Covid-19 Pandemisinde Hastaların Hekimlere Karşı Empatisi ve Hastaların Hekim Kaynaklı Empati Algısı
Yıl 2023,
Cilt: 5 Sayı: 2, 74 - 81, 31.12.2023
Meryem Dilek Acar
,
Mustafa Samancı
,
Elif Dikmetaş Yardan
Öz
Öz
Amaç Hekimlerin hem zihinsel hem de fiziksel çabaları nedeniyle ağır bir iş yükü vardır. Hekimler, stresli çalışma koşullarıyla baş edebilmek için anlaşılmak istemektedirler. Bu çalışmada özellikle pandemi gibi bir kriz durumunda, hastaların hekimlerine karşı empati düzeyleri ve hastaların hekim kaynaklı empatiyi algı düzeylerinin araştırılması amaçlandı.
Materyal ve Metod XXXXXX Hastanesi acil dışı polikliniklerine ayaktan başvuran hastaların (n=396, >18 yaş) hekimlerine karşı empati düzeyleri tespit edildi. Aynı hastaların hekim kaynaklı empatiyi algıları da 7'li Likert tipi bir ölçek olan 'The Jefferson Scale of Patient Perceptions of Physician Empathy' ile değerlendirildi. Bu hastaların kronik bir hastalıklarının olup olmadığı ve sağlık kurumu ziyaretleri araştırıldı. Hastaların mevcut özellikleriyle hekim kaynaklı empatiyi algı düzeyleri istatistiksel olarak karşılaştırıldı.
Bulgular Hastaların hekimlerine karşı empati düzeylerinin yüksek olduğu saptandı. Hastaların hekim kaynaklı empatiyi algı puanlarının da 5,14 olduğu tespit edildi. Pandemi sırasında gerektiğinde bir sağlık kuruluşunu ziyaret etmek için beklemeyen hastaların (%76,8), hekim kaynaklı empatiyi algı düzeyinin yüksek olduğu saptandı (p<0,05).
Sonuç Kritik durumlarla baş edebilmek için önemli bir iletişim becerisi olan empati, karşılıklı olmalıdır ve empati kurmak için en önemli konu güvendir. Çalışmaya katılan gönüllü hastalar, enfekte hastaların da ziyaret ettiği hastaneyi ziyaret ederek hekimlerine olan güvenlerini göstermektedir. Hekimlerine karşı empati düzeyi yüksek hastaların hekim kaynaklı empati algısının da yüksek olduğu saptanmıştır.
Anahtar Kelimeler Empati, Hastalar, Hekimler, Covid-19, Kriz
Etik Beyan
The approval of the study was obtained from Medical Research Ethics Committee of Ondokuz Mayıs University (Omukaek No: 2020/555). Ministry of Health of Turkiye (Form: 2020-08-18T06_18_14) and Provincial Health Directorate (No: 26521195-604.02) also approved the study.
Kaynakça
- Abrahamsson, B., Berg, M.L., Jutengren, G., Johnsson, A. (2015). To recommend the local primary health-care centre or not: What importance do patients attach to initial contact quality, staff continuity and responsive staff encounters? International Journal for Quality in Health Care, 27 (3), 1–11. DOI:10.1093/intqhc/mzv017
- Banerjee, D., Vaishnav, M., Rao, T.S., Raju, M.S., Dalal, P.K., Javed, A., et al. (2020). Impact of the COVID-19 pandemic on psychosocial health and well-being in South-Asian (World Psychiatric Association zone 16) countries: a systematic and advocacy review from the Indian Psychiatric Society. Indian J Psychiatry, 62 (9), 343.
