Empathy and emotional intelligence: What is it really about?

Empathy is the "capacity" to share and understand another’s "state of mind" or emotion. Itis often characterized as the ability to “put oneself into another’s shoes”, or in some way experience the outlookor emotions of another being within oneself. Empathy is a powerful communication skill that is often misunderstoodand underused. Initially, empathy was referred to as “bedside manner”; now, however, authors and educatorsconsider empathetic communication a teachable, learnable skill that has tangible benefits for both clinicianand patient: Effective empathetic communication enhances the therapeutic effectiveness of the clinician-patientrelationship. Appropriate use of empathy as a communication tool facilitates the clinical interview, increases theefficiency of gathering information, and honours the patient. Additionally, Emotional Intelligence (EI), often measuredas an Emotional Intelligence Quotient (EQ), describes a concept that involves the ability, capacity, skill or aself-perceived ability, to identify, assess, and manage the emotions of one’s self, of others, and of groups. Becauseit is a relatively new area of psychological research, the concept is constantly changing. The EQ concept argues thatIQ, or conventional intelligence, is too narrow; that there are wider areas of emotional intelligence that dictate andenable how successful we are. Success requires more than IQ (Intelligence Quotient), which has tended to be thetraditional measure of intelligence, ignoring essential behavioural and character elements. We’ve all met peoplewho are academically brilliant and yet are socially and inter-personally inept. And we know that despite possessinga high IQ rating, success does not automatically follow. The aim of this review is to describe the concept of empathyand emotional intelligence, compare it to other similar concepts and clarify their importance as vital parts of effectivesocial functioning. Just how vital they are, is a subject of constant debate

Evidence for models of diagnostic service provision in the community: literature mapping exercise and focused rapid reviews

Background Current NHS policy favours the expansion of diagnostic testing services in community and primary care settings. Objectives Our objectives were to identify current models of community diagnostic services in the UK and internationally and to assess the evidence for quality, safety and clinical effectiveness of such services. We were also interested in whether or not there is any evidence to support a broader range of diagnostic tests being provided in the community. Review methods We performed an initial broad literature mapping exercise to assess the quantity and nature of the published research evidence. The results were used to inform selection of three areas for investigation in more detail. We chose to perform focused reviews on logistics of diagnostic modalities in primary care (because the relevant issues differ widely between different types of test); diagnostic ultrasound (a key diagnostic technology affected by developments in equipment); and a diagnostic pathway (assessment of breathlessness) typically delivered wholly or partly in primary care/community settings. Databases and other sources searched, and search dates, were decided individually for each review. Quantitative and qualitative systematic reviews and primary studies of any design were eligible for inclusion. Results We identified seven main models of service that are delivered in primary care/community settings and in most cases with the possible involvement of community/primary care staff. Not all of these models are relevant to all types of diagnostic test. Overall, the evidence base for community- and primary care-based diagnostic services was limited, with very few controlled studies comparing different models of service. We found evidence from different settings that these services can reduce referrals to secondary care and allow more patients to be managed in primary care, but the quality of the research was generally poor. Evidence on the quality (including diagnostic accuracy and appropriateness of test ordering) and safety of such services was mixed. Conclusions In the absence of clear evidence of superior clinical effectiveness and cost-effectiveness, the expansion of community-based services appears to be driven by other factors. These include policies to encourage moving services out of hospitals; the promise of reduced waiting times for diagnosis; the availability of a wider range of suitable tests and/or cheaper, more user-friendly equipment; and the ability of commercial providers to bid for NHS contracts. However, service development also faces a number of barriers, including issues related to staffing, training, governance and quality control. Limitations We have not attempted to cover all types of diagnostic technology in equal depth. Time and staff resources constrained our ability to carry out review processes in duplicate. Research in this field is limited by the difficulty of obtaining, from publicly available sources, up-to-date information about what models of service are commissioned, where and from which providers. Future work There is a need for research to compare the outcomes of different service models using robust study designs. Comparisons of ‘true’ community-based services with secondary care-based open-access services and rapid access clinics would be particularly valuable. There are specific needs for economic evaluations and for studies that incorporate effects on the wider health system. There appears to be no easy way of identifying what services are being commissioned from whom and keeping up with local evaluations of new services, suggesting a need to improve the availability of information in this area. Funding The National Institute for Health Research Health Services and Delivery Research programme

GALEN-IN-USE: Application in Greek and influences on education

GALEN-IN-USE is a European project that aims to promote greater European harmonisation and to overcome the problems encountered in using traditional coding and classification systems. This paper presents the work done by the Greek Centre of Medical Informatics and Terminology, as a collaborating centre of GALEN-IN-USE(GIU), in order to apply GIU's tools to Greek Health Care System as well as the affect of this application in education

Comparison of a network of primary care physicians and an open spirometry programme for COPD diagnosis

Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death worldwide nowadays and the main problem to overcome is the non-presence of symptoms in the early stages. It thus needs to find a method that can detect the disease in its early stages and will do more effectively deal with it.Purpose: The comparison of two different strateges of incident detection COPD and the effectiveness of the questionnaire COPD-PS (Martinez). Study Population and Methodology: The study was conducted in 28 primary health care practices of the National Health System in semirural areas in Thessaly, Greece, during 2009-2010, with 1566 participants. Applying two programs and two strategies, where the first one was an open invitation population and spirometry, and the second strategy, the events detected by trained primary care physicains using COPD-PS (Martinez) questionnaire. Followed by comparison of the two tools.Results: The results showed that the second strategy is particularly effective and efficient in terms of cost, and mainly to the earlier stage. Regarding Martinez questionnaire, the results between the two questionnaires showed clearer accountability and high reliability of the Martinez questionnaire to identify COPD cases without performing spirometry.Conclusions: A case finding program which includes general primary care physicians were more effective in detecting new COPD cases and at a lower cost compared to an open screening spirometry program in a semi-rural population. The COPD-PS (Martinez) questionnaire is a tool that gives accurate results for the presence or absence of the disease.Εισαγωγή: Η Χρόνια Αποφρακτική Πνευμονοπάθεια (ΧΑΠ) αποτελεί την τέταρτη αιτία θανάτου παγκοσμίως και το βασικότερο πρόβλημα για την αντιμετώπισή της είναι η απουσία συμπτωμάτων στα αρχικά στάδια. Γίνεται έτσι επιτακτική η ανάγκη της έγκαιρης διάγνωσης ώστε να γίνει περισσότερο αποτελεσματική η αντιμετώπισή της.Σκοπός: Η σύγκριση δύο διαφορετικών στρατηγικών πρώιμης διάγνωσης της νόσου και η αποτελεσματικότητα του ερωτηματολογίου COPD-PS (Martinez) στην ανίχνευση περιστατικών ΧΑΠ.Πληθυσμός Μελέτης & Μέθοδος: Η μελέτη πραγματοποιήθηκε σε 28 κέντρα υγείας της περιοχής της Θεσσαλίας για τη διετία 2009-2010 με συνολικά 1566 συμμετέχοντες. Συγκεκριμένα εφαρμόστηκαν δύο προγραμμάτα και δύο στρατηγικές, όπου στην πρώτη έγινε ανοιχτή πρόσκληση του πληθυσμού και σπιρομέτρηση, και στη δεύτερη, ανιχνεύτηκαν τα περιστατικά με τη βοήθεια γενικών γιατρών και με βάση το ερωτηματολόγιο COPD-PS (Martinez) Ακολούθησε σύγκριση των δύο μεθόδων ως προς την αποτελεσματικότητα και την αποδοτικότητα τους. Αποτελέσματα: Τα αποτελέσματα έδειξαν πως η 2η στρατηγική είναι ιδιαίτερα αποτελεσματική αλλά και αποδοτική ως προς το κόστος κυρίως και ως προς το προγενέστερο στάδιο διάγνωσης της νόσου. Όσον αφορά το ερωτηματολόγιο COPD-PS (Martinez), τα αποτελέσματα μεταξύ των δύο ερωτηματολογίων έδειξαν σαφέστερη εγκυρότητα και μεγάλη αξιοπιστία του ερωτηματολογίου COPD-PS στον εντοπισμό περιστατικών ΧΑΠ, χωρίς τη διενέργεια σπιρομέτρησης. Συμπεράσματα: Ένα πρόγραμμα ανίχνευσης το οποίο περιλαμβάνει γενικούς γιατρούς Πρωτοβάθμιας Φροντίδας Υγείας ήταν πιο αποτελεσματικό για την ανίχνευση νέων περιστατικών ΧΑΠ και σε χαμηλότερο κόστος συγκριτικά με ένα πρόγραμμα ανοιχτής σπιρομέτρησης σε ημιαγροτικό πληθυσμό. Το ερωτηματολόγιο COPD-PS (Martinez) είναι ένα εργαλείο που δίνει ακριβή αποτελέσματα για την ύπαρξη ή μη της εν λόγω ασθένειας

Comparison of a network of primary care physicians and an open spirometry programme for COPD diagnosis

Background: Early diagnosis of Chronic Obstructive Pulmonary Disease (COPD) remains the cornerstone for effective management. In this study we compared an open spirometry programme and a case-finding programme providing spirometry to high-risk subjects selected by primary care physicians. Methods: A network of primary care physicians was created after invitation and all participants received training on COPD and spirometry. The study team visited 12 primary care settings in each programme in a 1-year period. Spirometry was performed in all eligible participants. COPD diagnosis and classification was based on GOLD guidelines and evaluation by a chest physician. Results: Patients with acceptable spirometry were evaluated (n = 201 in the case-finding and n = 905 in the open spirometry programme). The proportion of newly diagnosed COPD was 27.9% in the case-finding programme compared to 8.4% in the open spirometry programme (p < 0.0001). The numberneeded-to-screen (NNS) for a new diagnosis of COPD was 3.6 in the case-finding programme compared to 11.9 in the open spirometry programme. The majority of newly diagnosed patients were classified in GOLD stages I an II. The average cost for a new diagnosis of COPD was 173(sic) in the open spirometry programme and 102(sic) in the case-finding programme. Conclusions: A case-finding programme involving primary care physicians was more cost-effective for the identification of new cases of COPD compared to an open spirometry programme. The development of networks of primary care physicians with access to good quality spirometry and specialist consultation for early diagnosis of COPD is justified. (C) 2010 Elsevier Ltd. All rights reserved