Clinical Empathy Research Articles

Empathetic Communication in Telemedicine: A Pilot Study.

In health care, empathy is a clinician's ability to understand a patient's emotional state and convey that understanding in their care; and being culturally sensitive is communicating and respecting cultural differences. Providing health care on digital platforms introduces a new challenge of conveying empathy and cultural sensitivity. This study aimed to evaluate whether patients who were seen in-person had different perceptions of clinicians' empathy and cultural sensitivity compared to those who were seen via telemedicine. In this cross-sectional pilot study, we recruited primary care clinicians (N=8) and their telemedicine (N=14) and in-person patients (N=20) from two clinics at Emory University in Atlanta, Georgia. We evaluated clinicians' empathy and cultural sensitivity by self-report and from patients' standpoints. Patient perception of clinician empathy scores were similar (P value=.31) for in-person appointments (mean=33.8) and telemedicine appointments (mean=31.3). Patient perception of culturally sensitive communication varied in the sensitivity domain and was consistently low for the domain of discrimination (suggesting low discrimination among the clinicians) regardless of the modality of the visit. This novel pilot study demonstrated comparable empathy and culturally sensitive communication scores in telemedicine and in-person visits, highlighting the potential for continued use of telemedicine in outpatient primary care. Delivery of care via telemedicine can enable an expansion of high-quality care to underserved communities. Future studies are needed to confirm our findings to enhance the experience of telemedicine visits for patients and clinicians.

Comparison of empathy profiles of medical students at the start and in the advanced clinical phase of their training.

The National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM) cites empathy as a basic competence for medical doctors. Based on a multidimensional concept of clinical empathy, empathy profiles of medical students at the start of their training and in the 9th semester were identified and compared in order to draw conclusions for the conception of effective course offers. Using the Saarbrücker Personality Questionnaire on Empathy (SPF-IRI), self-rated empathy was recorded in a cross-sectional study of medical students (1st semester: N=192/9th semester: N=221). Two Stage Clustering was performed for data analysis. Three empathy profiles which could be meaningfully delineated by content were identified: 1. reflected, functional empathy, 2. unreflected, burdensome empathy and 3. distancing and avoidance. Students in the 9th semester mostly tended toward unreflected, burdensome empathy. Only one-third appeared capable of feeling empathy with patients while at the same time adequately regulating their own emotions and thus protecting themselves from emotional overload. An adequately reflected and functional empathy among medical students can neither be assumed at the start of their training, nor do existing course offers appear to provide sufficient training for this. Empathy should thus be implemented as a competence which needs to be promoted over the entire course of study. Emotion regulation plays a key role.

Preparation and validation of a Brazilian Clinical Empathy Scale (EBEC): pilot test

Preparation and validation of a Brazilian Clinical Empathy Scale (EBEC): pilot test

Patient perceptions of altering chemotherapy treatment due to peripheral neuropathy.

Clinical practice guidelines recommend altering neurotoxic chemotherapy treatment in patients experiencing intolerable chemotherapy-induced peripheral neuropathy (CIPN). The primary objective of this survey was to understand patient's perspectives on altering neurotoxic chemotherapy treatment, including their perceptions of the benefits of preventing irreversible CIPN and the risks of reducing treatment efficacy. A cross-sectional online survey was distributed via social networks to patients who were currently receiving or had previously received neurotoxic chemotherapy for cancer. Survey results were analyzed using descriptive statistics and qualitative analysis. Following data cleaning, 447 participants were included in the analysis. The median age was 57 years, 93% were white, and most were from the UK (53%) or USA (38%). Most participants who were currently or recently treated expected some CIPN symptom resolution (86%), but 45% of those who had completed treatment more than a year ago reported experiencing no symptom resolution. Participants reported that they would discontinue chemotherapy treatment for less severe CIPN if they knew their symptoms would be permanent than if symptoms would disappear after treatment. Most patients stated that the decision to alter chemotherapy or not was usually made collaboratively between the patient and their treating clinician (61%). The most common reason participants were reluctant to talk with their clinician about CIPN was fear that treatment would be altered. Participants noted a need for improved understanding of CIPN symptoms and their permanence, better patient education relating to CIPN prior to and after treatment, and greater clinician understanding and empathy around CIPN. This survey highlights the importance of shared decision-making, including a consideration of both the long-term benefits and risks of altering neurotoxic chemotherapy treatment due to CIPN. Additional work is needed to develop decision aids and other communication tools that can be used to improve shared decision making and help patients with cancer achieve their treatment goals.

