DOI QR코드

DOI QR Code

The Effects of Repeated Pain Measurement to Injury Pictures on Cognitive and Affective Empathy in Medical Students

통증사진에 대한 반복적 통증평가가 의대생의 인지적 공감과 정서적 공감에 미치는 영향

  • 이상권 (양산부산대학교병원 의생명융합연구소) ;
  • 천경주 (부산대학교 의학전문대학원 인문사회의학교실) ;
  • 장철훈 (부산대학교 의학전문대학원 진단검사의학교실) ;
  • 김성수 (부산대학교 의학전문대학원 인문사회의학교실)
  • Received : 2016.10.18
  • Accepted : 2016.12.19
  • Published : 2017.01.28

Abstract

To develop a more efficient computer-based empathy program that enables medical students to increase their empathy levels, and to test its applicability to medical students. We developed PACP (the Pain Assessment Computer Program) for measurement of medical students' levels of recognition of another's pain. An empathy questionnaire was administered to 145 medical students before and after the PACP. In the high empathy group, the scores for cognitive empathy increased significantly after completion of the PACP, while affective empathy scores showed no significant change. In contrast, in the low empathy group, both cognitive and affective empathy scores increased significantly after the PACP. The PACP effectively increased cognitive empathy for the high empathy group, and increased both cognitive and affective empathy, particularly for the low empathy group. Given the fact that existing empathy education programs are time-consuming and costly, and the demand for more efficient empathy education is high, the PACP as a useful tool can be applicable to medical students, particularly those with low empathy in order to enhance their empathic abilities within a short period of time.

본 연구의 목적은 의대생들의 공감능력 수준에 따른 타인의 통증인지 수준 평가와 공감능력의 변화를 파악하여 짧은 시간 내에 공감능력이 낮은 의대생들의 공감능력을 높일 수 있도록 하는 공감교육 컴퓨터 프로그램 개발에 있다. 총 145명 대상자들의 공감능력을 고집단과 저집단으로 나누었다. 또한, 타인의 통증인지 수준 평가를 측정하기 위해 개발한 컴퓨터 프로그램인 'Pain Assessment Computer Program(PACP)'을 사용하였다. PACP 수행 후 공감 고집단은 인지적 공감능력만 유의미하게 증가한 반면, 공감 저집단은 인지적 공감능력과 정서적 공감능력 모두 증가하였다. PACP 수행과정에서 두 집단 모두 인지적 공감능력이 공통적으로 증가하였는데 이는 대상자들이 인지적 요소를 우선적으로 사용함으로써 인지적 공감이 상승된 것으로 보이며, '인지적 노력'에 따른 인지적 공감능력의 향상에 긍정적인 영향을 준 것으로 판단된다. 이처럼 PACP는 짧은 시간 내에 공감능력이 낮은 의대생들의 공감능력을 향상시키는 보조 수단으로써 활용할 수 있을 것이다.

