with respect to academic and sociodemographic factors. RESULTS The results of this study showed that nursing interns showed a mean level of empathy of 67.46 (SD = 18.86). This result indicated that the nursing interns have moderate levels of empathy overall. There was statistical significant difference in the mean level of subscales of perspective-taking and empathic concern between males and females. Additionally, nursing interns who are less than 23 years old scored high in the subscale of perspective-taking. Married nursing interns and who preferred nursing as a profession scored higher in the subscale of empathic concern than unmarried ones and who did not preferred nursing as a profession. CONCLUSION Perspective taking incresed with younger male nursing interns, this reflects high cognitive flexibility with younger age nursing interns. Morover, the empathic concern incresed with male married nuring interns who preferred nursing as a profession. This implies that they should engage in continuous reflection and educational activities as part of their clinical training as nursing interns in order to improve their empathic attitudes.
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Affiliation(s)
- Suaad Ghazwani
- Master of Psychiatric and Mental Health Nursing, College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Amira Alshowkan
- Department of Community Nursing, College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nagla AlSalah
- Department of Community Nursing, College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Dilmaghani RB, Armoon B, Moghaddam LF. Work-family conflict and the professional quality of life and their sociodemographic characteristics among nurses: a cross-sectional study in Tehran, Iran. BMC Nurs 2022; 21:289. [PMID: 36316741 PMCID: PMC9624043 DOI: 10.1186/s12912-022-01069-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/05/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
Background Nurses are exposed to work-family conflict (WFC) due to specific occupational conditions, such as exposure to patients and shift work, which can affect the professional quality of life (ProQoL). The aim of the present study was to determine the relationship between different levels of work-family conflicts and professional quality of life and their sociodemographic characteristics among the nurses in two hospitals in Tehran, Iran. Methods This cross-sectional study included 234 nurses from two hospitals. Data were collected using a three-part questionnaire, including items related to nurses’ demographic characteristics, the WFC questionnaire, and the ProQoL questionnaire. Results There was a significant positive correlation between conflict in terms of time and behavior with compassion satisfaction and between the three types of conflict with job burnout (p < 0.05). The results indicate that the WFC and ProQoL scores and the mean WFC were higher among women, people who had a disabled family member, and nurses who worked equal to or more than 175 hours a month. Regarding the dimensions of ProQoL, the mean compassion satisfaction was lower among people who lived with their parents, people who had a second job had a child younger than one-year-old, and a disabled family member had higher means of job burnout. Also, those who had younger children experienced less PTSD. Furthermore, the mean of WFC and burnout among single nurses was significantly lower than among married and divorced/widowed nurses. Additionally, the mean of WFC and burnout among nurses living in rental houses and nurses reporting the level of satisfying relationships with co-workers as ‘bad’ were significantly more than for other nurses. Conclusion Stable mental and emotional conditions are of great importance for nurses to provide safe and quality services to their patients. The results also revealed that nurses’ compassion satisfaction and job burnout were associated with different types of conflict. The WFC of nurses is related to their ProQoL and affects their job satisfaction and burnout. Reducing conflict may improve the nurses’ satisfaction and thus improve patient care and healthcare services.