임상간호사의 공감역량과 자기자비, 회복탄력성, 환자중심간호 간 구조적 모형분석

Objectives The purpose is the study builds a research model based on previous research to construct a model that can predict the relationship between clinical nurses' empathy capacity, self-compassion, resilience, and pa-tient-centered nursing, and the model fit and structural relationship between the research hypothesis and the re-search model analyzed.
 Methods The subjects of the study were three general hospitals with more than 250 beds in U City, and 230 clinical nurses were selected as a convenience sample. Data were collected from August 1 to August 10, 2023 by filling out a structured questionnaire. Statistical analysis used SPSS 25.0 and AMOS 25.0 programs and was analyzed through structural equation model(SEM).
 Results The significance verification results of the path coefficient, in empathic capacity, self-compassion (β=.504, p<.001), resilience (β=.693, p<.001) and patient-centered nursing (β=.849, p) <.001) was significantly positive (+). The direct path from resilience to patient-centered nursing (β=.399, p<.001) was positive and significant, and the direct path from self-compassion to patient-centered nursing was not significant. The significance of the media-ting effect was verified through bootstrapping, and the indirect effect of empathy on patient-centered nursing by mediating self-compassion (β=.293, p<.001) and patient-centered nursing by mediating resilience The indirect effect (β=.508, p<.001) was verified to be statistically significant.
 Conclusions Clinical nurses' empathy competency had a direct effect on patient-centered nursing and also had an indirect effect through resilience and self-compassion, so it was verified that resilience and self-compassion played a partial mediating role in the impact of empathy competency on patient-centered nursing.

Family Responses to Different Types of Clinician Empathy Expression in Pediatric Care Conferences.

Background: Clinician empathy positively impacts patient outcomes. Few studies have assessed the effects of different types of empathic expression. Objective: To describe how families respond when clinicians express empathy in different ways. Design: Prospective, mixed-methods cohort. Setting/Subjects: English and interpreted pediatric inpatient care conferences at a U.S. quaternary hospital between January 1, 2018 and January 1, 2021. Measurements: Directed content analysis of clinician empathic statements and family responses. Results: Of 29 patient-family dyads, 11 (39%) used language interpretation. In response to 80 clinician empathic statements, families expressed agreement or shared more 84% (67/80) of the time. Families shared more about their perspective in response to explore statements 71.4% (10/14) of the time, in response to validate statements 61% (17/28) of the time, and in response to respect/support statements 39% (11/28) of the time. Conclusion: Certain types of empathic statements may be more effective at prompting families to share more about their perspective, a key element of shared decision-making.

BEDSIDE LEARNING: VITAL FOR NURSING EDUCATION - CREATING COMPETENT, EMPATHETIC HEALTHCARE PROFESSIONAL

This comprehensive review explores the vital role of bedside learning in nursing education, focusing on its impact on clinical skill development and empathy among students. By bridging theoretical knowledge with practical application, bedside teaching allows nursing students to apply classroom concepts directly to patient care, enhancing understanding and retention. The review highlights evidence-based practice (EBP) teaching strategies and emphasizes the need for improved interactive and clinically integrated approaches.. It cultivates empathy and compassion as students interact with patients personally, witnessing their struggles and hopes. Furthermore, bedside learning enhances communication skills, enabling students to establish meaningful connections with patients and healthcare teams. Finally, this method promotes critical thinking by challenging students to analyze patient cases and make informed decisions. Conclusion:In conclusion, research highlights the pivotal role of bedside teaching in clinical education, especially in nursing. Hands-on experiences and patient interactions are essential for developing clinical reasoning skills, fostering patient-centered care, and nurturing professional growth. Conflict of Interest: There is no conflict of interest.

