Emilie Boujut

To be or not to be empathic: the combined role of empathic concern and perspective taking in understanding burnout in general practice.

BackgroundGeneral practice is stressful and burnout is common among family physicians. A growing body of evidence suggests that the way physicians relate to their patients could be linked to burnout. The goal of this study was to examine how patterns of empathy explained physicians’ burnout.MethodsWe surveyed 294 French general practitioners (response rate 39%), measured burnout, empathic concern (EC) and perspective taking (PT) using self-reported questionnaires, and modeled burnout levels and frequencies with EC, PT and their interaction in linear and logistic regression analyses.ResultsMultivariate linear models for burnout prediction were associated with lower PT (β = −0.21, p < 0.001) and lower EC (β = −0.17, p < 0.05). Interestingly, the interaction (EC x PT) also predicted burnout levels (β = 0.11, p < 0.05). The investigation of interactions revealed that high scores on PT predicted lower levels of burnout independent from EC (odd ratios (OR) 0.37; 95% confidence interval (95% CI) 0.21–0.65 p < 0.001), and high scores on both EC and PT were protective against burnout: OR 0.31; 95% CI 0.15–0.63, p < 0.001).ConclusionsDeficits in PT alone might be a risk factor for burnout, whereas higher PT and EC might be protective. Educators should take into account how the various components of empathy are potentially associated with emotional outcomes in physicians.

Burnout and empathy in primary care: three hypotheses

In the last 10 years, a growing literature about empathy in primary care indicates that, for both patient and clinician, empathy helps to improve many aspects of health care practice and patient satisfaction. Wensing et al 1 indicated that humaneness, exploring the needs of patients, and good communication skills are some of the high priorities that patients expect from their GP. Cape et al 2 showed that doctor empathy coded by external observers was positively correlated with listening interactions and patient involvement. Vedsted and Heje3 found that patients tended to recommend their GP to others if they judged them as ‘empathic’. Mercer et al 4 showed a positive relationship both between GP empathy and patient enablement at the consultation, and between patient enablement and changes in the main symptom and well-being evaluated 3 months after the consultation. Finally, Verheul et al 5 investigated the impact of a warm and empathic consultation compared to a cold and formal consultation on the certainty of the outcome. The greatest beneficial effects of empathic communication on stress reduction and expectancies were observed when it was combined with a positive expectations style. To preserve effective empathy in care, the health provider must be in a positive frame of mind and not affected by stress or burnout. Burnout occurs when individuals feel emotionally overwhelmed by the …

Empathic concern and professional characteristics associated with clinical empathy in French general practitioners

ABSTRACT Objective: Clinical empathy, i.e. the ability of physicians to adopt patient perspective, is an essential component of care, which depends in part on empathic concern, i.e. compassionate emotions felt for others. However, too much empathic concern can be challenging for physicians. Aim of this study was to examine physician practice characteristics that could explain clinical empathy beyond empathic concern. We were also interested in testing whether professional reflective activities, such as Balint group attendance or clinical supervision, might make clinical empathy less dependent on empathic concern. Methods: A total of 295 French general practitioners (response rate of 37%) completed self-reported questionnaires on empathic concern and clinical empathy, using the Toronto empathy questionnaire (TEQ) and the Jefferson scale of physician empathy (JSPE), respectively. We also recorded information on their professional practice: professional experience, duration of consultations, and participation in Balint groups or being a clinical supervisor. Hierarchical regression analyses were carried out with clinical empathy as dependent variable. Results: Empathic concern was an important component of clinical empathy variance. The physician practice characteristics ‘consultation length’ and ‘being a Balint attendee or a supervisor,’ but not ‘clinical experience’ made a significant and unique contribution to clinical empathy beyond that of empathic concern. Participating to one reflective activity (either Balint group attendance or clinical supervision) made clinical empathy less dependent on empathic concern. Conclusion: Working conditions such as having enough consultation time and having the opportunity to attend a professional reflective activity support the maintenance of clinical empathy without the burden of too much empathic concern.

The effects of mindfulness training on weight-loss and health-related behaviours in adults with overweight and obesity: A systematic review and meta-analysis.

The aim of this study was to conduct a comprehensive quantitative synthesis of the effects of mindfulness training interventions on weight-loss and health behaviours in adults with overweight and obesity using meta-analytic techniques. Studies included in the analysis (k=12) were randomised controlled trials investigating the effects of any form of mindfulness training on weight loss, impulsive eating, binge eating, or physical activity participation in adults with overweight and obesity. Random effects meta-analysis revealed that mindfulness training had no significant effect on weight loss, but an overall negative effect on impulsive eating (d=-1.13) and binge eating (d=-.90), and a positive effect on physical activity levels (d=.42). Meta-regression analysis showed that methodological features of included studies accounted for 100% of statistical heterogeneity of the effects of mindfulness training on weight loss (R2=1,00). Among methodological features, the only significant predictor of weight loss was follow-up distance from post-intervention (β=1.18; p<.05), suggesting that the longer follow-up distances were associated with greater weight loss. Results suggest that mindfulness training has short-term benefits on health-related behaviours. Future studies should explore the effectiveness of mindfulness training on long-term post-intervention weight loss in adults with overweight and obesity.