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Affiliation(s)
- Reza Biabani Dilmaghani
- grid.411463.50000 0001 0706 2472Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Baharam Armoon
- grid.510755.30000 0004 4907 1344Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Ladan Fattah Moghaddam
- grid.411463.50000 0001 0706 2472Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Hodkinson A, Zhou A, Johnson J, Geraghty K, Riley R, Zhou A, Panagopoulou E, Chew-Graham CA, Peters D, Esmail A, Panagioti M. Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis. BMJ 2022; 378:e070442. [PMID: 36104064 PMCID: PMC9472104 DOI: 10.1136/bmj-2022-070442] [Citation(s) in RCA: 105] [Impact Index Per Article: 52.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To examine the association of physician burnout with the career engagement and the quality of patient care globally. DESIGN Systematic review and meta-analysis. DATA SOURCES Medline, PsycINFO, Embase, and CINAHL were searched from database inception until May 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Observational studies assessing the association of physician burnout (including a feeling of overwhelming emotional exhaustion, feelings of cynicism and detachment from job defined as depersonalisation, and a sense of ineffectiveness and little personal accomplishment) with career engagement (job satisfaction, career choice regret, turnover intention, career development, and productivity loss) and the quality of patient care (patient safety incidents, low professionalism, and patient satisfaction). Data were double extracted by independent reviewers and checked through contacting all authors, 84 (49%) of 170 of whom confirmed their data. Random-effect models were used to calculate the pooled odds ratio, prediction intervals expressed the amount of heterogeneity, and meta-regressions assessed for potential moderators with significance set using a conservative level of P<0.10. RESULTS 4732 articles were identified, of which 170 observational studies of 239 246 physicians were included in the meta-analysis. Overall burnout in physicians was associated with an almost four times decrease in job satisfaction compared with increased job satisfaction (odds ratio 3.79, 95% confidence interval 3.24 to 4.43, I2=97%, k=73 studies, n=146 980 physicians). Career choice regret increased by more than threefold compared with being satisfied with their career choice (3.49, 2.43 to 5.00, I2=97%, k=16, n=33 871). Turnover intention also increased by more than threefold compared with retention (3.10, 2.30 to 4.17, I2=97%, k=25, n=32 271). Productivity had a small but significant effect (1.82, 1.08 to 3.07, I2=83%, k=7, n=9581) and burnout also affected career development from a pooled association of two studies (3.77, 2.77 to 5.14, I2=0%, n=3411). Overall physician burnout doubled patient safety incidents compared with no patient safety incidents (2.04, 1.69 to 2.45, I2=87%, k=35, n=41 059). Low professionalism was twice as likely compared with maintained professionalism (2.33, 1.96 to 2.70, I2=96%, k=40, n=32 321), as was patient dissatisfaction compared with patient satisfaction (2.22, 1.38 to 3.57, I2=75%, k=8, n=1002). Burnout and poorer job satisfaction was greatest in hospital settings (1.88, 0.91 to 3.86, P=0.09), physicians aged 31-50 years (2.41, 1.02 to 5.64, P=0.04), and working in emergency medicine and intensive care (2.16, 0.98 to 4.76, P=0.06); burnout was lowest in general practitioners (0.16, 0.03 to 0.88, P=0.04). However, these associations did not remain significant in the multivariable regressions. Burnout and patient safety incidents were greatest in physicians aged 20-30 years (1.88, 1.07 to 3.29, P=0.03), and people working in emergency medicine (2.10, 1.09 to 3.56, P=0.02). The association of burnout with low professionalism was smallest in physicians older than 50 years (0.36, 0.19 to 0.69, P=0.003) and greatest in physicians still in training or residency (2.27, 1.45 to 3.60, P=0.001), in those who worked in a hospital (2.16, 1.46 to 3.19, P<0.001), specifically in emergency medicine specialty (1.48, 1.01 to 2.34, P=0.042), or situated in a low to middle income country (1.68, 0.94 to 2.97, P=0.08). CONCLUSIONS This meta-analysis provides compelling evidence that physician burnout is associated with poor function and sustainability of healthcare organisations primarily by contributing to the career disengagement and turnover of physicians and secondarily by reducing the quality of patient care. Healthcare organisations should invest more time and effort in implementing evidence-based strategies to mitigate physician burnout across specialties, and particularly in emergency medicine and for physicians in training or residency. SYSTEMATIC REVIEW REGISTRATION PROSPERO number CRD42021249492.
