The Effect of Self-Compassion, General Well-Being and Psychological Safety on Barriers to Physician Compassion

Yıl 2024, Cilt: 3 Sayı: 2, 261 - 278, 30.11.2024

Hesna Zeynep Sandal , Ebru Taysi

Öz

The purpose of this study was to examine the predictive effects of self-compassion, general well-being, and psychological safety on barriers to compassion among physicians working in different regions and health care institutions in Turkey based on the Transactional Model of Physician Compassion (TMFC) and the Affect Regulation Model. However, in order to obtain more information about the barriers to compassion, the effect of length of service on the dependent variable, barriers to compassion, was examined. A total of 163 physicians, 96 female (58.9%) and 67 male (41.1%), aged 23-60 years (mean = 32.94; SD = 9.50), with different specialties and length of service from different regions participated in the study. Four separate multiple linear regression analyses were conducted to test the extent to which the sub-dimensions of barriers to physician compassion were determined by self-compassion, general well-being, psychological safety, care of refugee/asylum seeker patients, specialty, and length of service. According to the results of the analyses, general well-being, psychological safety and length of service were found to have a predictive effect on barriers to physician compassion.
As the majority of literature on compassion in healthcare focuses on patients, compassion experienced by patients, and interventions to improve patient experience, this study aims to contribute to the literature by examining physicians in Turkey in a context that has not been studied before.

Anahtar Kelimeler

Physician Compassion, Self Compassion, General Well Being, Psychological Safety

Proje Numarası

22.02.2023 tarih ve 1140-01/a sayılı yönetim kurulu kararı

Hekim Merhameti Önündeki Engeller Üzerinde Öz Anlayış, Genel İyi Oluş ve Psikolojik Güvenliğin Etkisi

Öz

Bu çalışmada, Türkiye’de çeşitli bölgelerde ve sağlık kurumlarında görev yapan hekimlerin merhametleri önündeki engeller üzerinde, öz anlayış, genel iyi oluş ve psikolojik güvenliğin yordayıcı etkisinin Transaksiyonel Hekim Merhameti Modeli (THMM) ve Duygulanım düzenleme modeli temel alınarak incelenmesi amaçlanmıştır. Bununla birlikte, merhamet önündeki engellere yönelik daha fazla bilgi sahibi olmak amacıyla hizmet süresinin bağımlı değişken olan merhamet önündeki engeller üzerindeki etkisi araştırılmıştır. Araştırmaya farklı bölgelerden farklı uzmanlık alanlarına ve çalışma süresine sahip 96 kadın (%58.9), 67 erkek (%41.1) olmak üzere 23-60 (Ort. = 32.94; SS = 9.50) yaş aralığında toplam 163 hekim katılmıştır. Hekim merhameti önündeki engellerinin alt boyutlarının; öz anlayış, genel iyi oluş, psikolojik güvenlik ve hizmet süresi tarafından ne kadar belirlendiğini test etmek üzere dört ayrı çoklu doğrusal regresyon analizi yapılmıştır. Analiz sonuçlara göre genel iyi oluş, psikolojik güvenlik ve hizmet süresinin hekim merhameti önündeki engeller üzerinde yordayıcı etkisi bulunmuştur.
Sağlık hizmetlerinde merhamete dair alanyazının büyük bir kısmı, hastalara, hastalar tarafından deneyimlenen merhamete ve hasta deneyimlerini iyileştirmeye yönelik müdahalelere odaklandığı için, bu çalışmanın Türkiye’deki hekimler üzerinde daha önce çalışılmamış bir bağlamda incelenmesi ve alanyazına katkı sağlanması amaçlanmıştır.

