Predictors of Physician's Empathy: The Role of Spiritual Well-being, Dispositional Perspectives, and Psychological Well-being.

Objectives: Empathy is a core component of an efficient physician-patient relationship. Although students' preexisting medical views may influence responses to physician-patient relationship, there is little knowledge about the psychological predictive factors of empathic perspective for physician-patient relationship. We aimed to examine whether psychological well-being, dispositional perspective, and spiritual well-being could predict the empathic perspective of medical students regarding the physician-patient relationship.

Methods: In a cross-sectional study, 350 medical students of Babol University of Medical Sciences were recruited at four levels of education including basic sciences, preclinical medicine, clerkship, and internship. The students completed four questionnaires including Jefferson Scale of Empathy - student version, Brief Ryff psychological well-being, Individual Disposition, and Spiritual Well-Being.

Results: The score of medical student's perspective to clinical empathy was high (106.1±29.8, range: 20-140), but diminished with further years of education. Female students had higher empathy scores than their male counterparts. Pearson's correlation coefficient revealed a strong positive significant relationship between student's perspective to clinical empathy and spiritual well-being (r = 0.56), cognitive empathy (r = 0.51), and psychological well-being (r = 0.43), and tendency to egalitarianism (r = 0.37). The results of stepwise multivariate analysis regression revealed that cognitive empathy (β = 0.300), self-esteem (β = 0.133), and spiritual well-being (β = 0.388) positively predicted student's perspective to clinical empathy regarding the physician-patient relationship.

Conclusions: The results suggested that promoting empathic care in curricula of medical schools may be more effective if students' preexisting perspectives, cognitive empathy, self-esteem, spiritual well-being, and tendency to egalitarianism are taken into account.