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Affiliation(s)
- Alexander Hodkinson
- National Institute for Health and Care Research (NIHR) School for Primary Care Research, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Anli Zhou
- National Institute for Health and Care Research (NIHR) School for Primary Care Research, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Judith Johnson
- School of Psychology, University of Leeds, Leeds, UK
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Keith Geraghty
- National Institute for Health and Care Research (NIHR) School for Primary Care Research, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Ruth Riley
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Andrew Zhou
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Efharis Panagopoulou
- Laboratory of Hygiene, Aristotle Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - David Peters
- Westminster Centre for Resilience, Faculty of Science and Technology, University of Westminster, London, UK
| | - Aneez Esmail
- National Institute for Health and Care Research (NIHR) School for Primary Care Research, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Maria Panagioti
- National Institute for Health and Care Research (NIHR) School for Primary Care Research, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
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DETERMINATION OF THE RELATIONSHIP BETWEEN EMPATHIC SKILLS AND BURNOUT LEVELS OF NURSES WORKING IN A CITY HOSPITAL. INTERNATIONAL JOURNAL OF HEALTH SERVICES RESEARCH AND POLICY 2021. [DOI: 10.33457/ijhsrp.934535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Spilg EG, McNeill K, Sabri E, Duffy MC, Ananny L, Graham ID, LeBlanc V, Wells PS. A cross-sectional study of the interrelationship between burnout, empathy and resilience in academic physicians. PSYCHOL HEALTH MED 2021; 27:1813-1820. [PMID: 34281438 DOI: 10.1080/13548506.2021.1954670] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Burnout is a growing concern, with significant negative consequences for physicians and patient care. Burnout is negatively associated with physician empathy, while resilience may be a protective factor against the development of burnout but few studies have examined all three constructs in the same cohort. Understanding the associations between these constructs could aid in the development of interventions for physicians experiencing burnout and improve the delivery of compassionate care. We conducted a cross-sectional survey to determine levels of burnout, empathy and resilience in a sample of academic physicians and investigate the relationships between these variables. Validated scales were administered online to measure burnout (Maslach Burnout Inventory - Human Services Survey, MBI-HSS), empathy (Jefferson Scale of Empathy - Physicians/Health Professions Version, JSE) and resilience (Connor-Davidson Resilience Scale, CD-RISC). Descriptive statistics, correlation coefficients, and group comparisons were examined. Eighty-three physicians completed the JSE and CD-RISC, while a subset of 49 physicians also completed the MBI-HSS. Response rates were 31.9% and 18.8%, respectively. High burnout was reported by 49% of the sample. Physicians with high burnout reported lower levels of resilience than those who were not burnt-out. No differences in levels of empathy were observed between these two groups. Older physicians (>45 years) reported higher resilience scores than younger physicians. Resilience and empathy were significantly positively correlated. The reported rate of physician burnout in this sample of academic physicians is concerning, with burnout associated with lower levels of resilience. Further research is required to explore the relationship between physician age and resilience, the impact of resilience-building interventions on burnout and empathy in physicians, and how modifying these variables influences the delivery of compassionate care for patients.
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Affiliation(s)
- Edward G Spilg
- Department of Medicine, University of Ottawa, Ottawa, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Kylie McNeill
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Elham Sabri
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Melissa C Duffy
- Department of Educational Studies, University of South Carolina, Columbia, United States
| | - Lesley Ananny
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, Canada
| | - Ian D Graham
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Vicki LeBlanc
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, Canada
| | - Philip S Wells
- Department of Medicine, University of Ottawa, Ottawa, Canada
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Esquerda M, Teres J. COVID-19 pandemic, professionalism, and the social contract. Rev Clin Esp 2021; 221:494-495. [PMID: 34247987 PMCID: PMC8241588 DOI: 10.1016/j.rceng.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 04/21/2021] [Indexed: 11/16/2022]
Affiliation(s)
- M Esquerda
- Comissió de Deontologia Consell de Col.legis de Metges de Catalunya, Barcelona, Spain; Institut Borja de Bioètica, Universitat Ramon Llull, Barcelona, Spain; Hospital Sant Joan de Déu Terres de Lleida, Lleida, Spain.
