ABSTRACT
OBJECTIVE: The aim of this study was to assess whether burnout and empathy levels among general practitioners (GPs) might influence prescribing performance assessed using pharmaceutical prescription quality standard indicators. DESIGN AND SETTING: Cross-sectional descriptive study of 108 GPs from 22 primary care centers in Lleida, Spain, and of centralized data corresponding to 183 600 patients under their care. The study was conducted between May and July 2014. MAIN OUTCOME MEASURES: Burnout and empathy were measured using the Spanish versions of the Maslach Burnout Inventory and the Jefferson Scale for Physician Empathy, and prescribing quality was measured using the Catalan Pharmaceutical Prescription Quality Standard (EQPF). Normal distribution of scores was verified using the Chi-square and Kolmogorov-Smirnov-Lilliefors tests. The effect of each of the variables was evaluated using crude odds ratios. RESULTS: Older GPs scored significantly higher in the EQPF (P < 0.05). High empathy scores were positively associated with high EQPF scores. GPs with low burnout also performed better in the EQPF. CONCLUSIONS: More empathic, less burned-out, older GPs showed better prescribing performance according to quality indicators. However, further studies are needed to evaluate other factors influencing prescribing habits. The promotion of communication skills may increase empathy and reduce burnout, thus benefiting patients.
Subject(s)
Burnout, Psychological , Drug Prescriptions , General Practitioners/psychology , Physicians, Primary Care/psychology , Cross-Sectional Studies , Empathy , Female , Humans , Male , Middle Aged , Physician-Patient Relations , SpainABSTRACT
La práctica clínica de calidad no incluye tan solo la mejora de conocimientos en aspectos científicos y técnicos, sino también en la gestión de valores, la sensibilidad ética y las habilidades en la valoración y manejo de los conflictos éticos. La literatura revisada sugiere la existencia de la llamada «erosión ética», según la cual la competencia ética y la empatía disminuyen, o no progresan, durante la formación médica. La finalidad del presente estudio es determinar la relación entre estas variables: ética (razonamiento moral y sensibilidad ética) y empatía en un grupo de estudiantes de medicina, así como determinar la relación con otras variables como el curso académico y el género. Material y método: estudio observacional transversal realizado a 193 estudiantes de medicina de diferentes cursos. Se les administró un cuestionario sociodemográfico, escala de dilemas sociomorales de Rest, viñetas clínicas de medida de sensibilidad ética (Problem Identification Test) y el Test de empatía cognitiva y afectiva.Resultados: se halló una relación directa y significativa entre desarrollo moral, la sensibilidad ética y la mayor empatía. Se detectó un incremento de razonamiento moral y sensibilidad ética entre los alumnos de 1.° y 3.°, sin incremento entre 3.° y cursos superiores. No se encontraron diferencias significativas entre estas variables y el género. Conclusiones: en este estudio se ha hallado una correlación entre razonamiento moral, sensibilidad ética y empatía, así como una falta de progresión de las 2 primeras variables en los últimos cursos del grado de medicina
High-quality clinical practice includes not only improving clinicians' expertise in scientific and technical aspects but also managing values, ethical sensitivity and skills for assessing and dealing with ethical conflicts. The reviewed literature suggests the presence of an "ethical erosion", according to which ethical competence and empathy decrease or do not progress during medical training. The aim of this study was to determine the relationship between ethics (moral reasoning and ethical sensitivity) and empathy in a group of medical students and to determine the relationship with other variables such as academic year and sex. Material and method: a cross-sectional observational study was conducted with 193 medical students from different academic years, who were administered a sociodemographic questionnaire, the Rest sociomoral dilemma test, clinical vignettes to measure ethical sensitivity (Problem Identification Test [PIT]) and a cognitive and emotional empathy test (test de empatía cognitiva y afectiva, TECA). Results: we found a direct and significant relationship between moral development, ethical sensitivity and greater empathy. We detected an increase in moral reasoning and ethical sensitivity among first and third-year students, with no increase between the third year and later academic years. There were no significant differences between these variables and sex. Conclusions: this study found a correlation between moral reasoning, ethical sensitivity and empathy and a lack of progression of the first 2 variables in the last years of the medical degree
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Empathy , Moral Status , Humanization of Assistance , Education, Medical/trends , Ethics, Medical/education , Students, Medical/statistics & numerical data , Cross-Sectional Studies , Psychometrics/methodsABSTRACT
High-quality clinical practice includes not only improving clinicians' expertise in scientific and technical aspects but also managing values, ethical sensitivity and skills for assessing and dealing with ethical conflicts. The reviewed literature suggests the presence of an "ethical erosion", according to which ethical competence and empathy decrease or do not progress during medical training. The aim of this study was to determine the relationship between ethics (moral reasoning and ethical sensitivity) and empathy in a group of medical students and to determine the relationship with other variables such as academic year and sex. MATERIAL AND METHOD: A cross-sectional observational study was conducted with 193 medical students from different academic years, who were administered a sociodemographic questionnaire, the Rest sociomoral dilemma test, clinical vignettes to measure ethical sensitivity (Problem Identification Test [PIT]) and a cognitive and emotional empathy test (test de empatía cognitiva y afectiva, TECA). RESULTS: We found a direct and significant relationship between moral development, ethical sensitivity and greater empathy. We detected an increase in moral reasoning and ethical sensitivity among first and third-year students, with no increase between the third year and later academic years. There were no significant differences between these variables and sex. CONCLUSIONS: This study found a correlation between moral reasoning, ethical sensitivity and empathy and a lack of progression of the first 2 variables in the last years of the medical degree.
ABSTRACT
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