Clinical empathy and patients’ rights in geriatric care: analysis of the perception of physicians and elderly patients

The research object of this study is to analyze articulations between clinical empathy and patients’ rights and to propose a set of supporting foundations to build a theoretical basis for the formulation of an aspect of Clinical Bioethics, based on clinical empathy and patients’ rights. The research was carried out involving 5 geriatricians and 4 elderly patients. Geriatric care is permeated by a series of challenges related to the biopsychosocial process of aging, which causes cognitive, emotional, and physical vulnerabilities in elderly patients, which is combined with problematic issues concerning ageism. Thus, elderly patients, in addition to the weaknesses experienced by patients in general, have specificities that make them fear placing themselves in an equal relationship with the physician, by asking questions, inquiring about risks, and bringing their perspective into the decision-making process.

Becoming futile: the emotional pain of treating COVID-19 patients.

The COVID-19 pandemic has had a profoundly detrimental impact on the emotional wellbeing of health care workers. Numerous studies have shown that their rates of the various forms of work-related distress, which were already high before the pandemic, have worsened as the demands on health care workers intensified. Yet much less is known about the specific social processes that have generated these outcomes. This study adds to our collective knowledge by focusing on how one specific social process, the act of treating critically ill COVID-19 patients, contributed to emotional pain among health care workers. This article draws from 40 interviews conducted with intensive care unit (ICU) staff in units that were overwhelmed with COVID-19 patients. The study participants were recruited from two suburban community hospitals in Massachusetts and the interviews were conducted between January and May 2021. The results show that the uncertainty over how to treat critically ill COVID-19 patients, given the absence of standard protocols combined with ineffective treatments that led to an unprecedented number of deaths caused significant emotional pain, characterized by a visceral, embodied experience that signaled moral distress, emotional exhaustion, depersonalization, and burnout. Furthermore, ICU workers' occupational identities were undermined as they confronted the limits of their own abilities and the limits of medicine more generally. The inability to save incurable COVID-19 patients while giving maximal care to such individuals caused health care workers in the ICU an immense amount of emotional pain, contributing to our understanding of the social processes that generated the well-documented increase in moral distress and related measures of work-related psychological distress. While recent studies of emotional socialization among health care workers have portrayed clinical empathy as a performed interactional strategy, the results here show empathy to be more than dramaturgical and, in this context, entailed considerable risk to workers' emotional wellbeing.

Impact of a longitudinal course on medical professionalism on the empathy of medical students

ObjectiveMedical education should enhance empathy. We examined, using self-assessment instruments and standardized patients (SPs), the impact on empathy, of a multi-year intervention (years 4–6 of medical training) that uses reflective learning approaches. Methods241 final-year medical students participated; 110 from the 2018 graduation class (non-intervention group) and 131 from the 2019 graduation class (intervention group). Participants completed two self-reported empathy questionnaires – the Jefferson Scale of Empathy-Students (JSE-S) and the Interpersonal Reactivity Index (IRI) – and a personality questionnaire, the NEO Five-Factor Inventory. Additionally, SPs in a simulated station assessed participants’ empathy with two patient-reported instruments: the Consultation and Relational Empathy (CARE) scale and the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE). ResultsEmpathy scores were significantly higher in the intervention group compared to the non-intervention group when assessed by the SP (p < 0.001). No differences were found in self-reported questionnaires between the two groups. ConclusionA longitudinal, multi-year reflection-based intervention enhanced empathy amongst medical students as assessed by SPs, but not when assessed by student self-reported measures. Practice ImplicationsMulti-year reflective learning interventions during clinical training nurture empathy in medical students. Assessments completed by SPs or patients may enhance the evaluation of empathy.

