Practitioner empathy and the duration of the common cold.
Fam Med. 2009 Jul-Aug;41(7):494-501. PMID: 19582635
David P Rakel, Theresa J Hoeft, Bruce P Barrett, Betty A Chewning, Benjamin M Craig, Min Niu
OBJECTIVE: This study's objective was to assess the relationship of empathy in medical office visits to subsequent outcomes of the common cold.
METHODS: 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).
RESULTS: 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.
CONCLUSIONS: 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.
Article Published Date : Jul 01, 2009
Induction of empathy by the smell of anxiety.
PLoS One. 2009;4(6):e5987. Epub 2009 Jun 24. PMID: 19551135
Alexander Prehn-Kristensen, Christian Wiesner, Til Ole Bergmann, Stephan Wolff, Olav Jansen, Hubertus Maximilian Mehdorn, Roman Ferstl, Bettina M Pause
Center of Integrative Psychiatry, University of Kiel, Kiel, Germany.
The communication of stress/anxiety between conspecifics through chemosensory signals has been documented in many vertebrates and invertebrates. Here, we investigate how chemosensory anxiety signals conveyed by the sweat of humans (N = 49) awaiting an academic examination are processed by the human brain, as compared to chemosensory control signals obtained from the same sweat donors in a sport condition. The chemosensory stimuli were pooled according to the donation condition and administered to 28 participants (14 males) synchronously to breathing via an olfactometer. The stimuli were perceived with a low intensity and accordingly only about half of the odor presentations were detected by the participants. The fMRI results (event-related design) show that chemosensory anxiety signals activate brain areas involved in the processing of social emotional stimuli (fusiform gyrus), and in the regulation of empathic feelings (insula, precuneus, cingulate cortex). In addition, neuronal activity within attentional (thalamus, dorsomedial prefrontal cortex) and emotional (cerebellum, vermis) control systems were observed. The chemosensory perception of human anxiety seems to automatically recruit empathy-related resources. Even though the participants could not attentively differentiate the chemosensory stimuli, emotional contagion seems to be effectively mediated by the olfactory system.
Article Published Date : Jan 01, 2009
Emotional Recognition and Empathy both in Deaf and Blind Adults.
J Deaf Stud Deaf Educ. 2019 Jan 21;:
Authors: Martins AT, Faísca L, Vieira H, Gonçalves G
Studies addressing the recognition of emotions in blind or deaf participants have been carried out only with children and adolescents. Due to these age limits, such studies do not clarify the long-term effects of vision and hearing disabilities on emotion recognition in adults. We assessed the ability to recognize basic emotions in 15 deaf adults (aged 32.4 ± 8.1 yrs) and in 15 blind adults (48.3 ± 10.5 yrs). Auditory and visual stimuli expressing six basic emotional states were presented to participants (Florida Affect Battery). Participants also performed an empathy test. Deaf participants showed difficulties in emotion recognition tasks compared to the typical hearing participants; however, differences were only statistically reliable for Facial Emotion Discrimination and Naming tasks (specifically, naming expressions of fear). Deaf participants also revealed inferior levels of cognitive empathy. Concerning blind participants, their performance was lower than the controls' only when the task required the evaluation of emotional prosody while ignoring the semantic content of the sentence. Overall, although deaf and blind participants performed reasonably well on tasks requiring recognition of basic emotions, sensory loss may hinder their social perception skills when processing subtle emotions or when the extraction of simultaneous prosodic and semantic information is required.
PMID: 30668877 [PubMed - as supplied by publisher]
Preliminary Validation of the Interpersonal Dysphoria Model of Borderline Personality Disorder.
Psychopathology. 2019 Jan 21;:1-10
Authors: D Apos Agostino A, Aportone A, Petrini M, Manganelli E, Rossi Monti M, Starcevic V
BACKGROUND: Borderline personality disorder (BPD) is one of the most puzzling psychiatric disorders. In order to improve its understanding and management, we have recently proposed an interpersonal dysphoria model that emphasizes the key role of the complex emotional state of dysphoria in BPD. The purpose of this study was to test the interpersonal dysphoria model using a structural equation modeling analysis.
SAMPLING AND METHODS: The sample consisted of 105 patients with BPD and 105 healthy controls. A total of five self-report instruments and three semistructured interviews were administered to the participants.
RESULTS: The best-fitting structural model fit the data well in the BPD sample. Background dysphoria and negative interpersonal disposition were significant predictors of situational dysphoria, which in turn was a significant predictor of various symptoms of BPD. This model differs from the originally proposed one in terms of impaired empathy not being a component of negative interpersonal disposition and organizing and disorganizing BPD symptoms being replaced by interpersonal (abandonment fears, angry outbursts, and stormy relations) and affective (affective shifts and emptiness) symptoms.
