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.

[1]  J. Bensing,et al.  The impact of financial incentives on physician empathy: a study from the perspective of patients with private and statutory health insurance. , 2011, Patient education and counseling.

[2]  R. Mayou,et al.  Outcome in consecutive emergency department attenders following a road traffic accident , 2001, British Journal of Psychiatry.

[3]  R Philip Snaith.  The Hospital Anxiety And Depression Scale , 1986, British medical journal.

[4]  D. Hoyt,et al.  Outcome after major trauma: 12-month and 18-month follow-up results from the Trauma Recovery Project. , 1998 .

[5]  H. Golla,et al.  Patients feeling severely affected by multiple sclerosis: how do patients want to communicate about end-of-life issues? , 2012, Patient education and counseling.

[6]  Kappauf Hw.  Communication in oncology , 2004 .

[7]  James F Kellam,et al.  Long-term persistence of disability following severe lower-limb trauma. Results of a seven-year follow-up. , 2005, The Journal of bone and joint surgery. American volume.

[8]  Rory A Cooper,et al.  The relationship between quality of life and change in mobility 1 year postinjury in individuals with spinal cord injury. , 2011, Archives of physical medicine and rehabilitation.

[9]  Scott B. MacKenzie,et al.  Common method biases in behavioral research: a critical review of the literature and recommended remedies. , 2003, The Journal of applied psychology.

[10]  O. Ommen,et al.  The relationship between social support, shared decision-making and patient’s trust in doctors: a cross-sectional survey of 2,197 inpatients using the Cologne Patient Questionnaire , 2011, International Journal of Public Health.

[11]  M. Wirtz,et al.  General practitioner empathy, patient enablement, and patient-reported outcomes in primary care in an area of high socio-economic deprivation in Scotland--a pilot prospective study using structural equation modeling. , 2008, Patient education and counseling.

[12]  Pål Gulbrandsen,et al.  Effectiveness of a short course in clinical communication skills for hospital doctors: results of a crossover randomized controlled trial (ISRCTN22153332). , 2011, Patient education and counseling.

[13]  H. Pfaff,et al.  Breast cancer patients' trust in physicians: the impact of patients' perception of physicians' communication behaviors and hospital organizational climate. , 2009, Patient education and counseling.

[14]  N. Frye.  Presidential Address 1976 , 1977 .

[15]  D. Dillman.  Mail and telephone surveys : the total design method , 1979 .

[16]  M. Wirtz,et al.  Psychometric evaluation of an instrument to assess patient-reported 'psychosocial care by physicians': a structural equation modeling approach. , 2009, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[17]  B. Chewning,et al.  Practitioner empathy and the duration of the common cold. , 2009, Family medicine.

[18]  Outcome from injury: general health, work status, and satisfaction 12 months after trauma. , 1999 .

[19]  S. Mercer,et al.  A pilot prospective study on the consultation and relational empathy, patient enablement, and health changes over 12 months in patients going to the Glasgow Homoeopathic Hospital. , 2005, Journal of alternative and complementary medicine.

[20]  E. Hickling,et al.  Psychiatric Morbidity Associated with Motor Vehicle Accidents , 1995, The Journal of nervous and mental disease.

[21]  M. Wirtz,et al.  Validation of a theory-based instrument measuring patient-reported psychosocial care by physicians using a multiple indicators and multiple causes model. , 2010, Patient education and counseling.

[22]  R. Snaith,et al.  The Hospital Anxiety and Depression Scale , 1983 .

[23]  A. Finset,et al.  Long-term effect of communication training on the relationship between physicians' self-efficacy and performance. , 2013, Patient education and counseling.

[24]  B Bouillon,et al.  Quality of life in patients with multiple injuries--basic issues, assessment, and recommendations. , 2002, Restorative neurology and neuroscience.

[25]  J. Kleijnen,et al.  Influence of context effects on health outcomes: a systematic review , 2001, The Lancet.

[26]  Karon F Cook,et al.  The John Insall Award: Patient Expectations Affect Satisfaction with Total Knee Arthroplasty , 2006, Clinical orthopaedics and related research.

[27]  H. Kappauf.  Kommunikation in der Onkologie , 2004, Der Hautarzt.

