Relationship between the Empathy of Emergency Personnel and Their Approach to Acute Stroke Patients

Year 2022, Volume: 24 Issue: 2, 131 - 135, 30.08.2022

Cemile Haki Hakan Demirci

https://doi.org/10.18678/dtfd.1058450

Abstract

Aim: The aim of this study was to investigate the relationship between the empathy level of emergency department physicians and nurses and the referral of patients for intravenous thrombolytic and/or endovascular thrombectomy treatment.
Material and Methods: This cross-sectional study was carried out with the emergency department physicians and nurses of hospitals that did not have a stroke clinic in Bursa in July 2019, and included 198 emergency personnel.  Participants’ sociodemographic characteristics, professional working conditions, and stroke history in their immediate environment (friends and family) were recorded and empathy level was measured. The health professions version of the Jefferson Scale of Empathy was used in the assessment of empathy status among emergency physicians and nurses.
Results: The mean empathy score of the study group, by the Jefferson scale of empathy, was found 98.63±14.83 points. In this study, no significant relationship was found between the empathy score and the number of referrals (p=0.962). The total empathy score did not differ by the role of the participants in the hospital (p=0.161) or observation of stroke cases in their family or their friends (p=0.694). Healthcare professionals who had received emergency education (p<0.001), were older (p<0.001), spent more time in their profession (p=0.005), and had observed stroke cases in their family or friends (p=0.005) transferred more stroke cases.
Conclusion: This study suggests that interventions for increasing the empathy levels of emergency medicine specialists and nurses will not have a general effect on the referral of acute stroke cases for intravenous thrombolytic and endovascular thrombectomy treatment.

Keywords

empathy, acute stroke, emergency physicians and nurses

Acil Servis Personelinde Empati ve Akut İnmeli Hastalara Yaklaşımları Arasındaki İlişki

Abstract

Amaç: Bu çalışmanın amacı, acil servis hekimleri ve hemşirelerinin empati düzeyleri ile intravenöz trombolitik ve/veya endovasküler trombektomi tedavisi için hastaların sevk edilmesi arasındaki ilişkiyi araştırmaktır.
Gereç ve Yöntemler: Kesitsel tipteki bu çalışma Bursa'da inme kliniği olmayan hastanelerin acil servis hekimleri ve hemşireleri ile Temmuz 2019 tarihinde gerçekleştirilmiş ve çalışmaya toplam 198 acil servis personeli dahil edilmiştir. Katılımcıların sosyodemografik özellikleri, mesleki çalışma koşulları ve kendi yakın çevrelerindeki (aile ve arkadaşlar) inme öyküleri sorgulanarak kaydedildi ve empati düzeyleri ölçüldü. Acil servis hekimleri ve hemşirelerinin empati durumlarının değerlendirilmesinde Jefferson empati ölçeğinin sağlık çalışanları versiyonu kullanıldı.
Bulgular: Çalışma grubunun Jefferson empati ölçeği ile elde edilen ortalama empati skoru 98,63±14,83 puan olarak bulundu. Bu çalışmada empati puanı ile sevklerin sayısı arasında herhangi bir anlamlı ilişki bulunmadı (p=0,962). Toplam empati puanı, katılımcıların hastanedeki rolüne (p=0,161) veya ailelerinde ya da arkadaşları arasında inme vakası görülmesine (p=0,694) göre de bir farklılık göstermedi. Acil eğitimi almış olan (p<0,001), daha yaşlı olan (p<0,001), mesleğinde daha fazla zaman geçirmiş olan (p=0,005) ve ailesinde veya arkadaşlarında inme vakası gözlemlemiş olan (p=0,005) sağlık çalışanlarının daha fazla inme vakası sevk ettiği görüldü.
Sonuç: Bu çalışma, acil servis hekimleri ve hemşirelerinin empati düzeylerini artırmaya yönelik müdahalelerin, akut inme olgularının intravenöz trombolitik ve endovasküler trombektomi tedavisi için sevkinde genel bir etkiye sahip olmayacağını düşündürmektedir.