- Barello, S., Palamenghi, L., Graffigna, G. (2020). Empathic communication as a “Risky Strength” for Health during the COVID-19 Pandemic: the Case of Frontline Italian Healthcare Workers. Patient Education and Counseling, 103 (10), 2200-2202. DOI:10.1016/j.pec.2020.06.027
- Barello, S., Graffigna, G. (2020). Caring for Health Professionals in the COVID-19 Pandemic Emergency: Toward an “Epidemic of Empathy” in Healthcare. Front Psychol, 11, 1431. DOI: 10.3389/fpsyg.2020.01431
- Boysen, G.N., Nyström, M., Christensson, L., Herlitz, J., Sundström, B.W. (2017). Trust in the early chain of healthcare: lifeworld hermeneutics from the patient’s perspective. Int J Qual Stud Health Well-being, 12 (1), 1356674. https://doi.org/10.1080/17482631.2017.1356674
- Carr, L., Iacoboni, M., Dubeau, M. C., Mazziotta, J. C., Lenzi, G. L. (2003). Neural mechanisms of empathy in humans: A relay from neural systems for imitation to limbic areas. Proceedings of the National Academy of Sciences, 100, 5497–5502.
- Cicekci, F., Duran, N., Ayhan, B., Arican, S., Ilban, O., Kara, I., et al. (2017). The communication between patient relatives and physicians in intensive care units. BMC Anesthesiol, 17 (97). DOI: 10.1186/s12871-017-0388-1
- Correia, I., Almeida, A.E. (2020). Organizational Justice, Professional Identification, Empathy, and Meaningful Work During COVID-19 Pandemic: Are They Burnout Protectors in Physicians and Nurses? Front Psychol. 11. https://doi.org/10.3389/fpsyg.2020.566139
- Eby, D. (2018) Empathy in general practice: its meaning for patients and doctors. Br J Gen Pract, 68 (674), 412-413. DOI: 10.3399/bjgp18X698453
- Galbraith, N., Boyda, D., McFeeters, D., Hassan, T. (2020). The mental health of doctors during the COVID-19 pandemic. BJPsych Bull, 45 (2), 1–4. https://doi.org/10.1192/bjb.2020.44
- Gallese, V., Keysers, C., & Rizzolatti, G. (2004). A unifying view of the basis of social cognition. Trends in Cognitive Sciences, 8, 396–403.
Hagerty, B.M., Partusky, K.L. (2003). Reconceptualizing the nurse-patient relationship. Journal of Nursing Scholarship, 35 (2), 145–150.
- Iacoboni, M., Molnar-Szakacs, I., Gallese, V., Buccino, G., Mazziotta, J. C., & Rizzolatti, G. (2005). Grasping the intentions of others with one’s own mirror neuron system. PLoS Biology, 3, e79.
- Kane, G.C., Gotto, J.L., Mangione, S., West, S., Hojat, M. (2007). Jefferson Scale of Patient's Perceptions of Physician Empathy: preliminary psychometric data. Croat Med J, 48 (1), 81-6.
- King, D.B, Kamble, S., DeLongis, A. (2016). Coping with influenza A/H1N1 in India: empathy is associated with increased vaccination and health precautions. International Journal of Health Promotion and Education, 54 (6), 283-294. DOI:10.1080/14635240.2016.1174950
- Koski, L., Iacoboni, M., Dubeau, M. C., Woods, R. P., & Mazziotta, J. C. (2003). Modulation of cortical activity during different imitative behaviors. Journal of Neurophysiology, 89, 460–471.
- Lorié, Á., Reinero, D.A., Phillips, M., Zhang, L., Riess, H. (2017). Culture and nonverbal expressions of empathy in clinical settings: A systematic review. Patient Educ Couns, 100 (3), 411-424. DOI: 10.1016/j.pec.2016.09.018
- Mei, Y., Xu, X., Li, X. (2020). Encouraging Patient Engagement Behaviors from the Perspective of Functional Quality. Int J Environ Res Public Health, 17 (22), 8613. https://doi.org/10.3390/ijerph17228613
- Montemurro, N. (2020). The emotional impact of COVID-19: From medical staff to common people. Brain Behav Immun, 87. https://doi.org/10.1016/j.bbi.2020.03.032
- Moudatsou, M., Stavropoulou, A., Philalithis, A., Koukouli, S. (2020). The Role of Empathy in Health and Social Care Professionals. Healthcare (Basel), 8 (1), 26. DOI: 10.3390/healthcare8010026
- Ölmez, E.H. (2019). Hekim Empatisi ve Hekim Empatisi Konusunda Hastanın Algı Düzeylerinin Ölçümü: Özel Hastaneler Örneği. Yüksek Lisans Tezi, Beykent Üniversitesi, Hastane ve Sağlık Kurumları Yönetimi Bilim Dalı, İstanbul.
- Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V.G., Papoutsi, E., Katsaounou, P. (2020). Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun, 88, 901-907. DOI: 10.1016/j.bbi.2020.05.026
- Que, J., Le Shi, J.D., Deng, J., Liu, J., Zhang, L., Wu, S., et al. (2020). Psychological impact of the COVID-19 pandemic on healthcare workers: a cross-sectional study in China. Gen Psychiatry, 33, e100259. DOI: 10.1136/gpsych-2020-100259
- Redsell, S., Stokes, T., Jackson, C., Baker, R. (2007). Patients’ account of the differences in nurses’ and general practitioners’ roles in primary care. Journal of Advanced Nursing, 57 (2), 172–180.
- Republic of Turkiye Ministry of Health, Health Statistics Yearbook 2019. (Türkiye Cumhuriyeti Sağlık Bakanlığı Sağlık İstatistikleri Yıllığı. https://sbsgm.saglik.gov.tr/Eklenti/40564/0/saglik-istatistikleri-yilligi-2019pdf.pdf, 2019)
- Republic of Turkiye Ministry of Health, Health Statistics Yearbook 2020. (Türkiye Cumhuriyeti Sağlık Bakanlığı Sağlık İstatistikleri Yıllığı. https://sbsgm.saglik.gov.tr/Eklenti/43399/0/siy2020-tur-26052022pdf.pdf, 2020)
- Republic of Turkiye Ministry of Health, Health Statistics Yearbook 2021. (Türkiye Cumhuriyeti Sağlık Bakanlığı Sağlık İstatistikleri Yıllığı https://sbsgm.saglik.gov.tr/Eklenti/45316/0/siy2021-turkcepdf.pdf
- Roubillea, C., Ribsteina, J., Hurpinb, G., Feslera, P., Fiatc, E., Roubille, F. (2020). Confidence vanished or impaired until distrust in the doctor-patient relationship because of COVID-19 Confidence vanished or impaired until distrust: “COVID” in relationship. Rev Med Interne, 42 (1), 58-60. DOI: 10.1016/j.revmed.2020.10.007
- Singh, M. (2017). Intolerance and Violence Against Doctors. The Indian Journal of Pediatrics, 84, 768–773.
- Schulte-Rüther, M., Markowitsch, H.J., Fink, G.R., Piefke, M. (2007). Mirror neuron and theory of mind mechanisms involved in face-to-face interactions: a functional magnetic resonance imaging approach to empathy. J Cogn Neurosci, 19(8), 1354-72. doi: 10.1162/jocn.2007.19.8.1354. PMID: 17651008.
- The Lancet Psychiatry. (2020) Isolation and inclusion. Lancet Psychiatry, 7 (5), 371. https://doi.org/10.1016/S2215-0366(20)30156-5
- Urooj, U., Ansari, A., Siraj, A., Khan, S., Tariq, H. (2020). Expectations, Fears and Perceptions of doctors during Covid-19 Pandemic. Pak J Med Sci, 36 (COVID19-S4), 37-42. DOI: 10.12669/pjms.36.COVID19-S4.2643
- Viswanathan, R., Myers, M.F., Fanous, A.H. (2020). Support Groups and Individual Mental Health Care via Video Conferencing for Frontline Clinicians During the COVID-19 Pandemic. Psychosomatics, 61 (5), 538–543.
- Wolpert, D. M., Doya, K., & Kawato, M. (2003). A unifying computational framework for motor control and social interaction. Philosophical Transactions of the Royal Society of London, Series B, Biological Sciences, 358, 593–602.
- World Medical Association Declaration of Helsinki. (2017). Ethical principles for medical research involving human subjects. Retrieved March 15, 2017, from http://www.sls.se/PageFiles/229/helsingfors.pdf, 2008.