Keywords

References

  1. U. Bivona, A. Riccio, P. Ciurli, G. A. Carlesimo, V. D. Donne, E. Pizzonia, and A. Costa, "Low self-awareness of individuals with severe traumatic brain injury can lead to reduced ability to take another person's perspective," The J. of Head Trauma Rehabilitation, Vol.29, No.2, pp.157-171, 2014. https://doi.org/10.1097/HTR.0b013e3182864f0b
  2. J. Decety and P. L. Jackson, "A social-neuroscience perspective on empathy," Current Directions in Psychological Science, Vol.15, No.2, pp.54-58, 2006. https://doi.org/10.1111/j.0963-7214.2006.00406.x
  3. T. Singer, B. Seymour, J. O'Doherty, H. Kaube, R. J. Dolan, and C. D. Frith, "Empathy for pain involves the affective but not sensory components of pain," Science, Vol.303, No.5661, pp.1157-1162, 2004. https://doi.org/10.1126/science.1093535
  4. K. B. H. Zolnierek and M. R. DiMatteo, "Physician communication and patient adherence to treatment: a meta-analysis," Medical Care, Vol.47, No.8, p.826, 2009. https://doi.org/10.1097/MLR.0b013e31819a5acc
  5. D. Chen, R. Lew, W. Hershman, and J. Orlander, "A cross-sectional measurement of medical student Empathy," J. of General Internal Medicine, Vol.22, No.10, pp.1434-1438, 2007. https://doi.org/10.1007/s11606-007-0298-x
  6. F. F. Youssef, P. Nunes, B. Sa, and S. Williams, "An exploration of changes in cognitive and emotional empathy among medical students in the Caribbean," International J. of Medical Education, Vol.5, pp.185-192, 2014. https://doi.org/10.5116/ijme.5412.e641
  7. J. Decety, C. Y. Yang, and Y. Cheng, "Physicians down-regulate their pain empathy response: an event-related brain potential study," Neuroimage, Vol.50, No.4, pp.1676-1682, 2010. https://doi.org/10.1016/j.neuroimage.2010.01.025
  8. B. B. Murinson, E. Nenortas, R. S. Mayer, L. Mezei, S. Kozachik, S. Nesbit, and J. N. Campbell, "A new program in pain medicine for medical students: integrating core curriculum knowledge with emotional and reflective development," Pain Medicine, Vol.12, No.2, pp.186-195, 2011. https://doi.org/10.1111/j.1526-4637.2010.01050.x
  9. J. Oates, W. W. Weston, and J. Jordan, "The impact of patient-centered care on outcomes," The J. of Family Practice, Vol.49, pp.796-804, 2000.
  10. R. T. Toto, L. Man, B. Blatt, S. J. Simmens, and L. Greenberg, "Do empathy, perspective-taking, sense of power and personality differ across undergraduate education and are they inter-related?," Advances in Health Sciences Education, Vol.20, pp.23-31, 2015. https://doi.org/10.1007/s10459-014-9502-z
  11. W. Levinson, C. S. Lesser, and R. M. pstein, "Developing physician communication skills for patient centered care," Health Affairs, Vol.29, No.7, pp.1310-1318, 2010. https://doi.org/10.1377/hlthaff.2009.0450
  12. H. B. Paro, P. S. Silveira, B. Perotta, S. Gannam, S. C. Enns, R. R. Giaxa, and P. Z. Tempski, "Empathy among Medical Students: Is There a Relation with Quality of Life and Burnout?," PLOS ONE, Vol.9, No.4, p.e94133, 2014. https://doi.org/10.1371/journal.pone.0094133
  13. K. Berg, J. F. Majdan, D. Berg, J. Veloski, and M. Hojat, "Medical students' self-reported empathy and simulated patients' assessments of student empathy: an analysis by gender and ethnicity," Academic Medicine, Vol.86, No.8, pp.984-988, 2011. https://doi.org/10.1097/ACM.0b013e3182224f1f
  14. N. Imran, M. A. Aftab, I. I. Haider, and A. Farhat, "Educating tomorrow's doctors: A cross sectional survey of emotional intelligence and empathy in medical students of Lahore," Pakistan J. of Medical Sciences, Vol.29, No.3, pp.710-714, 2013.
