Scores on reduced personal accomplishment, as one of burnout constructs, moderates the mediation effect of putamen (path a1, dash arrow). The inclusion of burnout levels into the mediation model abolishes the causal relationship between work experience (left panel), putamen activity (top), and context-dependent valence ratings (right panel). They are calculated controlling for work experience and for other mediators, as the standard in mediation models. The connection of each mediator to the outcome (valence ratings) is the b path. The lines are labeled with path coefficients, and standard errors are shown in parentheses. The connection of work experience to each brain mediator (putamen or dlPFC) is the a path.
Work experience (left) as the predictor variable predicts the hemodynamic activity in the putamen (top) and dlPFC (bottom). (A) Path diagram demonstrates the relationship between variables in the path model. Mediation analysis of context-dependent valence ratings.
Whether and how each scale of Burnout moderates the existing model and area of interest are considered as well. While observing the context-dependent valence and arousal ratings, we selected work experience as the predictor variable, and performed analyses to test if the above ROIs were the mediators of the linkage between work experience and subjective ratings of valence and arousal. These areas are the main ROIsfor the mediation analysis.
The hemodynamic response in the anterior cingulate cortex (ACC −14, 32, 28) and dorsomedial prefrontal cortex (dmPFC −6, 26, 52) was significantly negatively correlated with arousal ratings (shown in green), whereas the response in the putamen (24, −8, 10) and dorsolateral prefrontal cortex (dlPFC −42, 18, 30) was positively correlated with valence ratings (shown in magenta).
Situational contexts software#
Suprathreshold voxels ( p < 0.05 corrected for voxel-wise comparisons) are displayed across four coronal and sagittal sections on the ch2bet template, using MRIcron software ( ). Significant correlations occurred between context-dependent subjective ratings and neuro-empathetic reaction (Pain vs. The correlation between subjective ratings and work experience was specific to the context. (A) Context-dependent valence and arousal ratings. Highlights -Differences in behavior ratings and brain activations between medical practitioners perceiving others' pain in a hospital and at home.-Situational contexts significantly influence individual's empathic processing.-Perceiving rewards from patient care protects medical practitioners from burnout.-Empathy is a flexible phenomenon.īurnout clinical empathy emotional regulation functional MRI situational context. Overall, the study demonstrates how situational contexts significantly influence individuals' empathic processing, and that perceiving reward from patient care protects them from burnout. Mediation analysis indicated that reduced personal accomplishment, a symptom of burnout, breaks down the mediation effect of the putamen on context-dependent valence ratings. The reverse comparison resulted in an increased activity in the insula and anterior midcingulate cortex (aMCC). Physical pain perceived in a hospital compared to a home context produced stronger activity in the right temporoparietal junction (rTPJ). Participants with longer hospital terms evaluated pain as less negative in valence and arousal when occurring in a hospital context, but not in a home context. This fMRI study recruited one hundred female nurses, who varied the length of work experience, and examined how their neural response, functional connectivity, and subjective evaluations of valence and arousal to perceiving another individual in physical pain are modulated by the situational context in which they occur (i.e., in a hospital or at home). However, how work experience modulates the empathic responses and brain activation patterns in medical professions remains elusive. Clinical empathy, which is defined as the ability to understand the patient's experience and feelings from the patient's perspective, is acknowledged to be an important aspect of quality healthcare.
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