Burnout, empathy and their relationships: a qualitative study with residents in General Medicine

Some studies have shown that burnout may have a negative impact on clinical empathy during internship. However, clinical empathy may also be a protective factor, preventing residents from experiencing burnout. Although several quantitative studies have been conducted to examine these relationships between burnout and empathy, no qualitative studies have been carried out. To examine how residents in general practice evaluate the link between burnout and empathy, 24 of them participated in a semi-structured interview. A thematic analysis was carried out to examine residents’ discourses and answers to closed questions. The results indicated that residents thought that empathy and burnout were clearly related in different ways. They identified five types of relationship: regulation strategy, empathy as protection, psychological balance/imbalance, fatigue and moderating factors.

Quality of life and illness perception in primary biliary cirrhosis: a controlled cross-sectional study.

OBJECTIVE The aim of this study was to understand better the quality of life (QOL) and illness perception in women with primary biliary cirrhosis (PBC) through a comparison with women having diabetes. METHODS One hundred and ninety-four women took part in this study: 130 with PBC, 64 with type 2 diabetes. They were administered the SF-12 to measure QOL and the Brief Illness Perception Questionnaire to assess representations of their illness. Analysis of covariance with bootstrapping was used to compare QOL and illness perception scores by controlling age and mean disease duration. RESULTS Physical QOL was significantly worse for women with PBC than for women with diabetes. Women with PBC felt their disease would last longer and reported more symptoms and concerns related to their disease than women with diabetes. Significant differences were also observed for causes: women with PBC mainly reported autoimmune, emotional, unknown/unlucky and medical causes whereas women with diabetes reported mostly lifestyle and hereditary causes. Marginally significant differences were observed regarding consequences on daily life, feeling of control over the disease and emotional responses, which were shown to be worse in PBC. Mental QOL, treatment control and overall understanding of the disease was similar in both groups. CONCLUSIONS This study shows that women with PBC have a worse QOL and somewhat different illness perception than women with diabetes. Further research could help understand PBC specificities better in order to improve patient care, especially if factors such as fatigue or rarity of the disease explain these results.

Comparative Study of Teachers in Regular Schools and Teachers in Specialized Schools in France, Working with Students with an Autism Spectrum Disorder: Stress, Social Support, Coping Strategies and Burnout

The inclusion of students with Autism Spectrum Disorder (ASD) in schools is a source of stress for teachers. Specialized teachers have, in theory, received special training. To compare the experiences of teachers dealing with students with ASD in different classroom environments. A total of 245 teachers filled out four self-report questionnaires measuring perceived stress, social support, coping strategies, and burnout. Specialized teachers perceive their teaching as a challenge, can count on receiving help from colleagues, use more problem-focused coping strategies and social support seeking behavior, and are less emotionally exhausted than teachers in regular classes. This study highlights that teachers in specialized schools and classes have better adjustment, probably due to their training, experience, and tailored classroom conditions.

French college students' sports practice and its relations with stress, coping strategies and academic success

College students at university have to face several stress factors. Although sports practice has been considered as having beneficial effects upon stress and general health, few studies have documented its influence on this specific population. The aim of this comparative study was to determine whether the intensity of the college students’ sports practice (categorized into three groups: rare, regular, or intensive) would influence their levels of stress and self-efficacy, their coping strategies, and their academic success/failure. Three self-completion questionnaires were administered to 1071 French freshmen during their compulsory medical visit at the preventive medicine service of the university. Results indicated that students with intensive sport practice reported lower scores of general stress, academic stress, and emotion-focused coping strategies, and higher scores of self-efficacy than those with rare practice. However, the proportion of successful students did not differ significantly between the three groups of sports practice.

Is the Questionnaire of Cognitive and Affective Empathy measuring two or five dimensions? Evidence in a French sample

Although many instruments measure empathy, most of them focus on specific facets (e.g., Spreng et al., 2009) or specific contexts (e.g. Wang et al., 2003) of empathy. For this reason, the Questionnaire of Cognitive and Affective Empathy (QCAE; Reniers et al., 2011) was recently built to grasp the general construct of empathy through its Affective-Cognitive duality, although not providing clear-cut results about the bidimensionality of the scale. In this study, Confirmatory Factor Analyses were conducted on the responses of 418 adults on the French QCAE (backtranslated for this study). A total of 8 models were tested - including the models of the original investigation. The 5-correlated factors model had the best fit, and the pattern of correlations between the factors did not support the Cognitive-Affective distinction. The QCAE is discussed as showing signs of psychometrical robustness, but also as a tool that is more 5-dimensional than bidimensional.

Relationship between depressive mood and eating disorders in a non-clinical young female sample: A one-year longitudinal analysis of cross-lagged and simultaneous effects

Although it is generally agreed that eating disorders (EDs) and depressive mood (DM) are related, the main ambiguity arises from difficulties in determining their cause-effect relationships. The aim of this study was to examine the longitudinal reciprocal causation between EDs and DM among female students. Several models (cross-lagged effects and simultaneous effects) were tested in order to disentangle the prospective relationships between DM (measured by the Beck Depression Inventory-Short Form) and EDs (measured by the Eating Attitudes Test-26) using structural equation modeling with latent variables on one-year longitudinal data. A total of 567 female students were interviewed at the beginning of the first university year (T1); 373 of them were re-interviewed 6 months later (T2), and 359 were re-interviewed after a further 6 months (T3). The results support (1) the prospective reciprocal effects model and (2) the simultaneous reciprocal effects model. The implications of the findings in terms of theoretical improvements and effective treatments are discussed.