| | - J Teres
- Comissió de Deontologia Col.legi de Metges de Barcelona, Barcelona, Spain
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10
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Affiliation(s)
- M Esquerda
- Presidenta Comissió de Deontología Consell de Col.legis de Metges de Catalunya, España.,Hospital Sant Joan de Déu Terres de Lleida, Lleida, España.,Institut Borja de Bioètica, Universitat Ramon Llull, Barcelona, España
| | - J Teres
- President Comissió de Deontología Col.legi de Metges de Barcelona, Barcelona, España.,Institut Borja de Bioètica, Universitat Ramon Llull, Barcelona, España
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11
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Oró P, Esquerda M, Mas B, Viñas J, Yuguero O, Pifarré J. Effectiveness of a Mindfulness-Based Programme on Perceived Stress, Psychopathological Symptomatology and Burnout in Medical Students. Mindfulness (N Y) 2021; 12:1138-1147. [PMID: 33437325 PMCID: PMC7790937 DOI: 10.1007/s12671-020-01582-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Medical students display a high prevalence of psychopathological symptomatology, stress and burnout, which may continue in their time as resident and fully qualified doctors. The aim of this study is to evaluate and compare the effects of a mindfulness-based programme on these variables in an experimental group of medical students who underwent the intervention programme compared to a control group who did not. METHODS A quasi-experimental study of two independent groups (experimental and control) with two repeated measures (pre and post) was performed. Eight sessions of 2-h duration each were held over the course of 16 weeks. A total of 143 students participated in the study, 68 in the intervention group and 75 in the control group. A sociodemographic questionnaire was administered along with the Symptom Checklist-90-R (SCL-90-R), the Perceived Stress Scale (PSS) and the Maslach Burnout Inventory-Student Survey (MBI-SS). RESULTS Our study revealed a clear improvement compared to the control group in perceived stress and psychopathological symptomatology, in the Global Severity Index, Positive Symptom Total and the primary symptom dimensions of somatization, obsessive compulsive, interpersonal sensitivity and anxiety of the SCL-90-R. The improvement was significant at both intra- and intergroup level. No impact was found on the level of burnout. CONCLUSIONS The mindfulness-based programme that was used resulted in an improvement in psychopathological symptomatology and stress, with no effect observed on BO score. This study can contribute to the design of a training programme to promote effective self-care and stress management strategies for both medical students and doctors.
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Affiliation(s)
- Pere Oró
- Facultat de Medicina, Universitat de Lleida, Lleida, Spain
| | - Montse Esquerda
- Facultat de Medicina, Universitat de Lleida, Lleida, Spain
- Institut Borja de Bioètica, Universitat Ramon Llull, Barcelona, Spain
| | - Blanca Mas
- Facultad de Psicología. Departamento de personalidad evaluación y tratamientos psicológicos, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Joan Viñas
- Facultat de Medicina, Universitat de Lleida, Lleida, Spain
- Institut Borja de Bioètica, Universitat Ramon Llull, Barcelona, Spain
| | - Oriol Yuguero
- Facultat de Medicina, Universitat de Lleida, Lleida, Spain
- Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Josep Pifarré
- Institut de Recerca Biomèdica de Lleida-IRB Lleida, Lleida, Spain
- Hospital Sant Joan de Déu Terres de Lleida, Lleida, Spain
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12
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Mahmoudi S, Barkhordari-Sharifabad M, Pishgooie AH, Atashzadeh-Shoorideh F, Lotfi Z. Burnout among Iranian nurses: a national survey. BMC Nurs 2020; 19:69. [PMID: 32690983 PMCID: PMC7364314 DOI: 10.1186/s12912-020-00461-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 07/12/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Nurses, particularly critical care nurses, are exposed to high levels of stress and burnout. Burnout is associated with many deleterious consequences affecting health care outcomes. The present study is intended to determine the dimensions of burnout in nurses on surgical, medical and critical care units and its relationship with demographic characteristics. METHODS In this descriptive research study, performed at critical and non- critical care units, 743 nurses were randomly selected by quota sampling from medical sciences universities in Iran. Data collection instruments included a "demographic questionnaire" and the "Persian version of the Copenhagen Burnout Inventory. Data were analyzed using SPSS20. RESULTS The findings showed that regarding all dimensions, the lowest level of burnout belonged to surgical wards whereas the highest level pertained to critical care wards indicating a significant difference among various aspects of burnout in different wards, i.e., surgery, medical, and critical care. There was no significant difference in gender, academic degree, and marital status in any of the aspects of burnout in critical care units; yet, the difference was significant between surgical and medical wards (P < 0.05). There were a negative significant correlation between some dimensions of burnout with age and nursing experience in critical care and medical wards (P < 0.05). Whereas in surgical wards, there were a positive significant correlation between some aspects of burnout with nursing experience and age (P < 0.05). CONCLUSION This study found that the critical care nurses have significantly higher level of burnout compared to the medical-surgical nurses. These results should be considered when planning burnout prevention schedules for nurses.
