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Erschienen in: Journal of General Internal Medicine 2/2007

01.02.2007 | Original Article

How Do Distress and Well-being Relate to Medical Student Empathy? A Multicenter Study

verfasst von: Matthew R. Thomas, MD, Liselotte N. Dyrbye, MD, Jefrey L. Huntington, MPH, Karen L. Lawson, MD, Paul J. Novotny, MS, Jeff A. Sloan, PhD, Tait D. Shanafelt, MD

Erschienen in: Journal of General Internal Medicine | Ausgabe 2/2007

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Objective

To determine whether lower levels of empathy among a sample of medical students in the United States are associated with personal and professional distress and to explore whether a high degree of personal well-being is associated with higher levels of empathy.

Design

Multi-institutional, cross-sectional survey.

Setting

All medical schools in Minnesota (a private medical school, a traditional public university, and a public university with a focus in primary care).

Participants

A total of 1,098 medical students.

Measurements

Validated instruments were used to measure empathy, distress (i.e., burnout and symptoms of depression), and well-being (high quality of life).

Results

Medical student empathy scores were higher than normative samples of similarly aged individuals and were similar to other medical student samples. Domains of burnout inversely correlated with empathy (depersonalization with empathy independent of gender, all P < .02, and emotional exhaustion with emotive empathy for men, P = .009). Symptoms of depression inversely correlated with empathy for women (all P ≤ .01). In contrast, students’ sense of personal accomplishment demonstrated a positive correlation with empathy independent of gender (all P < .001). Similarly, achieving a high quality of life in specific domains correlated with higher empathy scores (P < .05). On multivariate analysis evaluating measures of distress and well-being simultaneously, both burnout (negative correlation) and well-being (positive correlation) independently correlated with student empathy scores.

