Role of Empathy and Lifelong Learning Abilities in Physicians and Nurses Who Work in Direct Contact with Patients in Adverse Working Conditions

This research and the APC were funded by Fundacion Rioja Salud, reference funds FPBIO-2022.Empathy and lifelong learning are two professional competencies that depend on the four principles of professionalism: humanism, altruism, excellence, and accountability. In occupational health, there is evidence that empathy prevents work distress. However, in the case of lifelong learning, the evidence is still scarce. In addition, recent studies suggest that the development of lifelong learning varies in physicians and nurses and that it is sensitive to the influence of cultural stereotypes associated with professional roles. This study was performed with the purpose of determining the specific role that empathy and lifelong learning play in the reduction in occupational stress. This study included a sample composed by 40 physicians and 40 nurses with high dedication to clinical work in ambulatory consultations from a public healthcare institution in Paraguay. Somatization, exhaustion, and work alienation, described as indicators of occupational stress, were used as dependent variables, whereas empathy, lifelong learning, gender, discipline, professional experience, civil status, and family burden were used as potential predictors. Three multiple regression models explained 32% of the variability of somatization based on a linear relationship with empathy, lifelong learning, and civil status; 73% of the variability of exhaustion based on a linear relationship with empathy, somatization, work alienation, and discipline; and 62% of the variability of work alienation based on a linear relationship with lifelong learning, exhaustion, and discipline. These findings indicate that empathy and lifelong learning play important roles in the prevention of work distress in physicians and nurses. However, this role varies by discipline.Fundacion Rioja Salu

Empathy and Occupational Health and Well-Being in Ecuadorian Physicians Working with COVID-19 Patients: A Mixed-Method Study

Approximately one out of ten COVID-19 cases in Ecuador was a physician. It has been reported that this situation has led to a serious detriment of physicians’ health and well-being. This study aimed to (i) identify predictors of emotional exhaustion, somatization, and work alienation in Ecuadorian physicians working with COVID-19 patients and (ii) explore the pandemic impact on doctor–patient relationships and on empathy. In 79 Ecuadorian physicians (45 women) who worked with COVID-19 patients, two separate multiple regression models explained the following: 73% of the variability of emotional exhaustion was based on somatization, work alienation, working sector, and passing through a symptomatic infection (p < 0.001), and 56% of the variability of somatization was based on gender and emotional exhaustion (p < 0.001), respectively. Furthermore, intention to leave the profession was more frequent among physicians with greater work alienation (p = 0.003). On the contrary, more empathic physicians never considered leaving their profession during the COVID-19 pandemic (p = 0.03). In physicians’ verbatim, cognitive empathy appeared associated to a positive change in doctor–patient relationships. On the contrary, having an overwhelming emotional empathy appeared associated to a negative change in doctor–patient relationships. These findings characterize differences in how physicians cope while working in the frontline of the pandemic

Inter-Professional Collaboration and Occupational Well-Being of Physicians Who Work in Adverse Working Conditions

Inter-professional collaboration, empathy and lifelong learning, components of medical professionalism, have been associated with occupational well-being in physicians. However, it is not clear whether this role persists in adverse working conditions. This study was performed to assess whether this is the case. These three abilities, and the self-perception of somatization, exhaustion and work alienation, were measured in a sample of 60 physicians working in a hospital declared to be in an institutional emergency. A multiple regression model explained 40% of the variability of exhaustion, with a large effect size (Cohen’s-f 2 = 0.64), based on a linear relationship with teamwork (p = 0.01), and more dedication to academic (p < 0.001) and management activities (p < 0.003). Neither somatization nor alienation were predicted by empathy or lifelong learning abilities. Somatization, exhaustion, or alienation scores either explained empathy, inter-professional collaboration or lifelong learning scores. These findings indicate that, in adverse working environments, physicians with a greater sense of inter-professional collaboration or performing multi-task activities are more exposed to suffering exhaustion.Fundación Rioja Salu

Improvement of Inter-Professional Collaborative Work Abilities in Mexican Medical and Nursing Students: A Longitudinal Study

Background: Inter-professional and interpersonal relationships in collaborative work environments can prove to be critical elements in healthcare practice. When implementers fail to understand the importance of a collaborative perspective, this can lead to communication problems which ultimately harm the users. Objectives: To improve the inter-professional collaborative work skills of Mexican students in their first year of medical and nursing degrees through the use of a training program geared toward development of interpersonal skills and interdisciplinary work. Results: The control group of medical students showed a deterioration in the development of collaborative work skills (p < 0.01), whereas in the experimental group this deterioration was not present. In the experimental group of nursing students, a significant increase in the development of collaborative work skills (p < 0.05) was observed. The differences were clearly due to the professional area of study (p < 0.001). Conclusion: There are differences in collaborative work skill development among different professional areas. These differences can be reduced through the implementation of a program aimed at developing collaborative work and interpersonal skills in the early stages of training.This study was supported by the Rioja Salud Foundation (FRS), Spain, and by a grant from the Instituto de Salud Carlos III (Pi16/01934), co-financed by Operational Program of the European Regional Development Fund (FEDER-La Rioja) in Spain (6FRS-ABC-012)

