UNIVERSITY EXTENSION EXPERIENCE SEEKING EMPATHY IN HANSEN’S DISEASE PATIENTS: A BEFORE-AFTER QUASI-EXPERIMENTAL STUDY IN MEDICAL STUDENTS AND AFFECTED PERSONS

Abstract

Introduction: empathy is a core clinical competency for humanizing care of persons affected by Hansen’s disease (leprosy), who continue to face stigma and discrimination despite available diagnostic and therapeutic advances. Objective: to determine the level of empathy, knowledge and attitude of fifth-year medical students from Universidad Católica “Nuestra Señora de la Asunción”, Campus Guairá, before and after a university extension activity at the Santa Isabel Leprosarium (Sapucai, Paraguay), and to describe the satisfaction level and social situation of the Hansen’s disease patients seen, in June 2023. Materials and Methods: an analytical study with a before-after quasi-experimental design, without a control group, and a cross-sectional descriptive component for sociodemographic and patient-satisfaction variables. Forty-two medical students and 37 Hansen’s disease patients residing at the Santa Isabel Leprosarium participated, selected through non-probabilistic convenience sampling. A structured questionnaire (1-7 and 1-10 Likert-type scales) was administered to students before and after the extension, and a satisfaction questionnaire to patients at the end of the visit. Qualitative and discrete quantitative variables were summarized as absolute and relative frequencies, and the before-after analytical comparison of ordinal scores was performed using the Mann-Whitney U test, with significance set at p < 0.05. Results: maximum empathy (score 10) among students increased from 42.9% before to 66.7% after the extension, with a statistically significant increase in the median score (9 vs. 10; Mann-Whitney U test, p = 0.002); high knowledge (scores 8-10) rose from 35.2% to 75.5% (median 7 vs. 8; p < 0.001). Willingness to “put oneself in the patient’s place” (score 7) increased from 52.4% to 73.8% (p = 0.033). 78.6% of students already considered empathy a therapeutic factor before the extension, with no subsequent change (ceiling effect; p = 1.000). The attitude variable showed a bimodal pattern with no statistically significant difference between time points (p = 0.327). 73% of patients reported being very satisfied with the care received in 2023; 70.3% received no family visits and 29.7% received no visits from friends since admission to the leprosarium.

Conclusion: the university extension experience was associated with a perceptible increase in empathy, knowledge and attitudinal disposition of medical students toward persons with Hansen’s disease, and generated a high level of satisfaction and perceived benefit among patients, in a context of persistent social isolation. These findings support the systematic incorporation of community extension experiences into medical education as a strategy to strengthen clinical empathy and reduce stigma associated with neglected diseases.