Conclusions

Both distress and well-being are related to medical student empathy. Efforts to reduce student distress should be part of broader efforts to promote student well-being, which may enhance aspects of professionalism. Additional studies of student well-being and its potential influence on professionalism are needed.
Literatur
2.
Zurück zum Zitat Brownell AK, Cote L. Senior residents’ views on the meaning of professionalism and how they learn about it. Acad Med 2001;76(7):734–7.PubMed Brownell AK, Cote L. Senior residents’ views on the meaning of professionalism and how they learn about it. Acad Med 2001;76(7):734–7.PubMed
3.
Zurück zum Zitat Halpern J. What is clinical empathy? J Gen Intern Med 2003;18(8):670–4.PubMed Halpern J. What is clinical empathy? J Gen Intern Med 2003;18(8):670–4.PubMed
4.
Zurück zum Zitat Hojat M, Gonnella JS, Mangione S, et al. Empathy in medical students as related to academic performance, clinical competence and gender. Med Educ 2002;36(6):522–7.PubMed Hojat M, Gonnella JS, Mangione S, et al. Empathy in medical students as related to academic performance, clinical competence and gender. Med Educ 2002;36(6):522–7.PubMed
5.
Zurück zum Zitat The Medical School Objectives Writing Group. Learning objectives for medical student education-guidelines for medical schools: report I of the Medical School Objectives Project. Acad Med 1999;74(1):13–8. The Medical School Objectives Writing Group. Learning objectives for medical student education-guidelines for medical schools: report I of the Medical School Objectives Project. Acad Med 1999;74(1):13–8.
6.
Zurück zum Zitat Diseker RA, Michielutte R. An analysis of empathy in medical students before and following clinical experience. J Med Educ. 1981;56(12):1004–10.PubMed Diseker RA, Michielutte R. An analysis of empathy in medical students before and following clinical experience. J Med Educ. 1981;56(12):1004–10.PubMed
7.
Zurück zum Zitat Hojat M, Mangione S, Nasca TJ, et al. An empirical study of decline in empathy in medical school. Med Educ 2004;38(9):934–41.PubMed Hojat M, Mangione S, Nasca TJ, et al. An empirical study of decline in empathy in medical school. Med Educ 2004;38(9):934–41.PubMed
8.
Zurück zum Zitat Bellini LM, Shea JA. Mood change and empathy decline persist during three years of internal medicine training. Acad Med 2005;80(2):164–7.PubMed Bellini LM, Shea JA. Mood change and empathy decline persist during three years of internal medicine training. Acad Med 2005;80(2):164–7.PubMed
9.
Zurück zum Zitat Tutton PJ. Psychometric test results associated with high achievement in basic science components of a medical curriculum. Acad Med 1996;71(2):181–6.PubMed Tutton PJ. Psychometric test results associated with high achievement in basic science components of a medical curriculum. Acad Med 1996;71(2):181–6.PubMed
10.
Zurück zum Zitat McManus IC, Paice E, Keeling AA. Stress, burnout, and doctors’ attitudes to work are determined by personality and learning style: A twelve year longitudinal study of UK medical graduates. BMC Med 2004;2:29.PubMed McManus IC, Paice E, Keeling AA. Stress, burnout, and doctors’ attitudes to work are determined by personality and learning style: A twelve year longitudinal study of UK medical graduates. BMC Med 2004;2:29.PubMed
11.
Zurück zum Zitat Silver HK, Glicken AD. Medical student abuse. Incidence, severity, and significance [see comment]. JAMA 1990;263(4):527–32.PubMed Silver HK, Glicken AD. Medical student abuse. Incidence, severity, and significance [see comment]. JAMA 1990;263(4):527–32.PubMed
12.
Zurück zum Zitat Elnicki DM, Curry RH, Fagan M, et al. Medical students’ perspectives on and responses to abuse during the internal medicine clerkship. Teach Learn Med 2002;14(2):92–7.PubMed Elnicki DM, Curry RH, Fagan M, et al. Medical students’ perspectives on and responses to abuse during the internal medicine clerkship. Teach Learn Med 2002;14(2):92–7.PubMed
13.
Zurück zum Zitat Hafferty FW, Franks R. The hidden curriculum, ethics teaching, and the structure of medical education. Acad Med 1994;69(11):861–71.PubMed Hafferty FW, Franks R. The hidden curriculum, ethics teaching, and the structure of medical education. Acad Med 1994;69(11):861–71.PubMed
14.
Zurück zum Zitat Hafferty FW. Beyond curriculum reform: confronting medicine’s hidden curriculum. Acad Med 1998;73(4):403–7.PubMed Hafferty FW. Beyond curriculum reform: confronting medicine’s hidden curriculum. Acad Med 1998;73(4):403–7.PubMed
15.
Zurück zum Zitat Ramirez AJ, Graham J, Richards MA, Cull A, Gregory WM. Mental health of hospital consultants: the effects of stress and satisfaction at work [see comment]. Lancet 1996;347(9003):724–8.PubMed Ramirez AJ, Graham J, Richards MA, Cull A, Gregory WM. Mental health of hospital consultants: the effects of stress and satisfaction at work [see comment]. Lancet 1996;347(9003):724–8.PubMed
16.
Zurück zum Zitat Firth-Cozens J, Greenhalgh J. Doctors’ perceptions of the links between stress and lowered clinical care. Soc Sci Med 1997;44(7):1017–22.PubMed Firth-Cozens J, Greenhalgh J. Doctors’ perceptions of the links between stress and lowered clinical care. Soc Sci Med 1997;44(7):1017–22.PubMed
17.