임상간호사의 공감역량과 회복탄력성, 자기자비, 환자중심간호에 관한 연구

Objectives The purpose of this study is to identify differences and correlations between variables such as em-pathy capacity, resilience, self-compassion, and patient-centered nursing according to the general character-istics of clinical nurses.&#x0D; Methods A structured questionnaire was distributed to 230 clinical nurses working in three secondary medical in-stitutions with more than 250 beds in U City, and 218 copies of the data were used in the final analysis. This is a descriptive correlation study. Data analysis included descriptive statistics, independent samples t-test, one-way ANOVA, Scheffé post hoc test, Person’s correlation analysis, and tool reliability using the SPSS 25.0 program.&#x0D; Results There was a significant difference in empathy capacity according to general characteristics depending on age, and the age was higher in those aged 50 or older than in those aged 30 to 39 (F=3.81, P&lt;.01). There was a significant difference in resilience depending on age, and it was higher in those aged 50 or older than those aged 29 or younger, 30 to 39, or 40 to 49 (F=7.25, P&lt;.001). There was a statistically significant difference in pa-tient-centered nursing depending on the age, position, and work department of the study subject, with the age range being higher in those aged 50 or older than those aged 29 or younger, 30 to 39, or 40 to 49 (F=7.25). , P&lt;.001), the head nurse was higher than the charge nurse (F=6.18, P&lt;.01), and the working department was high-er in the general ward and intensive care unit than the operating room and anesthesiology department (F=4.76, P). &lt;.001). Looking at the correlation results, resilience is empathy competency (r=.551, p&lt;.01), patient-centered nursing is empathy competency (r=.637, p&lt;.01), and resilience (r=.602, p&lt;.01). .01), self-compassion showed a statistically significant positive correlation with empathy (r=.306, p&lt;.01), resilience (r=.508, p&lt;.01), and It showed a statistically significant positive correlation with patient-centered nursing (r=.269, p&lt;.01).&#x0D; Conclusions Clinical nurses' empathy capacity, resilience, and self-compassion show a positive correlation with patient-centered nursing, so the development and application of programs to improve clinical nurses' resilience and self-compassion and to improve empathy are important in improving the quality of nursing services.

Assistive technologies for elderly patients with dementia: perspectives from the bioethics of health care.

Dementia is currently one of the most common diseases affecting elderly people, ranking seventh among leading causes of death. As it causes memory loss, difficulties in reasoning, and resulting difficulties in making and executing decisions, assistive technologies and cognitive stimulation are valuable resources in the care process. Based on a theoretical inquiry into the bioethics of health care, and drawing on the work of Aline Albuquerque and Victor Montori, this article focuses on three main issues: first, the concept of bioethics in health care, patient-centered care, and the idea of clinical empathy. Second, it looks at the use of assistive technologies in caring for elderly patients with dementia. Lastly, we offer a discussion of whether the care process could be considered a health technology.

임상간호사의 공감능력과 간호조직문화인지가 임상의사결정능력에 미치는 영향

Objectives This study investigates the influence of clinical nurses' empathy ability and Cognition of nursing organizational culture on clinical decision-making ability.&#x0D; Methods Data collection was conducted on 198 clinical nurses at two general hospitals at P City from February10 to February 28th, 2023. The data responded to the survey were analyzed using descriptive analysis, t-test, One-way ANOVA, Pearson's correlation coefficient, and Hierarchical Multiple Regression Analysis.&#x0D; Results As results of this study, empathy ability scored 5.01 out of 7, Cognition of nursing organizational culture 3.47 out of 5, decision-making ability score was 3.56 out of 5. Empathy ability was significantly higher when the woker higher departmental experience (F=2.567, p&lt;.05), the higher position (F=3.662, p&lt;.05). Cognition of nursing organizational culture increased woker higher departmental experience (F=2.753, p&lt;.05) and higher the position (F=3.234, p&lt;.05). Clinical nurses' of clinical decision-making ability was correlated with empathy ability(r=.568, p&lt;.001) and there was a correlation with Cognition of nursing organizational culture (r=.467, p&lt;.001), there was a correlation with also correlated with empathy ability(r=.370, p&lt;.001). Empathy ability(β=.457, p&lt;.001) and Cognition of nursing organizational culture (β=.298, p&lt;.001) had an effect on clinical decision-making ability, explaining 39.9% of the variance. In other words, it was results show that higher levels of empathy ability and Cognition of nursing organizational culture were associated with enhanced clinical decision-making ability.&#x0D; Conclusions Based on the results of this study, there is a need of the development and application of programs to clinical decision-making ability improvement program to strengthen clinical competency of Clincal nurses.

