Empatia em estudantes de medicina de uma Universidade pública do Rio de Janeiro

Abstract

Medical empathy is defined as a proper understanding of the patient by the physician and the ability of the physician to communicate to him that understanding. It involves a multidimensional concept, with four main aspects: emotional, moral, cognitive and behavioral. Since the mid-20th century it has been considered an essential component of the physician-patient relationship, have been demonstrated several benefits for patients in terms of favorable clinical outcomes as well as for physicians in their daily practice. However, some studies have shown reduced empathy during the medical course. The objective of the present study was to evaluate the empathy of a population of medical students in Brazil in relation to characteristics that may be associated to their behavior. Data were obtained from the I MEDUERJ - 2011 Census, a cross-sectional study in which it was applied to medical students of the State University of Rio de Janeiro a self-administered online questionnaire containing socioeconomic and behavioral variables and resilience evaluation, alongside empathy, as a dependent variable, through the Jefferson Scale. The descriptive and bivariate statistics were calculated using the Mann-Whitney and Kruskal-Wallis tests for the categorical variables and the Spearman correlation coefficient for the numerical variables. Multivariate analysis was then performed using a multiple linear regression model. All 542 included students answered the questionnaire, being 60.5% female, 61.2% white, and the mean age was 23.5 years. The empathy score was 121.8 (SD = 11.79), with a minimum score of 72 and a maximum of 140, and no decline was observed during the course years. In the bivariate analysis, empathy showed positive association with female gender (p <0.001), regular religious practice (p = 0.014), previous attendees from both public and private schools (p = 0.049), medicine option for vocation/personal achievement or altruism (p <0.001), and greater resilience (p <0.001); negative association was found with alcohol consumption (p = 0.025), positive CAGE score (p = 0.036) and use of medications to stay awake, for anxiety and/or sleeping (p = 0.009). After the adjustment of the multivariate model, gender, previous school and resilience maintained their association with empathy. In conclusion, the Brazilian medical students have good levels of empathy when compared to other countries, and they are sustained throughout the medical course. Important characteristics are related to empathy, such as gender, prior education and resilience, pointing to the need for qualitative research to better understand their nature, and to cover other regions of the country.