Zurück zum Zitat Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med 2002;136(5):358–67.PubMed Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med 2002;136(5):358–67.PubMed
18.
Zurück zum Zitat Bellini LM, Baime M, Shea JA. Variation of mood and empathy during internship. JAMA 2002;287(23):3143–6.PubMed Bellini LM, Baime M, Shea JA. Variation of mood and empathy during internship. JAMA 2002;287(23):3143–6.PubMed
19.
Zurück zum Zitat Melville A. Job satisfaction in general practice: implications for prescribing. Soc Sci Med [Med Psychol Med Sociol] 1980;14A(6):495–9. Melville A. Job satisfaction in general practice: implications for prescribing. Soc Sci Med [Med Psychol Med Sociol] 1980;14A(6):495–9.
20.
Zurück zum Zitat DiMatteo MR, Sherbourne CD, Hays RD, et al. Physicians’ characteristics influence patients’ adherence to medical treatment: results from the Medical Outcomes Study. Health Psychol 1993;12(2):93–102.PubMed DiMatteo MR, Sherbourne CD, Hays RD, et al. Physicians’ characteristics influence patients’ adherence to medical treatment: results from the Medical Outcomes Study. Health Psychol 1993;12(2):93–102.PubMed
21.
Zurück zum Zitat Linn LS, Brook RH, Clark VA, Davies AR, Fink A, Kosecoff J. Physician and patient satisfaction as factors related to the organization of internal medicine group practices. Med Care 1985;23(10):1171–8.PubMed Linn LS, Brook RH, Clark VA, Davies AR, Fink A, Kosecoff J. Physician and patient satisfaction as factors related to the organization of internal medicine group practices. Med Care 1985;23(10):1171–8.PubMed
22.
Zurück zum Zitat Haas JS, Cook EF, Puopolo AL, Burstin HR, Cleary PD, Brennan TA. Is the professional satisfaction of general internists associated with patient satisfaction? J Gen Intern Med 2000;15(2):122–8.PubMed Haas JS, Cook EF, Puopolo AL, Burstin HR, Cleary PD, Brennan TA. Is the professional satisfaction of general internists associated with patient satisfaction? J Gen Intern Med 2000;15(2):122–8.PubMed
23.
Zurück zum Zitat Williams ES, Konrad TR, Scheckler WE, et al. Understanding physicians’ intentions to withdraw from practice: the role of job satisfaction, job stress, mental and physical health. Health Care Manage Rev 2001;26(1):7–19.PubMed Williams ES, Konrad TR, Scheckler WE, et al. Understanding physicians’ intentions to withdraw from practice: the role of job satisfaction, job stress, mental and physical health. Health Care Manage Rev 2001;26(1):7–19.PubMed
24.
Zurück zum Zitat Freeborn DK. Satisfaction, commitment, and psychological well-being among HMO physicians. West J Med 2001;174(1):13–8.PubMed Freeborn DK. Satisfaction, commitment, and psychological well-being among HMO physicians. West J Med 2001;174(1):13–8.PubMed
25.
Zurück zum Zitat Lichtenstein RL. The job satisfaction and retention of physicians in organized settings: a literature review. Med Care Rev 1984;41(3):139–79.PubMed Lichtenstein RL. The job satisfaction and retention of physicians in organized settings: a literature review. Med Care Rev 1984;41(3):139–79.PubMed
26.
Zurück zum Zitat Schmoldt RA, Freeborn DK, Klevit HD. Physician burnout: recommendations for HMO managers. HMO Pract 1994;8(2):58–63.PubMed Schmoldt RA, Freeborn DK, Klevit HD. Physician burnout: recommendations for HMO managers. HMO Pract 1994;8(2):58–63.PubMed
27.
Zurück zum Zitat Shanafelt TD, Sloan JA, Habermann TM. The well-being of physicians. Am J Med 2003;114(6):513–9.PubMed Shanafelt TD, Sloan JA, Habermann TM. The well-being of physicians. Am J Med 2003;114(6):513–9.PubMed
28.
Zurück zum Zitat Weiner EL, Swain GR, Wolf B, Gottlieb M. A qualitative study of physicians’ own wellness-promotion practices. West J Med 2001;174(1):19–23.PubMed Weiner EL, Swain GR, Wolf B, Gottlieb M. A qualitative study of physicians’ own wellness-promotion practices. West J Med 2001;174(1):19–23.PubMed
29.
Zurück zum Zitat Yamey G, Wilkes M. Promoting wellbeing among doctors. BMJ 2001;322(7281):252–3.PubMed Yamey G, Wilkes M. Promoting wellbeing among doctors. BMJ 2001;322(7281):252–3.PubMed
30.
Zurück zum Zitat Yiu V. Supporting the well-being of medical students. CMAJ 2005;172(7):889–90.PubMed Yiu V. Supporting the well-being of medical students. CMAJ 2005;172(7):889–90.PubMed
31.
Zurück zum Zitat Spilker B. Quality of life and pharmacoeconomics in clinical trials. New York: Lippincott-Raven; 1996. Spilker B. Quality of life and pharmacoeconomics in clinical trials. New York: Lippincott-Raven; 1996.
32.
Zurück zum Zitat Novack DH, Suchman AL, Clark W, Epstein RM, Najberg E, Kaplan C. Calibrating the physician. Personal awareness and effective patient care. Working Group on Promoting Physician Personal Awareness, American Academy on Physician and Patient [see comment]. JAMA 1997;278(6):502–9.PubMed Novack DH, Suchman AL, Clark W, Epstein RM, Najberg E, Kaplan C. Calibrating the physician. Personal awareness and effective patient care. Working Group on Promoting Physician Personal Awareness, American Academy on Physician and Patient [see comment]. JAMA 1997;278(6):502–9.PubMed
33.
Zurück zum Zitat Novack DH, Epstein RM, Paulsen RH. Toward creating physician-healers: fostering medical students’ self-awareness, personal growth, and well-being. Acad Med 1999;74(5):516–20.PubMed Novack DH, Epstein RM, Paulsen RH. Toward creating physician-healers: fostering medical students’ self-awareness, personal growth, and well-being. Acad Med 1999;74(5):516–20.PubMed