- World Health Organization. (2020). Current novel coronavirus (2019-nCoV) outbreak. https://www.who.int/health-topics/coronavirus. DOI:10.1111/j.1365-2648.2006.04085.x
- Wu, Q., Bachelor, Z., Wang, P. (2021). The Relationship Between the Physician-Patient Relationship, Physician Empathy, and Patient Trust. J Gen Intern Med. DOI: 10.1007/s11606-021-07008-9
- Yıldız, M. (2019). Hekimlerde Ölçülen Empati ile Hastaların Bu Hekimlerde Algıladığı Empati Arasındaki İlişkinin Değerlendirilmesi. Tıpta Uzmanlık Tezi Sağlık Bilimleri Üniversitesi, Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi Aile Hekimliği Kliniği, Bursa.
Patients Empathy to Physicians and Patients Perception of Physicians Empathy During The Covid-19 Pandemic
Yıl 2023,
Cilt: 5 Sayı: 2, 74 - 81, 31.12.2023
Meryem Dilek Acar
,
Mustafa Samancı
,
Elif Dikmetaş Yardan
Öz
Abstract
Objective Physicians have a heavy workload due to their menthal and physical efforts. Physicians want to be understood for coping with the stressful working conditions. In this study, the aim was to analyze patients empathy levels to physicians, patients’ perceptions of physician empathy levels especially during a crisis like a pandemic.
Materials and Methods The empathy levels of the patients (n=396, >18 ages) to physicians who had visited XXXXXX Hospital non-emergency outpatient clinics were investigated. The same patients' perception of the physicians empathy toward them was also assessed by ‘The Jefferson Scale of Patient Perceptions of Physician Empathy’, a 7-point Likert-type scale. These patients’ data of having/not having chronic illness and their health institution visits were evaluated. The patients characteristics compared statistically with their patients’ perceptions of physician empathy levels.
Results The empathy levels of the patients to their physicians was high. Patients’ perceptions of physician empathy toward them was also found as 5.14. The patients who did not wait for a visit to a health institution when needed during the pandemic (76.8%) have significiantly high patients’ perceptions of physician empathy (p<0,05).
Conclusions Empathy which is an important communication skill in order to cope with critical conditions should be mutual and trust is the most important issue for constructing empathy. The volunteer patients showed trust to their physicians by visiting the hospital which infected patients also visit. The patients with high empathy levels to their physicians also had high patients perception of physician empathy levels.
Keywords Empathy, Patients, Physicians, Covid-19, Crisis
Kaynakça
- Abrahamsson, B., Berg, M.L., Jutengren, G., Johnsson, A. (2015). To recommend the local primary health-care centre or not: What importance do patients attach to initial contact quality, staff continuity and responsive staff encounters? International Journal for Quality in Health Care, 27 (3), 1–11. DOI:10.1093/intqhc/mzv017
- Banerjee, D., Vaishnav, M., Rao, T.S., Raju, M.S., Dalal, P.K., Javed, A., et al. (2020). Impact of the COVID-19 pandemic on psychosocial health and well-being in South-Asian (World Psychiatric Association zone 16) countries: a systematic and advocacy review from the Indian Psychiatric Society. Indian J Psychiatry, 62 (9), 343.
- Barello, S., Palamenghi, L., Graffigna, G. (2020). Empathic communication as a “Risky Strength” for Health during the COVID-19 Pandemic: the Case of Frontline Italian Healthcare Workers. Patient Education and Counseling, 103 (10), 2200-2202. DOI:10.1016/j.pec.2020.06.027
- Barello, S., Graffigna, G. (2020). Caring for Health Professionals in the COVID-19 Pandemic Emergency: Toward an “Epidemic of Empathy” in Healthcare. Front Psychol, 11, 1431. DOI: 10.3389/fpsyg.2020.01431
- Boysen, G.N., Nyström, M., Christensson, L., Herlitz, J., Sundström, B.W. (2017). Trust in the early chain of healthcare: lifeworld hermeneutics from the patient’s perspective. Int J Qual Stud Health Well-being, 12 (1), 1356674. https://doi.org/10.1080/17482631.2017.1356674
- Carr, L., Iacoboni, M., Dubeau, M. C., Mazziotta, J. C., Lenzi, G. L. (2003). Neural mechanisms of empathy in humans: A relay from neural systems for imitation to limbic areas. Proceedings of the National Academy of Sciences, 100, 5497–5502.