Impact of Artificial Intelligence (AI) on Psychological and Mental Health Promotion: An Opinion Piece

The digital revolution has made integrating artificial intelligence (AI) into the medical sector easier. AI is currently being used to speed up the detection of diseases in their early stages, facilitate the delineation and understanding of disease variations, and improve optimised treatment protocols. Psychology is no exception, as new role players have emerged, most notably the incorporation of AI into both psychological research and clinical practice. However, there is an apparent unease with AI as a technological breakthrough advancing science in mental health, such as data privacy, national guidelines on the use of AI, successful integration of users into the clinical setting and empathy, compared to human psychologists. Regardless, AI functions in psychology are gradually snowballing. We present an opinion on the impact of AI on improving mental health based on the exploration of available published evidence. We highlight the potential of AI in improving mental health care through mental health disorder detection, diagnosis, treatment, and public health education. The article also discusses the potential challenges and future directions, highlighting the importance of interdisciplinary collaboration and developing novel AI-based approaches to improve mental health outcomes.

James Michael Gilbertson.

A vet who focused on high clinical standards, kindness and empathy.

Association between tolerance for ambiguity specific to the clinical context and empathy in medical trainees: A multicenter cross-sectional study in Japan

Purpose Physicians’ empathy and ambiguity tolerance have recently become a focus of medical education. However, the association between the two concepts remains unclear. This study examined the association between empathy and ambiguity tolerance in the clinical context among medical trainees. Methods We conducted a multicenter cross-sectional study in 12 institutions: 2 universities for medical students and 10 hospitals for residents. We assessed ambiguity tolerance using the Japanese version of the Tolerance of Ambiguity in Medical Students and Doctors scale. The outcome variable was empathy, measured using the Japanese translation of the Jefferson Scales of Empathy (JSE). Results Data from 100 medical students and 135 residents were analyzed. After adjustment for possible confounders, the factor scores of ‘tolerance for things that are not black or white in medicine’ showed a dose-dependent association with the JSE. There was no clear trend in the association between the total scores or other factor scores and empathy. Conclusion This nationwide multicenter study showed that the factor scores of ‘tolerance for things that are not black or white in medicine’ were associated with empathy among medical trainees. Our findings may be helpful for developing interventions in the field of medical education to nurture empathy.

Clinical empathy as perceived by patients with chronic illness in Canada: a qualitative focus group study.

Although clinical empathy - the ability of a physician to understand a patient's illness experience, communicate this understanding and act collaboratively to create a treatment plan - provides substantial benefits to both physicians and patients, medical students typically experience a decline in empathy during training. The primary objective of this study was to generate a model of clinical empathy grounded in the perspectives of people with chronic illness living in Canada, to promote empathy-focused curricular development in Canadian medical education. We conducted a qualitative focus group study using a constructivist grounded theory approach. We recruited adults (age ≥ 18 yr) with chronic illness who had recently seen a physician in Canada from virtual support groups. Six semistructured virtual focus groups with 3-5 participants each were scheduled between June and September 2021. We coded the transcripts using the constant comparative method, allowing for the construction of an overarching theory. Twenty patients (17 women and 3 men) participated in the focus groups; 1 group had 2 participants because 1 participant failed to appear. The majority of participants (14 [70%]) had at least a college degree. The mean rating for overall satisfaction with the Canadian health care system was 5.4/10.0 (median 5.0). The emergent theory showed that the perceived presence of physician empathy engendered positive internal processing by patients, leading to increased health care efficacy and enhanced mental health outcomes. Negative patient processing in response to the perceived absence of empathy led to reduced quality of health care delivery (e.g., ineffective referrals and more appointments), increased use of health care resources, disruptions in patients' personal lives, and negative physical and mental health outcomes. Clinical empathy can have life-altering impacts on patients, and its absence may increase resource use. As empathy involves understanding patients' lived experiences, any valid intervention to improve clinical empathy must be informed by patient perspectives.