34.
Zurück zum Zitat Epstein RM. Mindful practice [see comment]. JAMA 1999;282(9):833–9.PubMed Epstein RM. Mindful practice [see comment]. JAMA 1999;282(9):833–9.PubMed
35.
Zurück zum Zitat Shanafelt TD, West C, Zhao X, et al. Relationship between increased personal well-being and enhanced empathy among internal medicine residents. J Gen Intern Med 2005;20(7):559–64.PubMed Shanafelt TD, West C, Zhao X, et al. Relationship between increased personal well-being and enhanced empathy among internal medicine residents. J Gen Intern Med 2005;20(7):559–64.PubMed
36.
Zurück zum Zitat Davis MH. A multidimensional approach to individual differences in empathy. Catalog of Selected Documents in Psychology 1980;10 MS. 2124: p 85. Davis MH. A multidimensional approach to individual differences in empathy. Catalog of Selected Documents in Psychology 1980;10 MS. 2124: p 85.
37.
Zurück zum Zitat Davis MH. Measuring individual differences in empathy: Evidence for a multidimensional approach. J Pers Soc Psychol 1983;44(1):113–126. Davis MH. Measuring individual differences in empathy: Evidence for a multidimensional approach. J Pers Soc Psychol 1983;44(1):113–126.
38.
Zurück zum Zitat Coman GJ, Evans BJ, Stanley RO. Scores on the Interpersonal Reactivity Index: a sample of Australian medical students. Psychol Rep. 1988;62(3):943–5.PubMed Coman GJ, Evans BJ, Stanley RO. Scores on the Interpersonal Reactivity Index: a sample of Australian medical students. Psychol Rep. 1988;62(3):943–5.PubMed
39.
Zurück zum Zitat Maslach C. Maslach Burnout Inventory Manual. Palo Alto, CA: Consulting Psychologists Press; 1986. Maslach C. Maslach Burnout Inventory Manual. Palo Alto, CA: Consulting Psychologists Press; 1986.
40.
Zurück zum Zitat Rafferty JP, Lemkau JP, Purdy RR, Rudisill JR. Validity of the Maslach Burnout Inventory for family practice physicians. J Clin Psychol 1986;42(3):488–92.PubMed Rafferty JP, Lemkau JP, Purdy RR, Rudisill JR. Validity of the Maslach Burnout Inventory for family practice physicians. J Clin Psychol 1986;42(3):488–92.PubMed
41.
Zurück zum Zitat Spitzer RL, Williams JB, Kroenke K, et al. Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA 1994;272(22):1749–56.PubMed Spitzer RL, Williams JB, Kroenke K, et al. Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA 1994;272(22):1749–56.PubMed
42.
Zurück zum Zitat Whooley MA, Avins AL, Miranda J, Browner WS. Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med 1997;12(7):439–45.PubMed Whooley MA, Avins AL, Miranda J, Browner WS. Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med 1997;12(7):439–45.PubMed
43.
Zurück zum Zitat Ware J, Kosinski M, Dewey J, Gandek B. How to score and interpret single-item health status measures: a manual for users of the SF-8 health survey. Lincoln, RI: QualityMetric Incorporated; 2001. Ware J, Kosinski M, Dewey J, Gandek B. How to score and interpret single-item health status measures: a manual for users of the SF-8 health survey. Lincoln, RI: QualityMetric Incorporated; 2001.
44.
Zurück zum Zitat Larson EB, Yao X. Clinical empathy as emotional labor in the patient–physician relationship. JAMA 2005;293(9):1100–6.PubMed Larson EB, Yao X. Clinical empathy as emotional labor in the patient–physician relationship. JAMA 2005;293(9):1100–6.PubMed
45.
Zurück zum Zitat Brock CD, Salinsky JV. Empathy: an essential skill for understanding the physician–patient relationship in clinical practice. Fam Med 1993;25(4):245–8.PubMed Brock CD, Salinsky JV. Empathy: an essential skill for understanding the physician–patient relationship in clinical practice. Fam Med 1993;25(4):245–8.PubMed
46.
Zurück zum Zitat Benbassat J, Baumal R. What is empathy, and how can it be promoted during clinical clerkships? Acad Med 2004;79(9):832–9.PubMed Benbassat J, Baumal R. What is empathy, and how can it be promoted during clinical clerkships? Acad Med 2004;79(9):832–9.PubMed
47.
Zurück zum Zitat Charon R. The patient–physician relationship. Narrative medicine: a model for empathy, reflection, profession, and trust. JAMA 2001;286(15):1897–902.PubMed Charon R. The patient–physician relationship. Narrative medicine: a model for empathy, reflection, profession, and trust. JAMA 2001;286(15):1897–902.PubMed
48.
Zurück zum Zitat Carmel S, Glick SM. Compassionate–empathic physicians: personality traits and social-organizational factors that enhance or inhibit this behavior pattern. Soc Sci Med 1996;43(8):1253–61.PubMed Carmel S, Glick SM. Compassionate–empathic physicians: personality traits and social-organizational factors that enhance or inhibit this behavior pattern. Soc Sci Med 1996;43(8):1253–61.PubMed
49.
Zurück zum Zitat Evans BJ, Stanley RO, Burrows GD. Measuring medical students’ empathy skills. Br J Med Psychol 1993;66(Pt 2):121–33.PubMed Evans BJ, Stanley RO, Burrows GD. Measuring medical students’ empathy skills. Br J Med Psychol 1993;66(Pt 2):121–33.PubMed
50.