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Affiliation(s)
- Sara Mahmoudi
- Department of Nursing, School of Nursing, Dezful University of Medical Sciences, Dezful, Iran
| | | | - Amir-Hosein Pishgooie
- Department of Critical Care Nursing, School of Nursing, AJA University of Medical Sciences, Tehran, Iran
| | - Foroozan Atashzadeh-Shoorideh
- Department of Psychiatric Nursing and Management, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Vali-Asr Avenue, Cross of Vali-Asr and Hashemi Rafsanjani Highway, Opposite to Rajaee Heart Hospital, Tehran, Iran
| | - Zahra Lotfi
- Department of Nursing, Royal Free Hospital, London, UK
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The application of psychologically informed practice: observations of experienced physiotherapists working with people with chronic pain. Physiotherapy 2020; 106:163-173. [DOI: 10.1016/j.physio.2019.01.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 01/13/2019] [Indexed: 11/17/2022]
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14
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Cross-sectional study of the association between empathy and burnout and drug prescribing quality in primary care. Prim Health Care Res Dev 2019; 20:e145. [PMID: 31663492 PMCID: PMC6842647 DOI: 10.1017/s1463423619000793] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: The aim of this study was to assess whether burnout and empathy levels among general practitioners (GPs) might influence prescribing performance assessed using pharmaceutical prescription quality standard indicators. Design and Setting: Cross-sectional descriptive study of 108 GPs from 22 primary care centers in Lleida, Spain, and of centralized data corresponding to 183 600 patients under their care. The study was conducted between May and July 2014. Main Outcome Measures: Burnout and empathy were measured using the Spanish versions of the Maslach Burnout Inventory and the Jefferson Scale for Physician Empathy, and prescribing quality was measured using the Catalan Pharmaceutical Prescription Quality Standard (EQPF). Normal distribution of scores was verified using the Chi-square and Kolmogorov–Smirnov–Lilliefors tests. The effect of each of the variables was evaluated using crude odds ratios. Results: Older GPs scored significantly higher in the EQPF (P < 0.05). High empathy scores were positively associated with high EQPF scores. GPs with low burnout also performed better in the EQPF. Conclusions: More empathic, less burned-out, older GPs showed better prescribing performance according to quality indicators. However, further studies are needed to evaluate other factors influencing prescribing habits. The promotion of communication skills may increase empathy and reduce burnout, thus benefiting patients.
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Tawfik DS, Scheid A, Profit J, Shanafelt T, Trockel M, Adair KC, Sexton JB, Ioannidis JPA. Evidence Relating Health Care Provider Burnout and Quality of Care: A Systematic Review and Meta-analysis. Ann Intern Med 2019; 171:555-567. [PMID: 31590181 PMCID: PMC7138707 DOI: 10.7326/m19-1152] [Citation(s) in RCA: 250] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Whether health care provider burnout contributes to lower quality of patient care is unclear. PURPOSE To estimate the overall relationship between burnout and quality of care and to evaluate whether published studies provide exaggerated estimates of this relationship. DATA SOURCES MEDLINE, PsycINFO, Health and Psychosocial Instruments (EBSCO), Mental Measurements Yearbook (EBSCO), EMBASE (Elsevier), and Web of Science (Clarivate Analytics), with no language restrictions, from inception through 28 May 2019. STUDY SELECTION Peer-reviewed publications, in any language, quantifying health care provider burnout in relation to quality of patient care. DATA EXTRACTION 2 reviewers independently selected studies, extracted measures of association of burnout and quality of care, and assessed potential bias by using the Ioannidis (excess significance) and Egger (small-study effect) tests. DATA SYNTHESIS A total of 11 703 citations were identified, from which 123 publications with 142 study populations encompassing 241 553 health care providers were selected. Quality-of-care outcomes were grouped into 5 categories: best practices (n = 14), communication (n = 5), medical errors (n = 32), patient outcomes (n = 17), and quality and safety (n = 74). Relations between burnout and quality of care were highly heterogeneous (I2 = 93.4% to 98.8%). Of 114 unique burnout-quality combinations, 58 indicated burnout related to poor-quality care, 6 indicated burnout related to high-quality care, and 50 showed no significant effect. Excess significance was apparent (73% of studies observed vs. 62% predicted to have statistically significant results; P = 0.011). This indicator of potential bias was most prominent for the least-rigorous quality measures of best practices and quality and safety. LIMITATION Studies were primarily observational; neither causality nor directionality could be determined. CONCLUSION Burnout in health care professionals frequently is associated with poor-quality care in the published literature. The true effect size may be smaller than reported. Future studies should prespecify outcomes to reduce the risk for exaggerated effect size estimates. PRIMARY FUNDING SOURCE Stanford Maternal and Child Health Research Institute.