Keywords

empati, akut inme, acil hekim ve hemşireleri

References

• Feigin VL, Krishnamurthi RV, Parmar P, Norrving B, Mensah GA, Bennett DA, et al. Update on the global burden of ischemic and hemorrhagic stroke in 1990-2013: The GBD 2013 Study. Neuroepidemiology. 2015;45(3):161-76.
• The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995;333(24):1581-7.
• Wahlgren N, Ahmed N, Dávalos A, Hacke W, Millán M, Muir K, et al. Thrombolysis with alteplase 3-4.5 h after acute ischaemic stroke (SITS-ISTR): an observational study. Lancet. 2008;372(9646):1303-9.
• Saver JL, Goyal M, Bonafe A, Diener HC, Levy EI, Pereira VM, et al. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med. 2015;372(24):2285-95.
• Goyal M, Demchuk AM, Menon BK, Eesa M, Rempel JL, Thornton J, et al. Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med. 2015;372(11):1019-30.
• Goyal M, Menon BK, Van Zwam WH, Dippel DW, Mitchell PJ, Demchuk AM, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387(10029):1723-31.
• Saver JL. Time is brain--quantified. Stroke. 2006;37(1):263-6.
• Khatri P, Abruzzo T, Yeatts SD, Nichols C, Broderick JP, Tomsick TA. Good clinical outcome after ischemic stroke with successful revascularization is time-dependent. Neurology. 2009;73(13):1066-72.
• Meretoja A, Keshtkaran M, Saver JL, Tatlisumak T, Parsons MW, Kaste M, et al. Stroke thrombolysis: save a minute, save a day. Stroke. 2014;45(4):1053-8.
• Hojat M, Gonnella JS, Nasca TJ, Mangione S, Vergare M, Magee M. Physician empathy: definition, components, measurement, and relationship to gender and specialty. Am J Psychiatry. 2002;159(9):1563-9.
• Derksen F, Bensing J, Lagro-Janssen A. Effectiveness of empathy in general practice: a systematic review. Br J Gen Pract. 2013;63(606):e76-84.
• Hojat M, Louis DZ, Markham FW, Wender R, Rabinowitz C, Gonnella JS. Physicians' empathy and clinical outcomes for diabetic patients. Acad Med. 2011;86(3):359-64.
• Wang H, Kline JA, Jackson BE, Laureano-Phillips J, Robinson RD, Cowden CD, et al. Association between emergency physician self-reported empathy and patient satisfaction. PLoS One. 2018;13(9):e0204113.
• Smith DD, Kellar J, Walters EL, Reibling ET, Phan T, Green SM. Does emergency physician empathy reduce thoughts of litigation? A randomised trial. Emerg Med J. 2016;33(8):548-52.
• Yuguero O, Ramon Marsal J, Esquerda M, Vivanco L, Soler-González J. Association between low empathy and high burnout among primary care physicians and nurses in Lleida, Spain. Eur J Gen Pract. 2017;23(1):4-10.
• Ozturk M, Demirci H. Turkish validation of the Jefferson scale of empathy for nurses seeking kidney donations in intensive care units. Aging Male. 2020;23(5):564-70.
• Sharobeam A, Jones B, Walton-Sonda D, Lueck CJ. Factors delaying intravenous thrombolytic therapy in acute ischaemic stroke: a systematic review of the literature. J Neurol. 2021;268(8):2723-34.
• Yuguero O, Marsal JR, Esquerda M, Soler-González J. Occupational burnout and empathy influence blood pressure control in primary care physicians. BMC Fam Pract. 2017;18(1):63.
• Ozcakir A, Ediz B, Bilgel N. The relationship between subjective well-being and empathy among Turkish medical students. MedEdPublish. 2016;5:59.
• Kesbakhi MS, Rohani C, Mohtashami J, Nasiri M. Empathy from the perspective of oncology nurses. J Compassionate Health Care. 2017;4:7.
• Penšek L, Selič P. Empathy and burnout in Slovenian family medicine doctors: the first presentation of Jefferson scale of empathy results. Zdr Varst. 2018;57(3):155-65.
• Hojat M, Gonnella JS. Eleven years of data on the Jefferson scale of empathy-medical student version (JSE-S): proxy norm data and tentative cutoff scores. Med Princ Pract. 2015;24(4):344-50.
• Hojat M, Gonnella JS, Nasca TJ, Mangione S, Veloksi JJ, Magee M. The Jefferson scale of physician empathy: further psychometric data and differences by gender and specialty at item level. Acad Med. 2002;77(10 Suppl):S58-60.
• Wolfshohl JA, Bradley K, Bell C, Bell S, Hodges C, Knowles H, et al. Association between empathy and burnout among emergency medicine physicians. J Clin Med Res. 2019;11(7):532-8.
• Seo JW, Park KH, Park HY, Sun KH, Park SY, Kim TH, et al. Empathy and quality of life in Korean emergency physicians. J Korean Soc Emerg Med. 2016;27(2):150-6.