Anahtar Kelimeler

Hekim Merhameti, Öz Anlayış, Genel İyi Oluş, Psikolojik Güvenlik

Proje Numarası

22.02.2023 tarih ve 1140-01/a sayılı yönetim kurulu kararı

Kaynakça

• American Medical Association. (2016). AMA's Code of Medical Ethics. https://www.ama-assn.org/sites/default/files/media-browser/code-of-medical-ethicschapter-1.pdf
• Bayne, H., Neukrug, E., Hays, D., & Britton, B. (2013). A comprehensive model for optimizing empathy in person-centered care. Patient Education and Counseling, 93(2), 209–215.
• Begin, A. S., Hidrue, M., Lehrhoff, S., Del Carmen, M. G., Armstrong, K., & Wasfy, J. H. (2022). Factors associated with physician tolerance of uncertainty: An observational study. Journal of General Internal Medicine, 37(6), 1415–1421.
• Bratek, A., Bulska, W., Bonk, M., Seweryn, M., & Krysta, K. (2015). Empathy among physicians, medical students and candidates. Psychiatria Danubina, 27, 48–52.
• Cole-King, A., & Gilbert, P. (2014). Compassionate care: The theory and the reality. In Providing compassionate healthcare (pp. 68–84). Routledge.
• Derksen, F. A., Hartman, T. C., Bensing, J. M., & Lagro-Janssen, A. L. (2016). Managing barriers to empathy in the clinical encounter: A qualitative interview study with GPs. British Journal of General Practice, 66(653), e887–e895. https://doi.org/10.3399/bjgp16X687565
• Devaraj, S., & Patel, P. C. (2021). Change in psychological distress in response to changes in reduced mobility during the early 2020 COVID-19 pandemic: Evidence of modest effects from the US. Social Science & Medicine, 270, 113615.
• Diener, E., Wirtz, D., Tov, W., Kim-Prieto, C., Choi, D. W., Oishi, S., & Biswas-Diener, R. (2010). New wellbeing measures: Short scales to assess flourishing and positive and negative feelings. Social Indicators Research, 97, 143–156.
• Domínguez‐Salas, S., Gómez‐Salgado, J., Guillén‐Gestoso, C., Romero‐Martín, M., Ortega‐Moreno, M., & Ruiz‐Frutos, C. (2021). Health care workers’ protection and psychological safety during the COVID‐19 pandemic in Spain. Journal of Nursing Management, 29(7), 1924–1933.
• Edmondson, A. (1999). Psychological safety and learning behavior in work teams. Administrative Science Quarterly, 44(2), 350–383.
• Feldman, R. (2012). Oxytocin and social affiliation in humans. Hormones and Behavior, 61, 380–391.
• Fernando III, A. T., & Consedine, N. S. (2014). Development and initial psychometric properties of the Barriers to Physician Compassion questionnaire. Postgraduate Medical Journal, 90(1065), 388–395.
• Fernando, A. (2021). Beyond compassion fatigue: The systemic origins of compassion in medicine [Doctoral dissertation, The University of Auckland].
• George, R. E., & Lowe, W. A. (2019). Well‐being and uncertainty in health care practice. The Clinical Teacher, 16(4), 298–305.
• Gilbert, P. (2008). Developing a compassion-focused approach in cognitive behavioural therapy. In Cognitive Behaviour Therapy (pp. 201–220). Routledge.
• Gilbert, P. (2009). The Compassionate Mind: A New Approach to Life Challenges. Constable and Robinson Ltd.
• Gilbert, P. (2010). An introduction to compassion focused therapy in cognitive behavior therapy. International Journal of Cognitive Therapy, 3(2), 97–112.
• Hofmeyer, A., Kennedy, K., & Taylor, R. (2020). Contesting the term ‘compassion fatigue’: Integrating findings from social neuroscience and self-care research. Collegian, 27(2), 232–237.
• Hooper, C., Craig, J., Janvrin, D. R., Wetsel, M. A., & Reimels, E. (2010). Compassion satisfaction, burnout, and compassion fatigue among emergency nurses compared with nurses in other selected inpatient specialties. Journal of Emergency Nursing, 36(5), 420–427.