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Affiliation(s)
- Daniel S Tawfik
- Stanford University School of Medicine, Stanford, California (D.S.T., T.S., M.T.)
| | - Annette Scheid
- Brigham and Women's Hospital and Harvard Medical School, llBoston, Massachusetts (A.S.)
| | - Jochen Profit
- Stanford University School of Medicine, Stanford, California, and California Perinatal Quality Care Collaborative, Palo Alto, California (J.P.)
| | - Tait Shanafelt
- Stanford University School of Medicine, Stanford, California (D.S.T., T.S., M.T.)
| | - Mickey Trockel
- Stanford University School of Medicine, Stanford, California (D.S.T., T.S., M.T.)
| | - Kathryn C Adair
- Duke University School of Medicine, Duke University Health System, and Duke Patient Safety Center, Durham, North Carolina (K.C.A., J.B.S.)
| | - J Bryan Sexton
- Duke University School of Medicine, Duke University Health System, and Duke Patient Safety Center, Durham, North Carolina (K.C.A., J.B.S.)
| | - John P A Ioannidis
- Stanford University School of Medicine, Stanford University School of Humanities and Sciences, and Meta-Research Innovation Center at Stanford (METRICS), Stanford, California (J.P.I.)
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Wang Q, Wang L, Shi M, Li X, Liu R, Liu J, Zhu M, Wu H. Empathy, burnout, life satisfaction, correlations and associated socio-demographic factors among Chinese undergraduate medical students: an exploratory cross-sectional study. BMC MEDICAL EDUCATION 2019; 19:341. [PMID: 31492136 PMCID: PMC6729024 DOI: 10.1186/s12909-019-1788-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 09/03/2019] [Indexed: 05/11/2023]
Abstract
BACKGROUND Medical education is widely known to be a demanding process that may cause various mental health problems, such as burnout, which can lead to lowered levels of life satisfaction among medical students. Research shows that empathy is negatively correlated with burnout, but there are few studies on the relationship among empathy, burnout and life satisfaction in medical students. The objective of the present study is to explore the correlations of empathy and burnout with life satisfaction and the associated socio-demographic factors among Chinese undergraduate medical students. METHODS In this cross-sectional study, 1271 undergraduate medical students (age 19.42 ± 1.34 years, 36% male) from 1st to 4th grades completed questionnaires including the Interpersonal Reactivity Index Chinese version (IRI-C), the Maslach Burnout Inventory Modified Chinese version (MBI-MC), the Satisfaction With Life Scale (SWLS) and socio-demographic characteristics. Statistical analyses included Student's t-test, one-way ANOVA, post hoc Bonferroni tests, hierarchical linear regression analysis and general linear model-univariate full factorial model. RESULTS Over four academic years, medical students' empathy levels declined, but their burnout levels almost plateaued and their life satisfaction levels witnessed an initial fall before a rebound. Empathy was correlated with students' age and grade, and burnout was associated with students' maternal education. Significant differences in life satisfaction were detected with regard to medical students' age, academic year, the number of children in the family, place of residence and parents' educational levels. CONCLUSIONS Empathy explained 0.6% of the variance in life satisfaction in contrast to 13.7% of the variance explained by burnout in life satisfaction. Although empathy did not have a main effect on life satisfaction, there was an interaction effect of empathy and burnout on life satisfaction among students of high and low empathy and burnout levels. Students with high levels of empathy and low levels of burnout were most satisfied with life. Medical institutions and related authorities need to find effective measures to enhance students' empathy levels and reduce burnout to improve their life satisfaction.