Zurück zum Zitat Evans BJ, Stanley RO, Coman GJ, Burrows GD. Psychological tests to measure the effects of medical education on students’ interpersonal skills. Med Educ 1989;23(6):492–497.PubMed Evans BJ, Stanley RO, Coman GJ, Burrows GD. Psychological tests to measure the effects of medical education on students’ interpersonal skills. Med Educ 1989;23(6):492–497.PubMed
51.
Zurück zum Zitat Lee RT, Ashforth BE. A meta-analytic examination of the correlates of the three dimensions of job burnout. J Appl Psychol 1996;81(2):123–33.PubMed Lee RT, Ashforth BE. A meta-analytic examination of the correlates of the three dimensions of job burnout. J Appl Psychol 1996;81(2):123–33.PubMed
52.
Zurück zum Zitat Leiter MP, Durup J. The discriminant validity of burnout and depression: a confirmatory factor analytic study. Anxiety Stress Coping 1994;7:357–73. Leiter MP, Durup J. The discriminant validity of burnout and depression: a confirmatory factor analytic study. Anxiety Stress Coping 1994;7:357–73.
53.
Zurück zum Zitat Sloan JA, Loprinzi CL, Kuross SA, et al. Randomized comparison of four tools measuring overall quality of life in patients with advanced cancer. J Clin Oncol 1998;16(11):3662–73.PubMed Sloan JA, Loprinzi CL, Kuross SA, et al. Randomized comparison of four tools measuring overall quality of life in patients with advanced cancer. J Clin Oncol 1998;16(11):3662–73.PubMed
54.
Zurück zum Zitat Loprinzi CL, Kugler JW, Sloan JA, et al. Randomized comparison of megestrol acetate versus dexamethasone versus fluoxymesterone for the treatment of cancer anorexia/cachexia. J Clin Oncol 1999;17(10):3299–306.PubMed Loprinzi CL, Kugler JW, Sloan JA, et al. Randomized comparison of megestrol acetate versus dexamethasone versus fluoxymesterone for the treatment of cancer anorexia/cachexia. J Clin Oncol 1999;17(10):3299–306.PubMed
55.
Zurück zum Zitat Jatoi A, Yamashita J, Sloan JA, Novotny PJ, Windschitl HE, Loprinzi CL. Does megestrol acetate down-regulate interleukin-6 in patients with cancer-associated anorexia and weight loss? A North Central Cancer Treatment Group investigation [see comment]. Support Care Cancer 2002;10(1):71–5.PubMed Jatoi A, Yamashita J, Sloan JA, Novotny PJ, Windschitl HE, Loprinzi CL. Does megestrol acetate down-regulate interleukin-6 in patients with cancer-associated anorexia and weight loss? A North Central Cancer Treatment Group investigation [see comment]. Support Care Cancer 2002;10(1):71–5.PubMed
56.
Zurück zum Zitat Gill P, Kaur JS, Rummans T, Novotny PJ, Sloan JA. The hospice patient’s primary caregiver. What is their quality of life? J Psychosom Res 2003;55(5):445–51.PubMed Gill P, Kaur JS, Rummans T, Novotny PJ, Sloan JA. The hospice patient’s primary caregiver. What is their quality of life? J Psychosom Res 2003;55(5):445–51.PubMed
57.
Zurück zum Zitat Loprinzi L, Barton DL, Sloan JA, et al. Pilot evaluation of gabapentin for treating hot flashes [see comment]. Mayo Clin Proc 2002;77(11):1159–63.PubMed Loprinzi L, Barton DL, Sloan JA, et al. Pilot evaluation of gabapentin for treating hot flashes [see comment]. Mayo Clin Proc 2002;77(11):1159–63.PubMed
58.
Zurück zum Zitat Grunberg SM, Groshen S, Steingass S, Zaretsky S, Meyerowitz B. Comparison of conditional quality of life terminology and visual analogue scale measurements. Qual Life Res 1996;5(1):65–72.PubMed Grunberg SM, Groshen S, Steingass S, Zaretsky S, Meyerowitz B. Comparison of conditional quality of life terminology and visual analogue scale measurements. Qual Life Res 1996;5(1):65–72.PubMed
59.
Zurück zum Zitat Gudex C, Dolan P, Kind P, Williams A. Health state valuations from the general public using the visual analogue scale. Qual Life Res 1996;5(6):521–31.PubMed Gudex C, Dolan P, Kind P, Williams A. Health state valuations from the general public using the visual analogue scale. Qual Life Res 1996;5(6):521–31.PubMed
60.
Zurück zum Zitat Hyland ME, Sodergren SC. Development of a new type of global quality of life scale, and comparison of performance and preference for 12 global scales. Qual Life Res 1996;5(5):469–80.PubMed Hyland ME, Sodergren SC. Development of a new type of global quality of life scale, and comparison of performance and preference for 12 global scales. Qual Life Res 1996;5(5):469–80.PubMed
61.
Zurück zum Zitat Sriwatanakul K, Kelvie W, Lasagna L, Calimlim JF, Weis OF, Mehta G. Studies with different types of visual analog scales for measurement of pain. Clin Pharmacol Ther 1983;34(2):234–9.PubMedCrossRef Sriwatanakul K, Kelvie W, Lasagna L, Calimlim JF, Weis OF, Mehta G. Studies with different types of visual analog scales for measurement of pain. Clin Pharmacol Ther 1983;34(2):234–9.PubMedCrossRef
62.
Zurück zum Zitat Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena [see comment]. Res Nurs Health 1990;13(4):227–36.PubMed Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena [see comment]. Res Nurs Health 1990;13(4):227–36.PubMed
63.
Zurück zum Zitat Shanafelt TD, Novotny P, Johnson ME, et al. The well-being and personal wellness promotion strategies of medical oncologists in the North Central Cancer Treatment Group. Oncology 2005;68(1):23–32.PubMed Shanafelt TD, Novotny P, Johnson ME, et al. The well-being and personal wellness promotion strategies of medical oncologists in the North Central Cancer Treatment Group. Oncology 2005;68(1):23–32.PubMed
64.
