Resumo: Introdução: Empatia é a capacidade de se colocar no lugar do outro, com o objetivo
de entender seus pensamentos, emoções e contexto, e poder ajudá-lo. Portanto,
empatia é um conceito multidimensional, com componentes afetivo, cognitivo e
comportamental. A literatura descreve correlação positiva entre a medida da empatia
médica por instrumentos autoaplicados e o desfecho clínico dos seus pacientes. Além
disso, médicos mais empáticos são mais satisfeitos com a sua atuação profissional.
No entanto, ainda não sabemos se a empatia médica medida por autoavaliação tem
correlação com a empatia percebida pelos pacientes. Para fomentar uma medicina
centrada no paciente, os pacientes precisam participar do processo de avaliação da
empatia dos profissionais de saúde envolvidos em seu cuidado. Objetivos: Investigar
a relação da autoavaliação de empatia pelo médico, aluno ou residente e a avaliação
de empatia médica avaliada pelos seus pacientes após uma consulta médica.
Metodologia: Para esta tese, realizamos dois estudos observacionais transversais.
O estudo 1 envolveu 945 pacientes e 51 médicos em atendimento ambulatorial público
e privado de especialidades clínicas, cirúrgicas e de radiologia. O estudo 2 envolveu
566 pacientes e 89 alunos do quinto e sexto anos e residentes em atendimento público
de várias especialidades de três universidades. Os pacientes preencheram as
escalas: Consultation and Relational Empathy scale (CARE) e Escala Jefferson de
Percepção de Empatia Médica pelo Paciente (JSPPPE) e os seus médicos
responderam às escalas de Jefferson de Empatia Médica (JSE) e o Índice de
Reatividade Interpessoal de Davis (IRI). Utilizamos a correlação de Pearson para
comparação dos escores das escalas de médicos e pacientes; e a análise de fator
confirmatório e alfa Cronbach para validação e confiabilidade. Resultados: 902314786. Conclusão e discussão: A falta de correlação entre os níveis de empatia autoavaliados e as percepções dos pacientes, podem representar a necessidade da inclusão de pacientes no processo de avaliação. O paciente percebe o médico de modo diferente
da percepção do médico de sua própria empatia. Talvez o treinamento em empatia
deva se concentrar em refletir sobre o ponto de vista do doente e melhorar a sua
assistência, objetivo fim do cuidado médico, possibilitando novas estratégias
educacionais Ver menos

Abstract: Introduction: Empathy is the ability to put yourself in another's place with the purpose of understanding their thoughts, emotions and context, and being able to help them. Therefore, empathy is a multidimensional concept, including affective, cognitive and
behavioral components. The literature describes a positive correlation between the
measurement of medical empathy by self-assessment instruments and the patients'
clinical outcome. In addition, empathic doctors are more satisfied with their
professional career. However, we still do not know whether medical empathy
measured by self-assessment correlates with empathy perceived by patients. To foster
patient-centered medical care, patients need to participate in the process of evaluating
the empathy of the healthcare professionals involved in their care. Objectives:
Investigate the relationship of empathy self-assessment by the physician, medical
student, and resident compared with the evaluation of the medical empathy assessed
by their corresponding patients after a medical consultation. Methodology: For this
thesis, we performed two cross-sectional observational studies. The study 1 enrolled
945 patients and 51 physicians in public and private ambulatory care settings
practicing in several clinical, surgical and radiology specialties. Study 2 involved 566
patients and 89 medical students from the fifth and sixth years and residents in public
service of various specialties from three universities. Patients completed the scale:
Consultation and Relational Empathy scale (CARE) and Jefferson Scale of Patient's
Perceptions of Physician Empathy (JSPPPE) and their physicians answered the
Jefferson Scale of Physician Empathy (JSE), International Reactivity Index (IRI). We
used the Pearson correlation to compare the scores of physicians and patient's scales;
and the confirmatory factor and Cronbach alpha analysis for validity and reliability.
Results:In study 1, we did not observe a significant correlation between the scores of physicians' self-assessment scales and the scores of the scales filled by their patients, except between the Perspective Taking - JSE and JSPPPE sub-dimensions, finding a small correlation (r = 0.3; p <0.05); JSPPPE and CARE demonstrated moderate correlation (0.56; p <0.001); and JSPPPE has been validated. In this study, we also validated the Brazilian Portuguese version of JSPPPE and we noticed that the gender of physicians and the medical specialty influenced the JSPPPE score. The medical specialty and the nature of the consultation (return or first consultation) influenced the CARE measure. In study 2, we also did not observe a significant correlation, between the self-assessment scales' scores and those obtained by the scales applied to the patients, except for a discrete single positive correlation (0.241; p <0.001) between JSPPPE and JSE sub-dimension of Compassionate Care. Doctors from the private section, female gender, internal medicine, and senior medical students showed higher empathy's score on self-assessment and patient's perception.  onclusion and discussion: The lack of correlation between physician self-assessed empathy levels and patients' perceptions may indicate the need to include patient feedback in the evaluation process. The patient perceives the physician differently than the physicians' perception of his own empathy. Perhaps empathy training could result in the improvement of patient care perception and successful formulation and achievement of the patients' medical care goals. This information may result in new educational strategies Ver menos