  15. M. Neumann, F. Edelhäuser, D. Tauschel, M. R. Fischer, M. Wirtz, C. Woopen, and C. Scheffer, "Empathy decline and its reasons: a systematic review of studies with medical students and residents," Academic Medicine, Vol.86, No.8, pp.996-1009, 2011. https://doi.org/10.1097/ACM.0b013e318221e615
  16. 김주희, 김진경, "얼굴그림 동통척도를 이용한 환자와 간호사의 동통인지에 관한 연구," 성인간호학회지, 제7권, 제1호, pp.49-60, 1995.
  17. D. L. Wong and C. M.Baker, "Pain in children: comparison of assessment scales," J. of Pediatric Nursing, Vol.14, No.1, pp.9-17, 1988.
  18. 장선숙, 서지현, 조경제, 홍순찬, 우향옥, "정서적 공감을 위한 의사소통 기술과 임상수행평가," 한국의학교육학회지, 제22권, 제2호, pp.121-130, 2010.
  19. 양은배, "환자-의사간 의사소통 기술 교육에 대한 고찰," 한국의학교육학회지, 제20권, 제20호, pp.99-107, 2008.
  20. 박정숙, 제상모, 김민정, 정현수, 정성필, 이한식, "응급진료센터 의료진의 커뮤니케이션 능력의 평가 및 교육 효과," 대한응급의학회지, 제21권, 제6호, pp.887-891, 2010.
  21. S. S. Kim, S. Kaplowitz, and M. V. Johnston, "The effects of physician empathy on patient satisfaction and compliance," Evaluation & the Health Professions, Vol.27, No.3, pp.237-251, 2004. https://doi.org/10.1177/0163278704267037
  22. 강민아, 손주연, 김희정, "통합 연구 방법 적용 가능성에 대한 탐색 연구," 한국행정학보, 제41권, 제4호, pp.415-437, 2007.
  23. C. D. Batson, K. Sager, E. Garst, M. Kang, K. Rubchinsky, and K. Dawso, "Is empathy-induced helping due to self-other merging?," J. of Personality and Socical Psychology, Vol.73, No.3, pp.495-509, 1997. https://doi.org/10.1037/0022-3514.73.3.495
  24. H. Riess, J. M. Kelley, R. W. Bailey, E. J. Dunn, and M. Phillips, "Empathy training for resident physicians: a randomized controlled trial of a neuroscience-informed curriculum," J. of General Internal Medicine, Vol.27, No.10, pp.1280-1286, 2012. https://doi.org/10.1007/s11606-012-2063-z
  25. N. D. Feshbach, "Parental empathy and child adjustment/maladjustment," Empathy and its development, pp.271-291, 1990.
  26. S. J. Luck, An Introduction to the Event- Related Potential Technique, Cambridge, MA: MIT Press, pp.343-355, 2005.
  27. 전행자, 김영윤, "통판단과제에서 정신병질 경향성 집단의 고통공감," 한국심리학회지: 사회 및 성격, 제25권, 제4호, pp.121-137, 2011.
  28. L. Nummenmaa, J. Hirvonen, R. Parkkola, and J. K. Hietanen, "Is emotional contagion special? An fMRI study on neural systems for affective and cognitive empathy," Neuroimage, Vol.43, No.3, pp.571-580, 2008. https://doi.org/10.1016/j.neuroimage.2008.08.014
  29. P. L. Jackson, A. N. Meltzoff, and J. Decety, "How do we perceive the pain of others? A window into the neural processes involved in empathy," Neuroimage, Vol.24, No.3, pp.771-779, 2005. https://doi.org/10.1016/j.neuroimage.2004.09.006
  30. M. V. Saarela, Y. Hlushchuk, A. C. D. C. Williams, M. Schürmann, E. Kalso, and R. Hari, "The compassionate brain: humans detect intensity of pain from another's face," Cerebral cortex, Vol.17, No.1, pp.230-237, 2007. https://doi.org/10.1093/cercor/bhj141
  31. F. Deutsch and R. A. Madle, "Empathy: Historic and current conceptualizations, measurement, and a cognitive theoretical perspective," Human development, Vol.18, No.4, pp.267-287, 1975. https://doi.org/10.1159/000271488
  32. K. W. Lau, R. L. Norris, Z. Siddique, M. C. Altan, J. Baldwin, and W. Merchan-Merchan, "Cognitive Empathy in Design Course for a More Inclusive Mechanical Engineering," (In ASME 2016 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference) American Society of Mechanical Engineers, No. DETC2016- 60382, p.V003T04005, p.10, doi:10.1115/DETC2016- 60382, 2016.