- Cicekci, F., Duran, N., Ayhan, B., Arican, S., Ilban, O., Kara, I., et al. (2017). The communication between patient relatives and physicians in intensive care units. BMC Anesthesiol, 17 (97). DOI: 10.1186/s12871-017-0388-1
- Correia, I., Almeida, A.E. (2020). Organizational Justice, Professional Identification, Empathy, and Meaningful Work During COVID-19 Pandemic: Are They Burnout Protectors in Physicians and Nurses? Front Psychol. 11. https://doi.org/10.3389/fpsyg.2020.566139
- Eby, D. (2018) Empathy in general practice: its meaning for patients and doctors. Br J Gen Pract, 68 (674), 412-413. DOI: 10.3399/bjgp18X698453
- Galbraith, N., Boyda, D., McFeeters, D., Hassan, T. (2020). The mental health of doctors during the COVID-19 pandemic. BJPsych Bull, 45 (2), 1–4. https://doi.org/10.1192/bjb.2020.44
- Gallese, V., Keysers, C., & Rizzolatti, G. (2004). A unifying view of the basis of social cognition. Trends in Cognitive Sciences, 8, 396–403.
Hagerty, B.M., Partusky, K.L. (2003). Reconceptualizing the nurse-patient relationship. Journal of Nursing Scholarship, 35 (2), 145–150.
- Iacoboni, M., Molnar-Szakacs, I., Gallese, V., Buccino, G., Mazziotta, J. C., & Rizzolatti, G. (2005). Grasping the intentions of others with one’s own mirror neuron system. PLoS Biology, 3, e79.
- Kane, G.C., Gotto, J.L., Mangione, S., West, S., Hojat, M. (2007). Jefferson Scale of Patient's Perceptions of Physician Empathy: preliminary psychometric data. Croat Med J, 48 (1), 81-6.
- King, D.B, Kamble, S., DeLongis, A. (2016). Coping with influenza A/H1N1 in India: empathy is associated with increased vaccination and health precautions. International Journal of Health Promotion and Education, 54 (6), 283-294. DOI:10.1080/14635240.2016.1174950
- Koski, L., Iacoboni, M., Dubeau, M. C., Woods, R. P., & Mazziotta, J. C. (2003). Modulation of cortical activity during different imitative behaviors. Journal of Neurophysiology, 89, 460–471.
- Lorié, Á., Reinero, D.A., Phillips, M., Zhang, L., Riess, H. (2017). Culture and nonverbal expressions of empathy in clinical settings: A systematic review. Patient Educ Couns, 100 (3), 411-424. DOI: 10.1016/j.pec.2016.09.018
- Mei, Y., Xu, X., Li, X. (2020). Encouraging Patient Engagement Behaviors from the Perspective of Functional Quality. Int J Environ Res Public Health, 17 (22), 8613. https://doi.org/10.3390/ijerph17228613
- Montemurro, N. (2020). The emotional impact of COVID-19: From medical staff to common people. Brain Behav Immun, 87. https://doi.org/10.1016/j.bbi.2020.03.032
- Moudatsou, M., Stavropoulou, A., Philalithis, A., Koukouli, S. (2020). The Role of Empathy in Health and Social Care Professionals. Healthcare (Basel), 8 (1), 26. DOI: 10.3390/healthcare8010026
- Ölmez, E.H. (2019). Hekim Empatisi ve Hekim Empatisi Konusunda Hastanın Algı Düzeylerinin Ölçümü: Özel Hastaneler Örneği. Yüksek Lisans Tezi, Beykent Üniversitesi, Hastane ve Sağlık Kurumları Yönetimi Bilim Dalı, İstanbul.
- Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V.G., Papoutsi, E., Katsaounou, P. (2020). Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun, 88, 901-907. DOI: 10.1016/j.bbi.2020.05.026
- Que, J., Le Shi, J.D., Deng, J., Liu, J., Zhang, L., Wu, S., et al. (2020). Psychological impact of the COVID-19 pandemic on healthcare workers: a cross-sectional study in China. Gen Psychiatry, 33, e100259. DOI: 10.1136/gpsych-2020-100259
- Redsell, S., Stokes, T., Jackson, C., Baker, R. (2007). Patients’ account of the differences in nurses’ and general practitioners’ roles in primary care. Journal of Advanced Nursing, 57 (2), 172–180.
