Empathy and Occupational Health and Well-Being in Ecuadorian Physicians Working with COVID-19 Patients: A Mixed-Method Study

Abstract

Approximately one out of ten COVID-19 cases in Ecuador was a physician. It has been reported that this situation has led to a serious detriment of physicians' health and well-being. This study aimed to (i) identify predictors of emotional exhaustion, somatization, and work alienation in Ecuadorian physicians working with COVID-19 patients and (ii) explore the pandemic impact on doctor-patient relationships and on empathy. In 79 Ecuadorian physicians (45 women) who worked with COVID-19 patients, two separate multiple regression models explained the following: 73% of the variability of emotional exhaustion was based on somatization, work alienation, working sector, and passing through a symptomatic infection (p < 0.001), and 56% of the variability of somatization was based on gender and emotional exhaustion (p < 0.001), respectively. Furthermore, intention to leave the profession was more frequent among physicians with greater work alienation (p = 0.003). On the contrary, more empathic physicians never considered leaving their profession during the COVID-19 pandemic (p = 0.03). In physicians' verbatim, cognitive empathy appeared associated to a positive change in doctor-patient relationships. On the contrary, having an overwhelming emotional empathy appeared associated to a negative change in doctor-patient relationships. These findings characterize differences in how physicians cope while working in the frontline of the pandemic.

Keywords: COVID-19; doctor-patient relationship; emotional exhaustion; empathy; somatization; work alienation.

Figure 1

Scores of emotional exhaustion (A), somatization (B), and work alienation (C) by variables with statistical significance in Ecuadorian physicians who worked with COVID-19 patients. SE, scale of exhaustion; SS, scale of somatization; SA, scale of alienation.

Figure 2

Scores of clinical empathy by the intention to leave the medical profession in Ecuadorian physicians who worked with COVID-19 patients. JSE-HP, Jefferson Scale of Empathy, Healthcare professional version. * p < 0.05. Outlier is represented by a dot.