Zurück zum Zitat Armitage P. Tests for linear trend in proportions and frequencies. Biometrics 1955;11:375–386. Armitage P. Tests for linear trend in proportions and frequencies. Biometrics 1955;11:375–386.
65.
Zurück zum Zitat Dyrbye LN, Thomas MR, Shanafelt TD, et al. Personal life events and medical student burnout: a multicenter study. Acad Med 2006;81(4):374–84.PubMed Dyrbye LN, Thomas MR, Shanafelt TD, et al. Personal life events and medical student burnout: a multicenter study. Acad Med 2006;81(4):374–84.PubMed
66.
Zurück zum Zitat Newton BW, Savidge MA, Barber L, et al. Differences in medical students’ empathy. Acad Med. 2000;75(12):1215.PubMed Newton BW, Savidge MA, Barber L, et al. Differences in medical students’ empathy. Acad Med. 2000;75(12):1215.PubMed
67.
Zurück zum Zitat Crandall SJ, Volk RJ, Loemker V. Medical students’ attitudes toward providing care for the underserved. Are we training socially responsible physicians? JAMA 1993;269(19):2519–23.PubMed Crandall SJ, Volk RJ, Loemker V. Medical students’ attitudes toward providing care for the underserved. Are we training socially responsible physicians? JAMA 1993;269(19):2519–23.PubMed
68.
Zurück zum Zitat Woloschuk W, Harasym PH, Temple W. Attitude change during medical school: a cohort study. Med Educ 2004;38(5):522–34.PubMed Woloschuk W, Harasym PH, Temple W. Attitude change during medical school: a cohort study. Med Educ 2004;38(5):522–34.PubMed
69.
Zurück zum Zitat Patenaude J, Niyonsenga T, Fafard D. Changes in students’ moral development during medical school: a cohort study [see comment]. CMAJ 2003;168(7):840–4.PubMed Patenaude J, Niyonsenga T, Fafard D. Changes in students’ moral development during medical school: a cohort study [see comment]. CMAJ 2003;168(7):840–4.PubMed
70.
Zurück zum Zitat McCue JD. The effects of stress on physicians and their medical practice. N Engl J Med 1982;306(8):458–63.PubMedCrossRef McCue JD. The effects of stress on physicians and their medical practice. N Engl J Med 1982;306(8):458–63.PubMedCrossRef
71.
Zurück zum Zitat Melville A. Job satisfaction in general practice: implications for prescribing. Soc Sci Med 1980;14A:495–499. Melville A. Job satisfaction in general practice: implications for prescribing. Soc Sci Med 1980;14A:495–499.
72.
Zurück zum Zitat Firth-Cozens J. Emotional distress in junior house officers. Br Med J (Clin Res Ed) 1987;295(6597):533–6. Firth-Cozens J. Emotional distress in junior house officers. Br Med J (Clin Res Ed) 1987;295(6597):533–6.
73.
Zurück zum Zitat Firth-Cozens J. Interventions to improve physicians’ well-being and patient care. Soc Sci Med 2001;52:215–222.PubMed Firth-Cozens J. Interventions to improve physicians’ well-being and patient care. Soc Sci Med 2001;52:215–222.PubMed
74.
Zurück zum Zitat Purdy RR, Lemkau JP, Rafferty JP, Rudisill JR. Resident physicians in family practice: who’s burned out and who knows? Fam Med 1987;19(3):203–8.PubMed Purdy RR, Lemkau JP, Rafferty JP, Rudisill JR. Resident physicians in family practice: who’s burned out and who knows? Fam Med 1987;19(3):203–8.PubMed
75.
Zurück zum Zitat Whippen DA, Canellos GP. Burnout syndrome in the practice of oncology: results of a random survey of 1,000 oncologists. J Clin Oncol 1991;9(10):1916–20.PubMed Whippen DA, Canellos GP. Burnout syndrome in the practice of oncology: results of a random survey of 1,000 oncologists. J Clin Oncol 1991;9(10):1916–20.PubMed
76.
Zurück zum Zitat Lemkau J, Rafferty J, Gordon R, Jr. Burnout and career-choice regret among family practice physicians in early practice. Fam Pract Res J 1994;14(3):213–22.PubMed Lemkau J, Rafferty J, Gordon R, Jr. Burnout and career-choice regret among family practice physicians in early practice. Fam Pract Res J 1994;14(3):213–22.PubMed
77.
Zurück zum Zitat Whitley TW, Allison EJ, Jr., Gallery ME, et al. Work-related stress and depression among practicing emergency physicians: an international study. Ann Emerg Med 1994;23(5):1068–71.PubMed Whitley TW, Allison EJ, Jr., Gallery ME, et al. Work-related stress and depression among practicing emergency physicians: an international study. Ann Emerg Med 1994;23(5):1068–71.PubMed
78.
Zurück zum Zitat Ramirez AJ, Graham J, Richards MA, et al. Burnout and psychiatric disorder among cancer clinicians [see comment]. Br J Cancer. 1995;71(6):1263–9.PubMed Ramirez AJ, Graham J, Richards MA, et al. Burnout and psychiatric disorder among cancer clinicians [see comment]. Br J Cancer. 1995;71(6):1263–9.PubMed
79.
Zurück zum Zitat Campbell DA, Jr., Sonnad SS, Eckhauser FE, Campbell KK, Greenfield LJ. Burnout among American surgeons. Surgery 2001;130(4):696–702; discussion 702–5. Campbell DA, Jr., Sonnad SS, Eckhauser FE, Campbell KK, Greenfield LJ. Burnout among American surgeons. Surgery 2001;130(4):696–702; discussion 702–5.
80.
Zurück zum Zitat Guthrie E, Black D, Bagalkote H, Shaw C, Campbell M, Creed F. Psychological stress and burnout in medical students: a five-year prospective longitudinal study. J R Soc Med 1998;91(5):237–43.PubMed Guthrie E, Black D, Bagalkote H, Shaw C, Campbell M, Creed F. Psychological stress and burnout in medical students: a five-year prospective longitudinal study. J R Soc Med 1998;91(5):237–43.PubMed
81.