Effect of clinical practice stress, stress coping style and empathy on clinical competence of nursing students

Background: This cross-sectional survey aimed to explore the influence of clinical practice stress, stress coping, and empathy on the clinical competence of nursing students. Additionally, it aimed to compare the effectiveness of multiple regression analysis and quantile regression analysis in identifying the factors influencing clinical competence. Methods: Data was collected from 201 nursing students between June 15th and August 1st, 2016, and analyzed using several statistical methods, including descriptive statistics, t-tests, ANOVA, Pearson correlation, multiple linear regression, and quantile regression, using SPSS 21.0 and STATA 14.0 software. Results: The results demonstrated positive correlations among clinical competence and stress coping (r= .52, p &lt; .001) and empathy (r= .39, p &lt; .001). Variables like clinical learning environment (β= -.18, p=.007), practice workload (β= .22, p &lt; .001), and active stress coping (β= .57, p &lt; .001) were found to explain 50% of the variance in clinical competence. After quantile regression, affecting factors for clinical competence were active stress coping for all quantiles, clinical learning environment from 15% to 60% quantile, practice workload for 15~75% quantile, and nursing major satisfaction for 15% quantile. Conclusion: This study highlights the importance of stress coping abilities, empathetic skills, and a supportive clinical environment in fostering the clinical competence of nursing students. These findings can serve as a foundation for designing targeted strategies and educational programs to enhance nursing students' clinical competence effectively, considering various levels of clinical competency. The study results offer valuable insights into developing interventions to improve nursing education and enhance the overall quality of patient care delivered by future nursing professionals.

Reframing neonatal care from an empathic care perspective

Neonates are subjects of rights and, when they become patients, they should be valued as patients. Clinical empathy refers to the way health professionals empathize with patients and is an essential component of patient-centered care. Considering the paucity of studies regarding empathy in neonatal care, this theoretical article aimed to provoke a discussion about this issue and suggest a reframing of neonatal clinical practices. We emphasize why we should empathize with the neonate, considering the bioethical and quality of care aspects, the results of care, and the new reality of post-pandemic relationships. On a practical basis, we report how we can empathize with the neonate, reinforcing the need to see him as the patient, protect his best interests, the role of communication in healthcare, and the need to maintain the other-orientated perspective.

Alexithymia in Chinese patients with chronic schizophrenia: Prevalence, clinical correlates, and relationship with neurocognition and empathy.

Alexithymia is highly prevalent and strongly related to adverse consequences in patients with schizophrenia. However, its associated factors remain largely unexplored. The present study aimed to determine the prevalence of alexithymia and its association with sociocultural characteristics, clinical symptoms, neurocognition, and empathy in 854 Chinese patients with schizophrenia. Demographic information was collected through a self-designed questionnaire. Alexithymia was assessed by the Toronto Alexithymia Scale (TAS-20). We assessed clinical symptoms, neurocognition, and empathy via the following instruments: Positive and Negative Syndrome Scale, Repeatable Battery for the Assessment of Neuropsychological Status, and Interpersonal Reactivity Index. A multiple logistic regression model was conducted to determine the independent correlates of alexithymia. Approximately one-third (n = 277, 32%) of patients with schizophrenia had alexithymia. Patients with alexithymia had significantly more severe negative symptoms, neurocognition, and empathy impairment than patients without alexithymia. Being male, negative symptoms, personal distress, empathic concern, and language functioning were independently associated with alexithymia. Our findings demonstrate a high prevalence of alexithymia and its strong association with clinical symptoms, neurocognition, and empathy, which calls for timely screening and intervention for alexithymia in patients with schizophrenia. Targeting impaired language function, negative symptoms, and impaired affective empathy might help reduce alexithymia and its related negative consequences.