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Healthcare provider compassion is associated with lower PTSD symptoms among patients with life-threatening medical emergencies: a prospective cohort study

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Abstract

Purpose

We tested the hypothesis that, during a life-threatening medical emergency, patient perception of healthcare provider (HCP) compassion is associated with the subsequent development of post-traumatic stress disorder (PTSD) symptoms.

Methods

Prospective cohort study in the emergency department (ED) of an urban academic medical center. We included adult patients presenting with a life-threatening medical emergency, defined as respiratory or cardiovascular instability requiring a potentially life-sustaining intervention in the ED. We measured patient perception of HCP compassion in the ED using the Consultation and Relational Empathy (CARE) measure, a validated 40-point scale. Blinded to clinical outcomes (including the CARE measure), we assessed PTSD symptoms 1 month post-discharge using the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders-5.

Results

Of the 99/113 (88%) patients who completed follow-up, 25% (95% CI 17–35%) had PTSD symptoms at 1 month. In a multivariable model adjusting for potential confounders (e.g. severity of illness score in ED, need for intensive care unit admission, ED overcrowding, and family member emotional support in the ED), patient perception of greater HCP compassion in the ED was independently associated with lower PTSD symptoms at 1 month [odds ratio 0.93 (95% CI 0.89–0.98)]. A one-point increase in the CARE measure was associated with a 7% decrease in the odds of developing PTSD symptoms.

Conclusions

PTSD symptoms are common among ED patients with life-threatening medical emergencies. Patient perception of greater HCP compassion during the emergency is independently associated with lower risk of developing PTSD symptoms.

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Authors and Affiliations

  1. Department of Emergency Medicine, Cooper University Health Care, Cooper Medical School of Rowan University, One Cooper Plaza, K152, Camden, NJ, 08103, USA

    Jeena Moss, Lisa Shea, Christopher W. Jones, Hope Kilgannon & Brian W. Roberts

  2. Institutional Research and Outcomes Assessment, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA

    Michael B. Roberts

  3. Department of Medicine, Columbia University Medical Center, New York, NY, USA

    Donald E. Edmondson

  4. Department of Medicine, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, NJ, USA

    Stephen Trzeciak

  5. Center for Humanism, Cooper Medical School of Rowan University, Camden, NJ, USA

    Stephen Trzeciak & Brian W. Roberts

Authors
  1. Jeena Moss
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  2. Michael B. Roberts
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  3. Lisa Shea
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  4. Christopher W. Jones
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  5. Hope Kilgannon
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  6. Donald E. Edmondson
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  7. Stephen Trzeciak
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  8. Brian W. Roberts
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Corresponding author

Correspondence to Brian W. Roberts.

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Conflicts of interest

Dr. Trzeciak is an author on a soon to be released book about compassion science, entitled, “Compassionomics”. None of the other authors have potential conflicts of interest to disclose.

Ethical statement

The institutional review board at our institution approved this study, and all subjects provided written informed consent to participate in the study.

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Moss, J., Roberts, M.B., Shea, L. et al. Healthcare provider compassion is associated with lower PTSD symptoms among patients with life-threatening medical emergencies: a prospective cohort study. Intensive Care Med 45, 815–822 (2019). https://doi.org/10.1007/s00134-019-05601-5

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  • DOI: https://doi.org/10.1007/s00134-019-05601-5

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