Zurück zum Zitat Daly MG, Willcock SM. Examining stress and responses to stress in medical students and new medical graduates. Med J Aust. 2002;177(suppl):S14–5.PubMed Daly MG, Willcock SM. Examining stress and responses to stress in medical students and new medical graduates. Med J Aust. 2002;177(suppl):S14–5.PubMed
82.
Zurück zum Zitat Dyrbye LN, Thomas MR, Shanafelt TD. Medical student distress: causes, consequences, and proposed solutions. Mayo Clin Proc 2005;80(12):1613–1622.PubMedCrossRef Dyrbye LN, Thomas MR, Shanafelt TD. Medical student distress: causes, consequences, and proposed solutions. Mayo Clin Proc 2005;80(12):1613–1622.PubMedCrossRef
83.
Zurück zum Zitat Collier VU, McCue JD, Markus A, Smith L. Stress in medical residency: status quo after a decade of reform? Ann Intern Med 2002;136(5):384–90.PubMed Collier VU, McCue JD, Markus A, Smith L. Stress in medical residency: status quo after a decade of reform? Ann Intern Med 2002;136(5):384–90.PubMed
84.
Zurück zum Zitat Stress and impairment during residency training: strategies for reduction, identification, and management. Resident Services Committee, Association of Program Directors in Internal Medicine. Ann Intern Med 1988;109(2):154–61. Stress and impairment during residency training: strategies for reduction, identification, and management. Resident Services Committee, Association of Program Directors in Internal Medicine. Ann Intern Med 1988;109(2):154–61.
85.
Zurück zum Zitat Linzer M, Konrad TR, Douglas J, et al. Managed care, time pressure, and physician job satisfaction: results from the physician worklife study [see comment]. J Gen Intern Med 2000;15(7):441–50.PubMed Linzer M, Konrad TR, Douglas J, et al. Managed care, time pressure, and physician job satisfaction: results from the physician worklife study [see comment]. J Gen Intern Med 2000;15(7):441–50.PubMed
86.
Zurück zum Zitat Frank E, McMurray JE, Linzer M, Elon L. Career satisfaction of US women physicians: results from the Women Physicians’ Health Study. Society of General Internal Medicine Career Satisfaction Study Group. Arch Intern Med 1999;159(13):1417–26.PubMed Frank E, McMurray JE, Linzer M, Elon L. Career satisfaction of US women physicians: results from the Women Physicians’ Health Study. Society of General Internal Medicine Career Satisfaction Study Group. Arch Intern Med 1999;159(13):1417–26.PubMed
87.
Zurück zum Zitat Stoddard JJ, Hargraves JL, Reed M, Vratil A. Managed care, professional autonomy, and income: effects on physician career satisfaction. J Gen Intern Med 2001;16(10):675–84.PubMed Stoddard JJ, Hargraves JL, Reed M, Vratil A. Managed care, professional autonomy, and income: effects on physician career satisfaction. J Gen Intern Med 2001;16(10):675–84.PubMed
88.
Zurück zum Zitat Catalan J, Burgess A, Pergami A, Hulme N, Gazzard B, Phillips R. The psychological impact on staff of caring for people with serious diseases: the case of HIV infection and oncology. J Psychosom Res 1996;40(4):425–35.PubMed Catalan J, Burgess A, Pergami A, Hulme N, Gazzard B, Phillips R. The psychological impact on staff of caring for people with serious diseases: the case of HIV infection and oncology. J Psychosom Res 1996;40(4):425–35.PubMed
89.
Zurück zum Zitat Meier DE, Back AL, Morrison RS. The inner life of physicians and care of the seriously ill. JAMA 2001;286(23):3007–14.PubMed Meier DE, Back AL, Morrison RS. The inner life of physicians and care of the seriously ill. JAMA 2001;286(23):3007–14.PubMed
90.
Zurück zum Zitat Myers DG. The funds, friends, and faith of happy people. Am Psychol. 2000;55(1):56–67.PubMed Myers DG. The funds, friends, and faith of happy people. Am Psychol. 2000;55(1):56–67.PubMed
91.
Zurück zum Zitat Quill TE, Williamson PR. Healthy approaches to physician stress. Arch Intern Med 1990;150(9):1857–61.PubMed Quill TE, Williamson PR. Healthy approaches to physician stress. Arch Intern Med 1990;150(9):1857–61.PubMed
92.
Zurück zum Zitat Shanafelt TD. Finding meaning, balance, and personal satisfaction in the practice of oncology. J Support Oncol 2005;3(2):157–62, 164. Shanafelt TD. Finding meaning, balance, and personal satisfaction in the practice of oncology. J Support Oncol 2005;3(2):157–62, 164.
93.
Zurück zum Zitat Rabow MW, McPhee SJ. Doctoring to heal: fostering well-being among physicians through personal reflection. West J Med 2001;174(1):66–9.PubMed Rabow MW, McPhee SJ. Doctoring to heal: fostering well-being among physicians through personal reflection. West J Med 2001;174(1):66–9.PubMed
94.
Zurück zum Zitat Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol 1997;50(10):1129–36.PubMed Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol 1997;50(10):1129–36.PubMed
95.
Zurück zum Zitat Kellerman SE, Herold J. Physician response to surveys. A review of the literature. Am J Prev Med 2001;20(1):61–7.PubMed Kellerman SE, Herold J. Physician response to surveys. A review of the literature. Am J Prev Med 2001;20(1):61–7.PubMed
96.
Zurück zum Zitat Clark DC, Eckenfels EJ, Daugherty SR, Fawcett J. Alcohol-use patterns through medical school. A longitudinal study of one class. JAMA 1987;257(21):2921–6.PubMed Clark DC, Eckenfels EJ, Daugherty SR, Fawcett J. Alcohol-use patterns through medical school. A longitudinal study of one class. JAMA 1987;257(21):2921–6.PubMed