[28]  A. Maercker,et al.  Erfassung von psychischen Belastungsfolgen: Die Impact of Event Skala-revidierte Version (IES-R). , 1998 .

[29]  M. Wirtz,et al.  [Psychometric evaluation of the German version of the "Consultation and Relational Empathy" (CARE) measure at the example of cancer patients]. , 2008, Psychotherapie, Psychosomatik, medizinische Psychologie.

[30]  L. Harvey,et al.  A comparison of patients' and physiotherapists' expectations about walking post spinal cord injury: a longitudinal cohort study , 2012, Spinal Cord.

[31]  T Gennarelli,et al.  Progress in characterizing anatomic injury. , 1990, The Journal of trauma.

[32]  R. Stieglitz,et al.  Prediction of posttraumatic stress disorder by immediate reactions to trauma: a prospective study in road traffic accident victims , 1998, European Archives of Psychiatry and Clinical Neuroscience.

[33]  Yea-Ying Liu,et al.  Association Between Social Support and Health Outcomes: A Meta‐analysis , 2003, The Kaohsiung journal of medical sciences.

[34]  Justine Shults,et al.  Early predictors of long-term disability after injury. , 2003, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[35]  S. Mercer,et al.  Practitioner empathy, patient enablement and health outcomes: a prospective study of acupuncture patients. , 2006, Patient education and counseling.

[36]  L. Berkman,et al.  From social integration to health: Durkheim in the new millennium. , 2000, Social science & medicine.

[37]  S. Cobb.  Presidential Address-1976. Social support as a moderator of life stress. , 1976, Psychosomatic medicine.

[38]  James F. Steed,et al.  The effect of surgeon empathy and emotional intelligence on patient satisfaction , 2011, Advances in health sciences education : theory and practice.

[39]  M. Johnston,et al.  The Effects of Physician Empathy on Patient Satisfaction and Compliance , 2004, Evaluation & the health professions.

[40]  S. Mercer,et al.  Empathy and quality of care. , 2002, The British journal of general practice : the journal of the Royal College of General Practitioners.

[41]  A. Finset,et al.  Physicians' responses to patients' expressions of negative emotions in hospital consultations: a video-based observational study. , 2011, Patient education and counseling.

[42]  M. Goldstein,et al.  Impact of communication training on physician expression of empathy in patient encounters. , 2009, Patient education and counseling.

[43]  David Heaney,et al.  The consultation and relational empathy (CARE) measure: development and preliminary validation and reliability of an empathy-based consultation process measure. , 2004, Family practice.

[44]  Stefanie Mollborn,et al.  Delayed care and unmet needs among health care system users: when does fiduciary trust in a physician matter? , 2005, Health services research.

[45]  M. Wirtz,et al.  Determinants and patient-reported long-term outcomes of physician empathy in oncology: a structural equation modelling approach. , 2007, Patient education and counseling.

[46]  J. Chibnall,et al.  Effect of Treatment Success and Empathy on Surgeon Attributions for Back Surgery Outcomes , 2005, Journal of Behavioral Medicine.

[47]  J. Tulsky,et al.  Physician Empathy and Listening: Associations with Patient Satisfaction and Autonomy , 2011, The Journal of the American Board of Family Medicine.

[48]  W. Levinson,et al.  A study of patient clues and physician responses in primary care and surgical settings. , 2000, JAMA.

[49]  C. Fisher,et al.  The Impact of Patient Expectations on Outcome Following Treatment for Spinal Trauma: Part 1: What Are Spine Surgeons Telling Their Patients? , 2010, Spine.

[50]  Patient- and hospital-related determinants on subjective evaluation of medical treatment outcome of severely injured patients , 2008, Journal of Public Health.

[51]  J. Bensing,et al.  Analyzing the "nature" and "specific effectiveness" of clinical empathy: a theoretical overview and contribution towards a theory-based research agenda. , 2009, Patient education and counseling.

[52]  Scott B. MacKenzie,et al.  Working memory: theories, models, and controversies. , 2012, Annual review of psychology.

[53]  A. Donabedian.  An Introduction to Quality Assurance in Health Care , 2002 .

[54]  J P Anderson,et al.  Outcome after major trauma: discharge and 6-month follow-up results from the Trauma Recovery Project. , 1998, The Journal of trauma.