Practitioner empathy and the duration of the common cold

School of Medicine and Public Health, University of Wisconsin, Madison, WI 53715, USA.
Family medicine (Impact Factor: 1.17). 07/2009; 41(7):494-501.
Source: PubMed


This study's objective was to assess the relationship of empathy in medical office visits to subsequent outcomes of the common cold.
A total of 350 subjects ? 12 years of age received either a standard or enhanced physician visit as part of a randomized controlled trial. Enhanced visits emphasized empathy on the part of the physician. The patient-scored Consultation and Relational Empathy (CARE) questionnaire assessed practitioner-patient interaction, especially empathy. Cold severity and duration were assessed from twice-daily symptom reports. Nasal wash was performed to measure the immune cytokine interleukin-8 (IL-8).
Eighty-four individuals reported perfect (score of 50) CARE scores. They tended to be older with less education but reported similar health status, quality of life, and levels of optimism. In those with perfect CARE scores, cold duration was shorter (mean 7.10 days versus 8.01 days), and there was a trend toward reduced severity (mean area under receiver-operator characteristics curve 240.40 versus 284.49). After accounting for possible confounding variables, cold severity and duration were significantly lower in those reporting perfect CARE scores. In these models, a perfect score also correlated with a larger increase in IL-8 levels.
Clinician empathy, as perceived by patients with the common cold, significantly predicts subsequent duration and severity of illness and is associated with immune system changes.

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    • "of illness and was associated with more robust immune system responses, as measured by levels of inflammatory cytokine in nasal secretions (Rakel et al., 2009). To explore the factors associated with patient enablement in general practice consultations , one study of over 3,044, showed that patients' perceptions of the doctors' empathy was of key importance in their enablement in general practice consultations in both high and low deprivation settings individuals (Mercer et al., 2012). "
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    ABSTRACT: The past decades have seen an explosion of studies on empathy in various academic domains including affective neuroscience, psychology, medicine, and economics. However, the volumes of research have almost exclusively focused on its evolutionary origins, development, and neurobiological bases, as well as how the experience of empathy is modulated by social context and interpersonal relationships. In the present paper, we examine a much less attended side of empathy: why it has a positive impact on others? After specifying what the construct of empathy encompasses, we briefly review the various effects of empathy on health outcomes in the domain of medicine. We then propose two non-mutually exclusive mechanistic explanations that contribute to explain the positive effects of physician empathy on patients. (1) The social baseline theory (SBT), building on social support research, proposes that the presence of other people helps individuals to conserve metabolically costly somatic and neural resources through the social regulation of emotion. (2) The free energy principle (FEP) postulates that the brain optimizes a (free energy) bound on surprise or its complement value to respond to environmental changes adaptively. These conceptualizations can be combined to provide a unifying integrative account of the benefits of physicians’ empathetic attitude on their patients and how it plays a role in healing beyond the mere effect of the therapeutic alliance.
    Full-text · Article · Jan 2015 · Frontiers in Behavioral Neuroscience
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    • "Clinical empathy is an essential element of quality care, associated with improved patient satisfaction, increased adherence to treatment, and fewer malpractice complaints (Burns and Nolen- Hoeksema, 1992; Rakel et al., 2009, 2011; Hojat et al., 2011; Del Canale et al., 2012) as well as increased physician health, well-being, and professional satisfaction (Mercer and Reynolds, 2002; Benbassat and Baumal, 2004). However, despite all these clear advantages to both patients and physicians, empathy in medicine remains an undervalued and understudied topic (Riess, 2010; Schattner, 2012). "
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    ABSTRACT: Background: Medical practitioners such as physicians are continuously exposed to the suffering and the distress of patients. Understanding the way pain perception relates to empathetic dispositions and professional quality of life can contribute to the development of strategies aimed at protecting health professionals from burnout and compassion fatigue. In the present study we investigate the way individual dispositions relate to behavioral measures of pain sensitivity, empathy, and professional quality of life. Methods: A secure Web-based series of self-report measures and a behavioral task were administered to 1,199 board-certified physicians. Additionally, surveys were used to obtain measures of demographic and professional background; dispositional empathy (empathic concern, personal distress, and perspective taking); positive (compassion satisfaction) and negative (burnout and secondary traumatic stress) aspects of their professional life. In the behavioral task, participants were asked to watch a series of video clips of patients experiencing different levels of pain and provide ratings of pain intensity and induced personal distress. Results: Perceived pain intensity was significantly lower among more experienced physicians but similar across specialty fields with varying demands of emotional stress. Watching videos of patients in pain, however, elicited more personal distress among physicians in highly demanding medical fields, despite comparable empathy dispositions with other fields. The pain of male patients was perceived as less intense than the pain of female patients, and this effect was more marked for female physicians. The effect of dispositional empathy on pain perception and induced personal distress was different for each sub-component, with perspective taking and empathic concern (EC) being predictive of the behavioral outcomes. Physicians who experience both compassion satisfaction and fatigue perceive more pain and suffer more personal distress from it than those who only suffer the negative aspects of professional quality of life. Conclusions: Professional experience seems to desensitize physicians to the pain of others without necessarily helping them down-regulate their own personal distress. Pain perception is also related with specific aspects of empathy and varies depending on context, as is the case with the gender of their patients. Minimum levels of empathy appear necessary to benefit from the positive aspects of professional quality of life in medicine.
    Full-text · Article · Jul 2014 · Frontiers in Behavioral Neuroscience
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    • "Secondly, empathy improves health outcomes.12–14 Patients with empathetic doctors have been shown to have fewer complications from diabetes,12,13 a shorter duration of symptoms with the common cold,14 and have reduced stress and anxiety with doctor visits.15,16 "
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    ABSTRACT: Background The literature indicates that medical practitioners experience declining empathy levels in clinical practice. This highlights the need to educate medical students about empathy as an attribute early in the academic curriculum. The objective of this study was to evaluate year one students’ self-reported empathy levels following a 2-hour empathy workshop at a large medical school in Malaysia. Methods Changes in empathy scores were examined using a paired repeated-measures t-test in this prospective before and after study. Results Analyzing the matched data, there was a statistically significant difference and moderate effect size between mean empathy scores before and 5 weeks after the workshop (112.08±10.67 versus 117.93±13.13, P<0.0001, d=0.48) using the Jefferson Scale Physician Empathy (Student Version). Conclusion The results of this observational study indicate improved mean self-reported empathy scores following an empathy workshop.
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