• Kalafatoğlu, M. R., & Çelik, S. B. (2020). Genel iyi oluş ölçeği kısa formu’nun Türkçe’ye uyarlanması: Geçerlik ve güvenirlik çalışması. OPUS International Journal of Society Researches, 15(25), 3633–3653.
• Kleiner, S., & Pavalko, E. K. (2010). Clocking in: The organization of work time and health in the United States. Social Forces, 88(3), 1463–1486.
• Lawton, R., Robinson, O., Harrison, R., Mason, S., Conner, M., & Wilson, B. (2019). Are more experienced clinicians better able to tolerate uncertainty and manage risks? A vignette study of doctors in three NHS emergency departments in England. BMJ Quality & Safety, 28(5), 382–388.
• Neff, K. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2(2), 85–101.
• Neff, K., & Germer, C. (2017). Self-compassion and psychological. In The Oxford Handbook of Compassion Science (pp. 371–390).
• Pavlova, A., Wang, C. X., Boggiss, A. L., O’Callaghan, A., & Consedine, N. S. (2022). Predictors of physician compassion, empathy, and related constructs: A systematic review. Journal of General Internal Medicine, 1–12.
• Rees, D. W. (1995). Work‐related stress in health service employees. Journal of Managerial Psychology, 10(3), 4–11.
• Roskvist, R. P. (2023). Is compassion fatigue a self-fulfilling prophecy? An experimental study of manipulated expectations [Master’s thesis, The University of Auckland].
• Rothenberger, D. A. (2017). Physician burnout and well-being: A systematic review and framework for action. Diseases of the Colon & Rectum, 60(6), 567–576.
• Scott, I. A., Doust, J. A., Keijzers, G. B., & Wallis, K. A. (2023). Coping with uncertainty in clinical practice: A narrative review. Medical Journal of Australia, 218(6), 418–425.
• Shanafelt, T., Goh, J., & Sinsky, C. (2017). The business case for investing in physician well-being. JAMA Internal Medicine, 177(12), 1826–1832.
• Simpson, A. V., Farr-Wharton, B., & Reddy, P. (2020). Cultivating organizational compassion in healthcare. Journal of Management & Organization, 26(3), 340–354.
• Swendiman, R. A., Edmondson, A. C., & Mahmoud, N. N. (2019). Burnout in surgery viewed through the lens of psychological safety. Annals of Surgery, 269(2), 234–235.
• Tawfik, D. S., Profit, J., Morgenthaler, T. I., Satele, D. V., Sinsky, C. A., Dyrbye, L. N., … & Shanafelt, T. D. (2018). Physician burnout, well-being, and work unit safety grades in relationship to reported medical errors. Mayo Clinic Proceedings, 93(11), 1571–1580.
• Tessitore, F., Caffieri, A., Parola, A., Cozzolino, M., & Margherita, G. (2023). The role of emotion regulation as a potential mediator between secondary traumatic stress, burnout, and compassion satisfaction in professionals working in the forced migration field. International Journal of Environmental Research and Public Health, 20(3), 2266.
• Torralba, K. D., Jose, D., & Byrne, J. (2020). Psychological safety, the hidden curriculum, and ambiguity in medicine. Clinical Rheumatology, 39, 667–671.
• Veale, D., Gilbert, P., Wheatley, J., & Naismith, I. (2015). A new therapeutic community: Development of a compassion‐focused and contextual behavioural environment. Clinical Psychology & Psychotherapy, 22(4), 285–303.
• Wasson, R. S., Barratt, C., & O’Brien, W. H. (2020). Effects of mindfulness-based interventions on self-compassion in health care professionals: A meta-analysis. Mindfulness, 11(8), 1914–1934.
• West, C. P., Dyrbye, L. N., & Shanafelt, T. D. (2018). Physician burnout: Contributors, consequences, and solutions. Journal of Internal Medicine, 283(6), 516–529.
• Yoo, W., Mayberry, R., Bae, S., Singh, K., He, Q. P., & Lillard Jr, J. W. (2014). A study of effects of multicollinearity in the multivariable analysis. International Journal of Applied Science and Technology, 4(5), 9.