Improvement of Inter-Professional Collaborative Work Abilities in Mexican Medical and Nursing Students: A Longitudinal Study

Background: Inter-professional and interpersonal relationships in collaborative work environments can prove to be critical elements in healthcare practice. When implementers fail to understand the importance of a collaborative perspective, this can lead to communication problems which ultimately harm the users.Objectives: To improve the inter-professional collaborative work skills of Mexican students in their first year of medical and nursing degrees through the use of a training program geared toward development of interpersonal skills and interdisciplinary work.Methods: The sample was composed of 162 students (62 males and 99 females) from the School of Healthcare Sciences of the Autonomous University of Coahuila, Mexico. The main measures used were the Jefferson Scale of Empathy (JSE); the Jefferson Scale of Attitudes toward Inter-Professional Collaborative Work between Medical and Nursing Professionals (JSAPNC); and the Jefferson Scale of Lifelong Learning (JeffSPLL). The entire sample was divided into two groups (experimental and control groups). Both groups attended an extra-curricular program using a coaching methodology. In the first case the topic focused on attitudes toward inter-professional collaborative work. In the second case, the program focused on addiction. Both programs ran for 4 months. Psychometric instruments were applied at the beginning and at the end of both programs. After analyzing the reliability of the instruments, an ANOVA test was performed.Results: The control group of medical students showed a deterioration in the development of collaborative work skills (p &lt; 0.01), whereas in the experimental group this deterioration was not present. In the experimental group of nursing students, a significant increase in the development of collaborative work skills (p &lt; 0.05) was observed. The differences were clearly due to the professional area of study (p &lt; 0.001).Conclusion: There are differences in collaborative work skill development among different professional areas. These differences can be reduced through the implementation of a program aimed at developing collaborative work and interpersonal skills in the early stages of training

Unveiling the Active Nucleus of Centaurus A

We report new HST WFPC2 and NICMOS observations of the center of the nearest radio galaxy Centaurus A (NGC 5128) and discuss their implications for our understanding of the active nucleus and jet. We detect the active nucleus in the near-IR (K and H) and, for the first time, in the optical (I and V), deriving the spectral energy distribution of the nucleus from the radio to X-rays. The optical and part of the near-IR emission can be explained by the extrapolation of the X-ray power law reddened by A_V~14mag, a value consistent with other independent estimates. The 20pc-scale nuclear disk discovered by Schreier et al. (1998) is detected in the [FeII] 1.64mic line and presents a morphology similar to that observed in Pa alpha with a [FeII]/Pa alpha ratio typical of low ionization Seyfert galaxies and LINERs. NICMOS 3 Pa alpha observations in a 50"x50" circumnuclear region suggest enhanced star formation (~0.3Msun/yr) at the edges of the putative bar seen with ISO, perhaps due to shocks driven into the gas. The light profile, reconstructed from V, H and K observations, shows that Centaurus A has a core profile with a resolved break at ~4" and suggests a black--hole mass of ~10^9 Msun. A linear blue structure aligned with the radio/X-ray jet may indicate a channel of relatively low reddening in which dust has been swept away by the jet.Comment: 19 pages, 13 figures, Astrophysical Journal, in press. High quality figures available at http://www.arcetri.astro.it/~marconi/colpic.htm

18F-FDG PET/CT in breast cancer: Evidence-based recommendations in initial staging

Current guidelines do not systematically recommend 18F-FDG PET/CT for breast cancer staging; and the recommendations and level of evidence supporting its use in different groups of patients vary among guidelines. This review summarizes the evidence about the role of 18F-FDG PET/CT in breast cancer staging and the therapeutic and prognostic impact accumulated in the last decade. Other related aspects, such as the association of metabolic information with biology and prognosis are considered and evidence-based recommendations for the use of 18F-FDG PET/CT in breast cancer staging are offered. We systematically searched MEDLINE for articles reporting studies with at least 30 patients related to clinical questions following the Problem/Population, Intervention, Comparison, and Outcome framework. We critically reviewed the selected articles and elaborated evidence tables structuring the summarized information into methodology, results, and limitations. The level of evidence and the grades of recommendation for the use of 18F-FDG PET/CT in different contexts are summarized. Level III evidence supports the use of 18F-FDG PET/CT for initial staging in patients with recently diagnosed breast cancer; the diagnostic and therapeutic impact of the 18F-FDG PET/CT findings is sufficient for a weak recommendation in this population. In patients with locally advanced breast cancer, level II evidence supports the use of 18F-FDG PET/CT for initial staging; the diagnostic and therapeutic impact of the 18F-FDG PET/CT findings is sufficient for a strong recommendation in this population. In patients with recently diagnosed breast cancer, the metabolic information from baseline 18F-FDG PET/CT is associated with tumor biology and has prognostic implications, supported by level II evidence. In conclusion, 18F-FDG PET/CT is not recommended for staging all patients with early breast cancer, although evidence of improved regional and systemic staging supports its use in locally advanced breast cancer. Baseline tumor glycolytic activity is associated with tumor biology and prognosis