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Affiliation(s)
- Qinghua Wang
- English Department, School of Fundamental Sciences, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
| | - Meng Shi
- English Department, School of Fundamental Sciences, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
| | - Xuelian Li
- Department of Epidemiology, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
| | - Rong Liu
- Department of Statistics, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
| | - Jie Liu
- Department of Statistics, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
| | - Min Zhu
- Department of Healthcare Management, School of Humanities and Social Sciences, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
| | - Huazhang Wu
- Department of Healthcare Management, School of Humanities and Social Sciences, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
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17
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Ethics and empathy: The relationship between moral reasoning, ethical sensitivity and empathy in medical students. Rev Clin Esp 2019. [DOI: 10.1016/j.rceng.2018.09.009] [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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18
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Yuguero O, Esquerda M, Viñas J, Soler-Gonzalez J, Pifarré J. Ethics and empathy: The relationship between moral reasoning, ethical sensitivity and empathy in medical students. Rev Clin Esp 2018; 219:73-78. [PMID: 30318248 DOI: 10.1016/j.rce.2018.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 09/11/2018] [Accepted: 09/13/2018] [Indexed: 10/28/2022]
Abstract
High-quality clinical practice includes not only improving clinicians' expertise in scientific and technical aspects but also managing values, ethical sensitivity and skills for assessing and dealing with ethical conflicts. The reviewed literature suggests the presence of an "ethical erosion", according to which ethical competence and empathy decrease or do not progress during medical training. The aim of this study was to determine the relationship between ethics (moral reasoning and ethical sensitivity) and empathy in a group of medical students and to determine the relationship with other variables such as academic year and sex. MATERIAL AND METHOD A cross-sectional observational study was conducted with 193 medical students from different academic years, who were administered a sociodemographic questionnaire, the Rest sociomoral dilemma test, clinical vignettes to measure ethical sensitivity (Problem Identification Test [PIT]) and a cognitive and emotional empathy test (test de empatía cognitiva y afectiva, TECA). RESULTS We found a direct and significant relationship between moral development, ethical sensitivity and greater empathy. We detected an increase in moral reasoning and ethical sensitivity among first and third-year students, with no increase between the third year and later academic years. There were no significant differences between these variables and sex. CONCLUSIONS This study found a correlation between moral reasoning, ethical sensitivity and empathy and a lack of progression of the first 2 variables in the last years of the medical degree.
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Affiliation(s)
- O Yuguero
- Facultad de Medicina, Universitat de Lleida, Lleida, España; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, España
| | - M Esquerda
- Facultad de Medicina, Universitat de Lleida, Lleida, España; Institut Borja Bioètica, Universitat Ramon Llull, Barcelona, España; Sant Joan de Déu Terres de Lleida, Lleida, España.
| | - J Viñas
- Facultad de Medicina, Universitat de Lleida, Lleida, España; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, España; Institut Borja Bioètica, Universitat Ramon Llull, Barcelona, España
| | | | - J Pifarré
- Facultad de Medicina, Universitat de Lleida, Lleida, España; Sant Joan de Déu Terres de Lleida, Lleida, España; GSS-Hospital Universitari Santa Maria, Lleida, España
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Yuguero O, Melnick ER, Marsal JR, Esquerda M, Soler-Gonzalez J. Cross-sectional study of the association between healthcare professionals' empathy and burnout and the number of annual primary care visits per patient under their care in Spain. BMJ Open 2018; 8:e020949. [PMID: 30061437 PMCID: PMC6067329 DOI: 10.1136/bmjopen-2017-020949] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the association between physician and nurse self-reported empathy and burnout and the number of annual primary care visits per patient under their care. METHODS Design: A cross-sectional survey study was conducted from January 2013 to July 2014. Site: The 22 primary care centres of the Lleida Health Region in Spain. MAIN OUTCOME MEASURES The Jefferson Scale of Physician Empathy and the Maslach Burnout Inventory were used to measure empathy and burnout, respectively. The number of visits and the number of diagnoses coded per visit were obtained through the Region's electronic health record. RESULTS Two hundred and sixty-seven healthcare professionals (physicians and nurses, 52.6% participation of the total in the region) with 301 657 patients under their care. Healthcare professionals' degree of burnout and empathy was associated with the number of annual visits per patient under their care. Burned out nurses and physicians received fewer visits (4.5vs3.7 in nurses and 18.1vs18.9 in physicians), whereas more empathic physicians received more visits per patient (19.4vs17.2, p<0.05) and documented more diagnoses per visit (10.2vs9.7, p=0.001). Less burned out and less empathic nurses documented more diagnoses per visit (10.2vs10.0 and 8.2vs9.9, p<0.05). CONCLUSIONS The number of annual primary care visits per patient that healthcare professionals receive is closely associated with healthcare professionals' empathy and burnout. These results should serve to promote empathic skills and establish organisational changes that promote efficiency in the practice and, in turn, reduce the degree of burnout of healthcare professionals.
