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      Empatía médica en residentes y tutores de medicina familiar y comunitaria. La visión del profesional y del paciente Translated title: Clinical empathy among family and community medicine residents and tutors. The view of physicians and patients

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          Resumen

          Objetivo

          Determinar el grado de empatía de residentes y tutores de medicina de familia. Saber si existe relación entre la empatía autopercibida por los médicos y la valorada por sus pacientes.

          Diseño

          Estudio observacional transversal mediante encuesta.

          Emplazamiento

          Unidad Docente de Atención Primaria, Madrid.

          Participantes

          Se envió una encuesta por correo electrónico a todos los tutores y residentes de familia de la Unidad Docente. Respondieron 50 residentes (39,4%) y 41 tutores (45%). Un total de 428 pacientes fueron captados de forma oportunista en un Centro de Salud. Se entrevistó a sus médicos.

          Mediciones principales

          La empatía se midió mediante la Escala de Empatía Médica de Jefferson y la Escala de Percepciones de los Pacientes sobre la Empatía Médica de Jefferson.

          Resultados

          Los tutores puntuaron 2,53 puntos más alto en empatía cognitiva que los residentes (p = 0,04). Las puntuaciones de la empatía emocional de los tutores son menores en aquellos de mayor edad (r = −0,32; p < 0,05). Los residentes españoles (el 82%) y sin experiencia laboral previa puntuaron más alto en empatía global (p = 0,02). Los residentes de último año obtuvieron calificaciones significativamente más bajas en empatía que el resto de sus compañeros. Se observó correlación positiva (r = 0,72; p = 0,01) entre la autopercepción de la empatía del profesional y la referida por sus pacientes.

          Conclusiones

          Los residentes con experiencia profesional previa, los de último año de residencia y los de origen latinoamericano presentan puntuaciones más bajas de empatía. Existe fuerte relación entre la empatía autopercibida por los médicos y la visión que sus pacientes tienen sobre la misma.

          Translated abstract

          Aim

          To determine the degree of clinical empathy among family medicine residents and tutors. To gauge whether there is a relationship between physicians’ self-perceived empathy levels and their patients’ assessments.

          Study design

          Observational, cross-sectional survey.

          Location

          Primary Care Teaching Unit. Madrid.

          Participants

          A survey was sent by email to all the Teaching Unit's family medicine tutors and residents. Responses were received from 50 residents (39.4%) and 41 tutors (45%). In addition, 428 patients were opportunistically recruited at a healthcare centre and their doctors were also interviewed.

          Primary measurement instruments

          Empathy was measured using the Jefferson Scale of Empathy and the Jefferson Scale of Patient Perceptions of Physician Empathy.

          Results

          The tutors scored 2.53 points higher for cognitive empathy than the residents ( P = .04). Emotional empathy scores declined among older tutors (r =  −0.32; P = .05). The Spanish students (82% of the total) without previous work experience scored higher for overall empathy ( P = .02). Final-year residents recorded significantly worse empathy assessments than the other residents. A positive correlation (r = 0.72; P = .01) was observed between physicians’ self-perceived empathy and their patients’ perceptions.

          Conclusions

          Residents with previous work experience, final-year residents and those of Latin American origin score lower for empathy. There is a strong relationship between physicians’ self-perceived empathy and their patients’ views of their empathy levels.

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          Most cited references16

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          Effectiveness of empathy in general practice: a systematic review.

          Empathy as a characteristic of patient-physician communication in both general practice and clinical care is considered to be the backbone of the patient-physician relationship. Although the value of empathy is seldom debated, its effectiveness is little discussed in general practice. This literature review explores the effectiveness of empathy in general practice. Effects that are discussed are: patient satisfaction and adherence, feelings of anxiety and stress, patient enablement, diagnostics related to information exchange, and clinical outcomes. To review the existing literature concerning all studies published in the last 15 years on the effectiveness of physician empathy in general practice. Systematic literature search. Searches of PubMed, EMBASE, and PsychINFO databases were undertaken, with citation searches of key studies and papers. Original studies published in English between July 1995 and July 2011, containing empirical data about patient experience of GPs' empathy, were included. Qualitative assessment was applied using Giacomini and Cook's criteria. After screening the literature using specified selection criteria, 964 original studies were selected; of these, seven were included in this review after applying quality assessment. There is a good correlation between physician empathy and patient satisfaction and a direct positive relationship with strengthening patient enablement. Empathy lowers patients' anxiety and distress and delivers significantly better clinical outcomes. Although only a small number of studies could be used in this search, the general outcome seems to be that empathy in the patient-physician communication in general practice is of unquestionable importance.
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            Relationship between increased personal well-being and enhanced empathy among internal medicine residents.

