"Running On Empty": Examining the Effect of Physician Stress, Burnout, and Empathy On Patient-Centered Communication During the Long-Call Shift
AuthorPassalacqua, Stacey Ann
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PublisherThe University of Arizona.
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EmbargoEmbargo: Release after 8/2/2011
AbstractMedical residency is characterized by sleep deprivation, stress, and heavy workload. The impact of these pressures on physician-patient communication has not been fully explored. The aim of the current study was to investigate how contextual demands, stress, and burnout impact empathy and provision of patient-centered communication among internal medicine residents in two hospitals. The long-call shift was studied, as it is known to be particularly taxing and is a primary feature of medical residency. Assessments were obtained both prior to and at the conclusion of residents' shifts. Cognitive complexity was examined as a potential mediator of the relationship between stress and burnout, and burnout and empathy. Results revealed that there was a significant decline in physician empathy from the beginning to the end of the long-call shift and that this decline in empathy predicted less patient-centered communication from physicians. Stress, burnout, and decline in empathy were all positively associated, indicating that resident physicians who were more stressed and burned out were at increased risk for declines in empathy over the course of their shift. Cognitive complexity was not found to be a significant mediator of any associations between study variables, though it was associated with several key variables in unexpected ways. These findings highlight the importance of identifying and addressing barriers to patient-centered communication, as a number of these barriers may be routinely present in the demanding environment of medical residency.
Degree ProgramGraduate College