- Republic of Turkiye Ministry of Health, Health Statistics Yearbook 2019. (Türkiye Cumhuriyeti Sağlık Bakanlığı Sağlık İstatistikleri Yıllığı. https://sbsgm.saglik.gov.tr/Eklenti/40564/0/saglik-istatistikleri-yilligi-2019pdf.pdf, 2019)
- Republic of Turkiye Ministry of Health, Health Statistics Yearbook 2020. (Türkiye Cumhuriyeti Sağlık Bakanlığı Sağlık İstatistikleri Yıllığı. https://sbsgm.saglik.gov.tr/Eklenti/43399/0/siy2020-tur-26052022pdf.pdf, 2020)
- Republic of Turkiye Ministry of Health, Health Statistics Yearbook 2021. (Türkiye Cumhuriyeti Sağlık Bakanlığı Sağlık İstatistikleri Yıllığı https://sbsgm.saglik.gov.tr/Eklenti/45316/0/siy2021-turkcepdf.pdf
- Roubillea, C., Ribsteina, J., Hurpinb, G., Feslera, P., Fiatc, E., Roubille, F. (2020). Confidence vanished or impaired until distrust in the doctor-patient relationship because of COVID-19 Confidence vanished or impaired until distrust: “COVID” in relationship. Rev Med Interne, 42 (1), 58-60. DOI: 10.1016/j.revmed.2020.10.007
- Singh, M. (2017). Intolerance and Violence Against Doctors. The Indian Journal of Pediatrics, 84, 768–773.
- Schulte-Rüther, M., Markowitsch, H.J., Fink, G.R., Piefke, M. (2007). Mirror neuron and theory of mind mechanisms involved in face-to-face interactions: a functional magnetic resonance imaging approach to empathy. J Cogn Neurosci, 19(8), 1354-72. doi: 10.1162/jocn.2007.19.8.1354. PMID: 17651008.
- The Lancet Psychiatry. (2020) Isolation and inclusion. Lancet Psychiatry, 7 (5), 371. https://doi.org/10.1016/S2215-0366(20)30156-5
- Urooj, U., Ansari, A., Siraj, A., Khan, S., Tariq, H. (2020). Expectations, Fears and Perceptions of doctors during Covid-19 Pandemic. Pak J Med Sci, 36 (COVID19-S4), 37-42. DOI: 10.12669/pjms.36.COVID19-S4.2643
- Viswanathan, R., Myers, M.F., Fanous, A.H. (2020). Support Groups and Individual Mental Health Care via Video Conferencing for Frontline Clinicians During the COVID-19 Pandemic. Psychosomatics, 61 (5), 538–543.
- Wolpert, D. M., Doya, K., & Kawato, M. (2003). A unifying computational framework for motor control and social interaction. Philosophical Transactions of the Royal Society of London, Series B, Biological Sciences, 358, 593–602.
- World Medical Association Declaration of Helsinki. (2017). Ethical principles for medical research involving human subjects. Retrieved March 15, 2017, from http://www.sls.se/PageFiles/229/helsingfors.pdf, 2008.
- World Health Organization. (2020). Current novel coronavirus (2019-nCoV) outbreak. https://www.who.int/health-topics/coronavirus. DOI:10.1111/j.1365-2648.2006.04085.x
- Wu, Q., Bachelor, Z., Wang, P. (2021). The Relationship Between the Physician-Patient Relationship, Physician Empathy, and Patient Trust. J Gen Intern Med. DOI: 10.1007/s11606-021-07008-9
- Yıldız, M. (2019). Hekimlerde Ölçülen Empati ile Hastaların Bu Hekimlerde Algıladığı Empati Arasındaki İlişkinin Değerlendirilmesi. Tıpta Uzmanlık Tezi Sağlık Bilimleri Üniversitesi, Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi Aile Hekimliği Kliniği, Bursa.