CONCLUSIONS: Although some revision was needed, the findings provide support to the proposed model, which needs to be further tested in a larger sample of individuals with BPD.
PMID: 30665228 [PubMed - as supplied by publisher]
Demographic and spatial trends in diabetes-related virtual nursing examinations.
Soc Sci Med. 2019 Jan 03;222:225-230
Authors: Schultze SR, Mujica FC, Kleinheksel AJ
Diabetes currently affects nearly 30 million Americans, but the distribution of cases is not uniform across all demographics or every state. In the course of their education, nurses learn how to become important conduits for information on diabetes management during their eventual interactions with patients. Exploring the status and trends of diabetes-related knowledge in nursing students is one method to explore the idea that one's community affects how one sees disease. However, they are not yet experts, which places them in a period of transition. This study used data mined from the Shadow Health Digital Clinical Experience™ virtual patient exams conducted by nursing students between the years of 2012 and 2015 to find any potential demographic or spatial trends within simulation performance results from nursing students who examined a virtual patient with self-managed diabetes. Findings of the analysis indicated that age and experience affected the way in which an examination was conducted, where older and more experienced nursing students asked 8% fewer examination questions, yet showed 32% more empathy and offered 76% more educational statements than their younger counterparts. Spatial trends were less pronounced, although deeper analysis revealed that students in states closer to the national mean for population rate with diabetes perform better, show more empathy, and offer more educational statements during examinations compared to states well above or well below the national mean. This suggests that targeted information may be preferable to "one-size-fits-all" public health awareness and education programs for diabetes programs used uniformly across the country.
PMID: 30665062 [PubMed - as supplied by publisher]
Factors for Supporting Primary Care Physician Engagement With Patient Apps for Type 2 Diabetes Self-Management That Link to Primary Care: Interview Study.
JMIR Mhealth Uhealth. 2019 Jan 16;7(1):e11885
Authors: Ayre J, Bonner C, Bramwell S, McClelland S, Jayaballa R, Maberly G, McCaffery K
BACKGROUND: The health burden of type 2 diabetes can be mitigated by engaging patients in two key aspects of diabetes care: self-management and regular contact with health professionals. There is a clear benefit to integrating these aspects of care into a single clinical tool, and as mobile phone ownership increases, apps become a more feasible platform. However, the effectiveness of online health interventions is contingent on uptake by health care providers, which is typically low. There has been little research that focuses specifically on barriers and facilitators to health care provider uptake for interventions that link self-management apps to the user's primary care physician (PCP).
OBJECTIVE: This study aimed to explore PCP perspectives on proposed features for a self-management app for patients with diabetes that would link to primary care services.
METHODS: Researchers conducted 25 semistructured interviews. The interviewer discussed potential features that would link in with the patient's primary care services. Interviews were audio-recorded, transcribed, and coded. Framework analysis and the Consolidated Criteria for Reporting Qualitative Research checklist were employed to ensure rigor.
RESULTS: Our analysis indicated that PCP attitudes toward proposed features for an app were underpinned by perceived roles of (1) diabetes self-management, (2) face-to-face care, and (3) the anticipated burden of new technologies on their practice. Theme 1 explored PCP perceptions about how an app could foster patient independence for self-management behaviors but could also increase responsibility and liability for the PCP. Theme 2 identified beliefs underpinning a commonly expressed preference for face-to-face care. PCPs perceived information was more motivating, better understood, and presented with greater empathy when delivered face to face rather than online. Theme 3 described how most PCPs anticipated an initial increase in workload while they learned to use a new clinical tool. Some PCPs accepted this burden on the basis that the change was inevitable as health care became more integrated. Others reported potential benefits were outweighed by effort to implement an app. This study also identified how app features can be positively framed, highlighting potential benefits for PCPs to maximize PCP engagement, buy-in, and uptake. For example, PCPs were more positive when they perceived that an app could facilitate communication and motivation between consultations, focus on building capacity for patient independence, and reinforce rather than replace in-person care. They were also more positive about app features that were automated, integrated with existing software, flexible for different patients, and included secondary benefits such as improved documentation.
CONCLUSIONS: This study provided insight into PCP perspectives on a diabetes app integrated with primary care services. This was observed as more than a technological change; PCPs were concerned about changes in workload, their role in self-management, and the nature of consultations. Our research highlighted potential facilitators and barriers to engaging PCPs in the implementation process.
PMID: 30664468 [PubMed]