The mediating role of psychological capital on the relation between distress and empathy of medical residents: a cross-sectional survey

ABSTRACT

Background: Medical residents usually suffer from work overload and experience both personal and professional distress, which affects their level of the empathy to patients. Psychological capital (PsyCap) is a psychological resource that is negatively associated with indicators of distress.

Objective: This study explored the potential mediating effect of PsyCap on the relationship between distress and empathy, which may help healthcare professionals in their defense of empathy erosion due to distress.

Design: A total of 620 first-year residents were recruited for this cross-sectional survey. Empathy and PsyCap of residents were assessed by the Chinese version of the Jefferson Scale of Physician Empathy and the Psychological Capital Questionnaire, respectively. In this study, both personal and professional aspects contributing to resident distress were investigated by the Satisfaction with Life Scale and an occupational distress scale. T-tests and one-way ANOVA were used to test differences in empathy of residents. Pearson’s correlation was used to examine correlations between distress, PsyCap, and empathy. Structured equation modeling was used to conduct the pathway analysis to test the mediating effect of PsyCap on the association between distress and empathy.

Results: 537 residents (86.6%) completed the survey. Distress, empathy, and PsyCap were significantly correlated (P < .01) and in the expected directions. The first step analysis showed that as distress increased, the empathy of residents significantly decreased (P < .01), with the direct effect coefficient being 0.265. When PsyCap was included, the direct effect coefficient decreased to 0.033. This indirect effect was significant (P < .01). The variance accounted for was 81.14%, which indicated a partial mediating effect of PsyCap.

Conclusions: PsyCap may serve a significant protective role against the impact of distress on the level of empathy of medical residents. In addition to reducing distress, PsyCap development could be considered in empathy decline prevention and empathy cultivating strategies.

Abbreviations: PsyCap: Psychological capital; JSPE: Jefferson Scale of Physician Empathy; PCQ: Psychological Capital Questionnaire; SWLS: Satisfaction with Life Scale; VAF: Variance accounted for; SD: Standard deviation.

KEYWORDS:

• Medical residents
• empathy
• distress
• psychological capital
• mediating role

Acknowledgments

The authors would like to express their gratitude to Professor Bo Qu for his critical review of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Availability of data and materials

The datasets generated and/or analyzed during the current study are not publicly available due to concerns about the potential ability to identify individual participants using their demographic information and survey answers but are available from the corresponding author on reasonable request.

Authors contributions

JJ and HHL designed the study, participated in data collection, analyzed and interpreted the data, and drafted the manuscript. HHL participated in data collection and performed the statistical analysis. WWS and NJ helped to draft the manuscript and revised it critically for intellectual content. WYZ performed the statistical analysis and participated in interpretation of the data. DLW conceived the study and organized the survey. All authors read and approved the final manuscript.

Ethics approval

This study was approved by the Bioethics Academic Commission of China Medical University, Shenyang, China, and all subjects provided written informed consent prior to participation.

Consent for publication

Written informed consent was obtained from study participants for participation in the study and for publication of this research.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This study was supported by the China Postdoctoral Science Foundation [funding number: 2019M661181]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.