            While resident distress and its potential to negatively effect patient care have been well documented, little is known bout resident well-being or its potential to enhance care. We measured resident well-being and explored its relationship with empathy. Anonymous, cross-sectional survey. Internal medicine residents at Mayo Clinic Rochester (n=165, summer 2003). Well-being was measured using the previously validated Medical Outcomes Study 8-item Short Form (SF-8). Empathy was measured using the previously validated Perspective Taking (PT) and Empathetic Concerns (EC) Sub-scales of the Interpersonal Reactivity Index (IRI). Eighty-three (50%) residents responded to the survey. Mean scores for well-being as measured by the SF-8 were comparable to the general population, and empathy scores on the IRI were similar to other resident samples. Resident empathy on both the cognitive (PT) and emotive (EC) sub-scales of the IRI was higher for residents with higher mental well-being on the SF-8; however, this difference was statistically significant only for the cognitive sub-scale. The importance of a number of personal wellness promotion strategies differed for residents with higher mental well-being on the SF-8. High mental well-being was associated with enhanced resident empathy in this cross-sectional survey. Future studies need to explore the potential for high resident well-being to enhance medical care and competency in addition to exploring the negative consequences of resident distress. Studies investigating how to promote resident well-being are needed.
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              Eleven Years of Data on the Jefferson Scale of Empathy-Medical Student Version (JSE-S): Proxy Norm Data and Tentative Cutoff Scores

              Objective This study was designed to provide typical descriptive statistics, score distributions and percentile ranks of the Jefferson Scale of Empathy-Medical Student version (JSE-S) of male and female medical school matriculants to serve as proxy norm data and tentative cutoff scores. Subjects and Methods The participants were 2,637 students (1,336 women and 1,301 men) who matriculated at Sidney Kimmel (formerly Jefferson) Medical College between 2002 and 2012, and completed the JSE at the beginning of medical school. Information extracted from descriptive statistics, score distributions and percentile ranks for male and female matriculants were used to develop proxy norm data and tentative cutoff scores. Results The score distributions of the JSE tended to be moderately skewed and platykurtic. Women obtained a significantly higher mean score (116.2 ± 9.7) than men (112.3 ± 10.8) on the JSE-S (t2,635 = 9.9, p < 0.01). It was suggested that percentile ranks can be used as proxy norm data. The tentative cutoff score to identify low scorers was ≤95 for men and ≤100 for women. Conclusions Our findings provide norm data and cutoff scores for admission decisions under certain conditions and for identifying students in need of enhancing their empathy.
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                Author and article information

                Contributors
                Journal
                Aten Primaria
                Aten Primaria
                Atencion Primaria
                Elsevier
                0212-6567
                1578-1275
                03 December 2018
                March 2020
                03 December 2018
                : 52
                : 3
                : 185-192
                Affiliations
                [a ]Centro de Salud Valle de la Oliva, Majadahonda, Madrid, España
                [b ]Departamento de Medicina, Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, España
                [c ]Sección de Epidemiología Aplicada, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España
                [d ]Decanato Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, España
                [e ]Unidad Docente Multiprofesional Atención Familiar y Comunitaria Noroeste, Madrid, España
                Author notes
                [* ]Autor para correspondencia. josemanuel.blanco@ 123456salud.madrid.org
                Article
                S0212-6567(18)30158-6
                10.1016/j.aprim.2018.04.009
                7063160
                30522783
                60e03c9b-91e2-4623-9803-7b7d33e2d3c9
                © 2018 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 8 March 2018
                : 26 April 2018
                Categories
                Originales

                empatía,médico residente,médico,paciente,médico graduado extranjero,experiencia profesional,empathy,resident doctor,doctor,patient,foreign graduate doctor,professional experience

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