The Relationship Between Physician Empathy and Disease Complications: An Empirical Study of Primary Care Physicians and Their Diabetic Patients in Parma, Italy
The Relationship Between Physician Empathy and Disease Complications: An Empirical Study of Primary Care Physicians and Their Diabetic Patients in Parma, Italy
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DOI：
10.1097/acm.0b013e3182628fbf
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发表时间：
2012-09-01
影响因子：
7.4
通讯作者：
Gonnella, Joseph S.
中科院分区：
文献类型：
--
作者：
Del Canale, Stefano;Louis, Daniel Z.;Gonnella, Joseph S.
目的验证医师共情量表得分与糖尿病患者临床结局相关的假设。方法本回顾性相关研究纳入意大利帕尔马地方卫生当局2009年全年284298名成人患者中20961名1型或2型糖尿病患者，其中242名初级保健医生中有1名。比较参与医师杰弗逊共情量表评分与2009年住院糖尿病患者急性代谢并发症（高渗状态、糖尿病酮症酸中毒、昏迷）的发生率。结果共情评分高的患者急性代谢并发症发生率显著低于共情评分中低的患者（分别为4.0 / 1000、7.1 / 1000、6.5 / 1000,P < 0.05）。Logistic回归分析显示，医生共情得分与急性代谢并发症相关：优势比(OR) = 0.59（95%可信区间[CI]， 0.37-0.95，共情得分高和低的医生对比）。患者年龄（= 69岁）也有助于预测急性代谢并发症：OR = 1.7 （95% CI, 1.2-1.4）。医生的性别和年龄、患者的性别、执业类型（单独执业、联合执业）、执业地理位置（山地、丘陵、平原）以及患者就诊时间与急性代谢并发症无关。结论医生共情与糖尿病患者的临床结果有显著关系，应被视为临床能力的重要组成部分。
PurposeTo test the hypothesis that scores of a validated measure of physician empathy are associated with clinical outcomes for patients with diabetes mellitus.MethodThis retrospective correlational study included 20,961 patients with type 1 or type 2 diabetes mellitus from a population of 284,298 adult patients in the Local Health Authority, Parma, Italy, enrolled with one of 242 primary care physicians for the entire year of 2009. Participating physicians' Jefferson Scale of Empathy scores were compared with occurrence of acute metabolic complications (hyperosmolar state, diabetic ketoacidosis, coma) in diabetes patients hospitalized in 2009.ResultsPatients of physicians with high empathy scores, compared with patients of physicians with moderate and low empathy scores, had a significantly lower rate of acute metabolic complications (4.0, 7.1, and 6.5 per 1,000 patients, respectively, P < .05). Logistic regression analysis showed physicians' empathy scores were associated with acute metabolic complications: odds ratio (OR) = 0.59 (95% confidence interval [CI], 0.37-0.95, contrasting physicians with high and low empathy scores). Patients' age (= 69 years) also contributed to the prediction of acute metabolic complications: OR = 1.7 (95% CI, 1.2-1.4). Physicians' gender and age, patients' gender, type of practice (solo, association), geographical location of practice (mountain, hills, plain), and length of time the patient had been enrolled with the physician were not associated with acute metabolic complications.ConclusionsThese results suggest that physician empathy is significantly associated with clinical outcome for patients with diabetes mellitus and should be considered an important component of clinical competence.