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Affiliation(s)
- Oriol Yuguero
- Faculty of Medicine, University of Lleida, Lleida, Spain
- Biomedical Research Institute of Lleida, IRBLLEIDA, Lleida, Spain
| | - Edward R Melnick
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Josep R. Marsal
- Research Support Unit, Primary Care Research Institute (IDIAP), Barcelona, Spain
- Epidemiology Unit, Cardiovascular Department, Vall d’Hebron University Hospital, Barcelona, Spain
| | - Montserrat Esquerda
- Faculty of Medicine, University of Lleida, Lleida, Spain
- Direction, Borja Bioethics Institute, Barcelona, Spain
| | - Jorge Soler-Gonzalez
- Faculty of Medicine, University of Lleida, Lleida, Spain
- Biomedical Research Institute of Lleida, IRBLLEIDA, Lleida, Spain
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Yang N, Cao Y, Li X, Li S, Yan H, Geng Q. Mediating Effects of Patients' Stigma and Self-Efficacy on Relationships Between Doctors' Empathy Abilities and Patients' Cellular Immunity in Male Breast Cancer Patients. Med Sci Monit 2018; 24:3978-3986. [PMID: 29891832 PMCID: PMC6029513 DOI: 10.12659/msm.910794] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Doctors' empathy is closely related to patients' health. This study aimed to examine whether patients' stigma and self-efficacy play a mediating role in the relationship between doctors' empathy abilities and patients' cellular immunity in male patients with breast cancer. MATERIAL AND METHODS Doctors' empathy scores and patients' demographic data, disease condition, stigma, and self-efficacy were measured. Patient T cell subset was tested at admission and 3 months after the operation and was compared by paired t test. The multivariate linear regression model was applied to analyze the factors influencing the immune index. Pearson correlation analysis and structural equation modeling were applied to explore the relationships among patients' stigma, self-efficacy, and cellular immunity and doctors' empathy abilities. RESULTS At the 2 time points, only the change in NK subset was statistically significant, while the changes in percentage of CD3+, CD4+, CD8+, and B cells were not statistically significant. The doctors' empathy abilities were negatively correlated with patients' stigma and were positively related to patients' self-efficacy. Patients' stigma was negatively related to NK subset, while self-efficacy was positively associated with NK subset. Patients' stigma and self-efficacy played a mediating role in the relationship between doctors' empathy abilities and patients' NK subset, and stigma had a stronger effect than self-efficacy. CONCLUSIONS Doctors' empathy abilities affected breast cancer patients' NK subset through their stigma and self-efficacy. The mental health of male breast cancer patients need more attention and empathy education needs to be improved.
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Affiliation(s)
- Ningxi Yang
- School of Health Sciences, Wuhan University, Wuhan, Hubei, China (mainland).,Institute of Medical Humanities, Peking University Health Science Center, Beijing, China (mainland)
| | - Yingnan Cao
- Medical Insurance Office, Beijing Jishuitan Hospital/4th Medical College of Peking University, Beijing, China (mainland)
| | - Xiaoyan Li
- School of Health Sciences, Wuhan University, Wuhan, Hubei, China (mainland)
| | - Shiyue Li
- School of Health Sciences, Wuhan University, Wuhan, Hubei, China (mainland)
| | - Hong Yan
- School of Health Sciences, Wuhan University, Wuhan, Hubei, China (mainland)
| | - Qingshan Geng
- Guangdong General Hospital, Guangzhou, Guangdong, China (mainland)
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