97.
Zurück zum Zitat Mangus RS, Hawkins CE, Miller MJ. Tobacco and alcohol use among 1996 medical school graduates. JAMA 1998;280(13):1192–3, 1195. Mangus RS, Hawkins CE, Miller MJ. Tobacco and alcohol use among 1996 medical school graduates. JAMA 1998;280(13):1192–3, 1195.
98.
Zurück zum Zitat Clark DC, Daugherty SR, Zeldow PB, Gotterer GS, Hedeker D. The relationship between academic performance and severity of depressed mood during medical school. Compr Psychiatry 1988;29(4):409–20.PubMed Clark DC, Daugherty SR, Zeldow PB, Gotterer GS, Hedeker D. The relationship between academic performance and severity of depressed mood during medical school. Compr Psychiatry 1988;29(4):409–20.PubMed
99.
Zurück zum Zitat Ball S, Bax A. Self-care in medical education: effectiveness of health-habits interventions for first-year medical students. Acad Med 2002;77(9):911–7.PubMed Ball S, Bax A. Self-care in medical education: effectiveness of health-habits interventions for first-year medical students. Acad Med 2002;77(9):911–7.PubMed
100.
Zurück zum Zitat Rosal MC, Ockene IS, Ockene JK, Barrett SV, Ma Y, Hebert JR. A longitudinal study of students’ depression at one medical school. Acad Med 1997;72(6):542–6.PubMed Rosal MC, Ockene IS, Ockene JK, Barrett SV, Ma Y, Hebert JR. A longitudinal study of students’ depression at one medical school. Acad Med 1997;72(6):542–6.PubMed
101.
Zurück zum Zitat Winefield HR, Chur-Hansen A. Evaluating the outcome of communication skill teaching for entry-level medical students: does knowledge of empathy increase? Med Educ 2000;34(2):90–4.PubMed Winefield HR, Chur-Hansen A. Evaluating the outcome of communication skill teaching for entry-level medical students: does knowledge of empathy increase? Med Educ 2000;34(2):90–4.PubMed
102.
Zurück zum Zitat Kopelman LM. Values and virtues: how should they be taught? Acad Med 1999;74(12):1307–10.PubMed Kopelman LM. Values and virtues: how should they be taught? Acad Med 1999;74(12):1307–10.PubMed
103.
Zurück zum Zitat Spiro H. What is empathy and can it be taught? Ann Intern Med 1992;116(10):843–6.PubMed Spiro H. What is empathy and can it be taught? Ann Intern Med 1992;116(10):843–6.PubMed
104.
Zurück zum Zitat More ES. Empathy as a hermeneutic practice. Theor Med 1996;17:243–254.PubMed More ES. Empathy as a hermeneutic practice. Theor Med 1996;17:243–254.PubMed
105.
Zurück zum Zitat Branch WT, Jr. Supporting the moral development of medical students. J Gen Intern Med 2000;15(7):503–8.PubMed Branch WT, Jr. Supporting the moral development of medical students. J Gen Intern Med 2000;15(7):503–8.PubMed
106.
Zurück zum Zitat DiLalla LF, Hull SK, Dorsey JK. Effect of gender, age, and relevant course work on attitudes toward empathy, patient spirituality, and physician wellness. Teach Learn Med 2004;16(2):165–70.PubMed DiLalla LF, Hull SK, Dorsey JK. Effect of gender, age, and relevant course work on attitudes toward empathy, patient spirituality, and physician wellness. Teach Learn Med 2004;16(2):165–70.PubMed
107.
Zurück zum Zitat Kopelman LM. Philosophy and medical education. Acad Med 1995;70(9):795–805.PubMed Kopelman LM. Philosophy and medical education. Acad Med 1995;70(9):795–805.PubMed
108.
Zurück zum Zitat Roter DL, Stewart M, Putnam SM, Lipkin M, Jr., Stiles W, Inui TS. Communication patterns of primary care physicians. JAMA 1997;277(4):350–6.PubMed Roter DL, Stewart M, Putnam SM, Lipkin M, Jr., Stiles W, Inui TS. Communication patterns of primary care physicians. JAMA 1997;277(4):350–6.PubMed
109.
Zurück zum Zitat Hornblow AR, Kidson MA, Jones KV. Measuring medical students’ empathy: a validation study. Med Educ 1977;11(1):7–12.PubMed Hornblow AR, Kidson MA, Jones KV. Measuring medical students’ empathy: a validation study. Med Educ 1977;11(1):7–12.PubMed
110.
Zurück zum Zitat Nightingale SD, Yarnold PR, Greenberg MS. Sympathy, empathy, and physician resource utilization. J Gen Intern Med 1991;6(5):420–3. Nightingale SD, Yarnold PR, Greenberg MS. Sympathy, empathy, and physician resource utilization. J Gen Intern Med 1991;6(5):420–3.
111.
Zurück zum Zitat 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.PubMedCrossRef 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.PubMedCrossRef
112.
Zurück zum Zitat Oswald PA. Does the interpersonal Reactivity Index Perspective-taking scale predict who will volunteer time to counsel adults entering college? Percept Mot Skills 2003;97(3 Pt 2):1184–6.PubMed Oswald PA. Does the interpersonal Reactivity Index Perspective-taking scale predict who will volunteer time to counsel adults entering college? Percept Mot Skills 2003;97(3 Pt 2):1184–6.PubMed
Metadaten
Titel
How Do Distress and Well-being Relate to Medical Student Empathy? A Multicenter Study
verfasst von
Matthew R. Thomas, MD
Liselotte N. Dyrbye, MD
Jefrey L. Huntington, MPH
Karen L. Lawson, MD
Paul J. Novotny, MS
Jeff A. Sloan, PhD
Tait D. Shanafelt, MD
Publikationsdatum
01.02.2007
Verlag
Springer-Verlag
Erschienen in
Journal of General Internal Medicine / Ausgabe 2/2007
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-006-0039-6

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