Investigating the effect of psycho-educational intervention on preoperative anxiety in bariatric surgery candidates: a randomized controlled trial.

Medical humanistic care, as an interdisciplinary field applying humanistic principles to healthcare, primarily involves medicine and nursing and engages practitioners, patients, and students in clinical context [, ]. Previous researchers have proposed that the ultimate goal of medical humanistic care is to enhance patients’ quality of life and address their complex requirements []. Effective implementation of medical humanistic care has been shown to enhance recovery rates, particularly in mental and psychological illnesses, and provide substantial benefits to patients []. Furthermore, it fosters essential professional qualities including integrity, honesty, and compassion among healthcare workers, while reducing professional burnout, improving service quality, and strengthening therapeutic and nursing relationships [, ]. Based on previous evidence, positive doctor-patient and nurse-patient relationships are a critical factor in ensuring the smooth delivery of healthcare, while medical humanistic care serves as an underlying safeguard for these relationships []. Notably poor therapeutic relationships between healthcare providers and patients frequently lead to incidents of medical violence []. Empirical evidence from large-scale national surveys confirms the global prevalence of this issue. A 2018 study by the Chinese Medical Doctor Association reported that 62% and 66% of physicians had experienced medical disputes and conflicts, respectively, with verbal abuse constituting, the most common form, at 51% []. Similarly, a 2015 survey by the Indian Medical Association revealed that 75% Indian doctors had encountered workplace violence []. The lack of medical humanistic care is one of the key contributing factors to such incidents of medical violence. Although sufficient education in medical humanistic care has been confirmed to lower rates of medical violence, its translation into outcomes varies [, ]. A randomized controlled trial showed that structured communication training significantly reduced perceived patient aggression among healthcare workers, demonstrating a large effect size []. Conversely, other training focusing on de-escalation, though it greatly improved confidence and reduced burnout, failed to produce a significant short-term decline in violence incidence []. This indicates that while the empowerment of healthcare workers through boosted confidence and better mental health is a direct benefit of humanistic education, its effect on tangible violence reduction likely requires a longer period or depends on synergistic advancements with comprehensive measures aimed at patients and the healthcare system. The value of medical humanistic care education is overlooked in many parts of the world, as evidenced by studies in the United States, United Kingdom, and China [–]. In mainland China, the deficiency is systemic, characterized not only by a limited range of standalone courses but also by a lack of integration across the educational ecosystem, including the scarcity of dedicated medical humanities institutes, the persistence of didactic pedagogical methods with little innovation, and a broader campus culture and faculty development system that may not consistently reinforce humanistic values [].