Spirituality of medical students: associations with empathy and attitudes in the doctor-patient relationship

Lacombe, Julianni Bernardelli; Valadares, Emiliana S.; Catani, Renata Rodrigues; Mendonça, Tânia M. S.; Paro, Helena Borges Martins da Silva; Morales, Nívea Macedo O.

doi:10.1590/1981-5271v45.2-20200181.ING

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ORIGINAL ARTICLE • Rev. bras. educ. med. 45 (02) • 2021 • https://doi.org/10.1590/1981-5271v45.2-20200181.ING copy

Spirituality of medical students: associations with empathy and attitudes in the doctor-patient relationship

Espiritualidade dos estudantes de Medicina: associações com empatia e atitude na relação médico-paciente

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract:

Introduction:

Currently, the study of the factors that improve interpersonal relationships in patient care and medical education has been considered relevant and necessary. Understanding what precedes empathy and medical interns’ and young doctors’ attitudes is a relevant topic for health professionals’ education and for their academic and professional performance. Although patients and medical students have indicated that spirituality is an important issue, it is not frequently addressed in medical schools.

Objective:

This study aims to verify the association between (i) well-being related to spirituality, religiosity and the medical interns’ and residents’ personal beliefs and (ii) empathy and attitudes in the doctor-patient relationship.

Methods:

This was a quantitative, cross-sectional, observational study. A total of 64 undergraduate students in the last years of medical school and 50 residents answered the following self-administered instruments: WHOQOL-SRPB, Jefferson Scale of Empathy, and Patient-Practitioner Orientation Scale. Descriptive statistics, Pearson’s correlation and stepwise linear regressions were used to analyze data.

Results:

Significant correlations (p<0.05) varying from weak (r=0.10) to moderate (r=0.39) were found. The WHOQOL-SRPB final score affected the global score of empathy (R2 = 0.12; p <0.00; VIF=1.00). The component meaning and purpose in life affected the global score of the patient-centered attitude (R2= 0.14; p <0.00; VIF=1.00).

Conclusions:

Spirituality, religiosity and personal beliefs are associated with patient-centered attitudes and medical interns’ and residents’ empathy. In general, well-being related to spirituality preceded empathy, and the component meaning and purpose in life preceded patient-centered attitudes. These results imply the need to consider well-being related to spirituality in interns’ and residents’ education for a better doctor-patient relationship.

Keywords:
Spirituality; Empathy; Medical Education; Medical Students; Doctor-Patient Relationship

Variable	N	%
Sex
Female	77	67.5%
Marital status
Single	103	90.4%
Religion
Did not answer	3	2.6%
Catholic	51	44.7%
Afro-Brazilian	1	0.9%
Protestant	13	11.4%
Spiritism	21	18.4%
None	23	20.2%
Other	2	1.8%
Religious involvement
High	67	58.77%
Low	47	41.22%
Medical Interns: Intended Specialty
Person-centered	32	50%
Technology-centered	15	23.43%
Did not answer	17	26.56%
Medical Residents: Current Specialty
Person-centered	45	90%
Technology-centered	5	10%

Variable	Mean	SD	Minimum	Maximum
WOQOL-SRPB
S1	70.40	22.92	20	100
S2	82.65	13.53	40	100
S3	73.89	12.51	45	100
S4	73.60	12.91	35	100
S5	72.57	18.98	20	100
S6	72.77	11.60	40	100
S7	76.16	11.58	45	100
S8	69.29	23.72	20	100
Total Score	74.02	12.17	36.25	99.37
JSE
Sub1	49.27	4.62	37	56
Sub2	8.48	2.77	2	14
Sub3	60.81	7.13	39	70
Total Score	118.56	10.25	89	136
PPOS
Share	4.21	0.63	2.33	5.77
Care	4.96	0.43	3.66	6.00
Total Score	4.59	0.43	3.21	5.55

Variable		Student/ resident	Age	Gender	Religious involvement	S1 Connection	S2 Meaning and purpose in life	S3 Experiences of awe and wonder	S4 Wholeness and Integration	S5 Spiritual strength	S6 Peace- Harmony	S7 Hope	S8 Faith	WHOQOL-SRPB Global score
JSE
Final Score	(r)	-.117	-.093	.203*	.222*	.237*	.252**	.272**	.337**	.250**	.325**	.191*	.199*	.352**
Sub1	(r)	-.141	.102	.206*	.166	.072	.122	.088	.175	.091	.226*	.113	.044	.144
Sub2	(r)	-.066	.048	.023	-.094	-.037	.121	.071	.066	-.021	.075	.108	.066	.041
Sub3	(r)	-.051	.086	.149	.248**	.309**	.236*	.306**	.342**	.309**	.291**	.160	.283**	.394**
PPOS
Final Score	(r)	.123	.071	.163	.115	.189*	.323**	.336**	.364**	.233*	.315**	.266**	.164	.358**
Share	(r)	.087	-.029	.114	.129	.122	.269**	.289**	.334**	.151	.275**	.212*	.097	.283**
Care	(r)	.121	.185	.161	.043	.201*	.257**	.255**	.246**	.250**	.236*	.228*	.190*	.312**

DEPENDENT VARIABLES	INDEPENDENT VARIABLES	Constant	R2	Adjusted R2	F	pvalueF
Perspective-taking		43.62	.15	.14	19.64	.00**	β	pvalueβ	VIF	Tolerance
	WHOQOL-SRPB Global score						.39	.00**	1.00	1.00
Compassion		39.47	.09	.07	5.45	.01**	β	pvalueβ	VIF	Tolerance
	Sex						.20	.03*	1.00	1.00
	S6- Inner peace						.22	.01**	1.00	1.00
JSE Global score		96.65	.12	.11	15.16	.00**	β	pvalueβ	VIF	Tolerance
	WHOQOL-SRPB Global score						.35	.00**	1.00	1.00
Share		3.05	.10	.09	12.72	.00**	β	pvalueβ	VIF	Tolerance
	S4-Wholeness and Integration						.32	.00**	1.00	1.00
Care		4.05	.11	.10	13.06	.00**	β	pvalueβ	VIF	Tolerance
	S2-Meaning and purpose in life						.33	.00**	1.00	1.00
PPOS Global score		3.53	.14	.13	18.08	.00**	β	pvalueβ	VIF	Tolerance
	S2-Meaning and purpose in life						.38	.00**	1.00	1.00

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