Objectives: Although health care providers are required to sustain care in difficult circumstances, some patients challenge this principle. Evoking compassion seems likely to be helpful in such situations. This research aimed to evaluate whether inducing compassion in health care providers might mitigate disengagement with patients who have challenging presenting features such as those with disgusting symptoms and/or are to blame for their own health problems.
Design: An online experimental study with clinical health care providers.
Methods: Medical students (n = 219) and qualified health care professionals (n = 108) took part in an online experiment. Participants were randomized to view a slideshow of either neutral images (control) or compassion-inducing images (compassion condition) and were then presented with a series of patient vignettes where presenting problems systematically varied on patient responsibility and disgusting symptoms. Engagement was assessed by asking participants how caring they felt, how much they would want to help, how challenging it would be, and whether they would wear a mask.
Results: Participants reported less engagement with patients who were responsible for their illness and who presented with disgusting symptoms. Induced compassion offset disengagement and qualified health professionals were more caring and willing to help patients than medical students. The compassion induction eliminated some differences between experienced and trainee clinicians.
Conclusions: This research demonstrates that disgust and patient responsibility impacts clinical engagement and that medical students are more impacted by such scenarios than qualified health providers. Inducing compassion may help to mitigate these differences, and further investigation into strategies that foster engagement with difficult patients is warranted. Statement of contribution What is already known on the subject? Health care providers are required to sustain care across all patients; however, some patients are more difficult to engage with than others. Clinical engagement appears to be impacted when patients present with disgusting symptoms and/or are to blame for their own health problems. What does this study add? This work reports on a vignette-based study that shows that disgusting symptoms and patient responsibility impact self-reported measures of clinical engagement in response to patient scenarios. Qualified health care providers are less likely to disengage in these situations than medical students. A very brief online induction of compassion has potential to mitigate differences between trained professionals and students.
Keywords: compassion; disgust; emotion; engagement; health; health care providers; medicine.
© 2019 The British Psychological Society.