title: Short- and long-term subjective medical treatment outcome of trauma surgery patients: the importance of physician empathy.
abstract: OBJECTIVE
  To investigate accident casualties' long-term subjective evaluation of treatment outcome 6 weeks and 12 months after discharge and its relation to the experienced surgeon's empathy during hospital treatment after trauma in consideration of patient-, injury-, and health-related factors. The long-term results are compared to the 6-week follow-up outcomes.
  
  
  METHODS
  Two hundred and seventeen surgery patients were surveyed at 6 weeks, and 206 patients at 12 months after discharge from the trauma surgical general ward. The subjective evaluation of medical treatment outcome was measured 6 weeks and 12 months after discharge with the respective scale from the Cologne Patient Questionnaire. Physician Empathy was assessed with the Consultation and Relational Empathy Measure. The correlation between physician empathy and control variables with the subjective evaluation of medical treatment outcome 12 months after discharge was identified by means of logistic regression analysis under control of sociodemographic and injury-related factors.
  
  
  RESULTS
  One hundred and thirty-six patients were included within the logistic regression analysis at the 12-month follow-up. Compared to the 6-week follow-up, the level of subjective evaluation of medical treatment outcome was slightly lower and the association with physician empathy was weaker. Compared to patients who rated the empathy of their surgeon lower than 31 points, patients with ratings of 41 points or higher had a 4.2-fold higher probability to be in the group with a better medical treatment outcome (3.5 and above) on the Cologne Patient Questionnaire scale 12 months after discharge from hospital (P=0.009, R (2)=33.5, 95% confidence interval: 1.440-12.629).
  
  
  CONCLUSIONS
  Physician empathy is the strongest predictor for a higher level of trauma patients' subjective evaluation of treatment outcome 6 weeks and 12 months after discharge from the hospital. Interpersonal factors between surgeons and their patients are possible key levers for improving patient outcomes in an advanced health system. Communication trainings for surgeons might prepare them to react appropriately to their patients' needs and lead to satisfactory outcomes for both parties.
authors.affiliation: Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Campus Cologne-Merheim, Germany.
authors.forename: Simone
authors.initials: S
authors.lastname: Steinhausen
authors.affiliation: Federal Centre for Health Education (BZgA), Cologne, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Ommen
authors.affiliation: Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Campus Cologne-Merheim, Germany.
authors.forename: Sunya-Lee
authors.initials: SL
authors.lastname: Antoine
authors.affiliation: Institute for Applied Social Sciences (infas), Bonn, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Koehler
authors.affiliation: Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Science and Faculty of Medicine, University of Cologne, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Pfaff
authors.affiliation: Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Campus Cologne-Merheim, Germany.
authors.forename: Edmund
authors.initials: E
authors.lastname: Neugebauer
keywords: accident; communication; injury; long-term outcome; patient-reported outcome; physician–patient interaction; trauma surgery