Lack Of Empathy Research Articles

Exploring social media influencers’ moral dilemmas through role theory

ABSTRACT This study examines how social media influencers (SMIs) perceive their role in the complex relationships between brands, followers, and society, the moral dilemmas they face, and how they deal with them. The results show that SMIs find themselves in different roles depending on which stakeholders’ expectations they fulfil. Using role theory as a theoretical framework, we find that the conflicts between extended expectations (commitment, authenticity, and responsibility) lead to various moral dilemmas: non-disclosure, withholding negative experiences, lack of empathy, promotion of products without genuine experience, sharing opinions on socially relevant issues, and promotion of harmful products. Strategies for resolving these dilemmas which help SMIs manage their complex moral obligations include: spotlighting a role, downplaying a role, customizing a role, and resorting to a role.

Re-conceptualizing the villain: Todd Phillips’s Joker through the lens of Vedic hermeneutics

This article attempts to examine the portrayal of the character of Arthur Fleck in Todd Phillips’s Joker (2019). In the initial part of the film, Arthur exhibits signs that reveal he is headed towards committing a violent crime. Arthur displays signs of psychopathy and a lack of empathy. This article links criminal behaviour analysis to the Bible of the Arya Samaj, an Indian text, to find out how ancient Indian literature’s empirical theories, which are intertwined with philosophical and religious content, shed light on criminal behaviour. The primary purpose of this article is to analyse the behavioural pattern in the character of Fleck and establish links to Dayanand Saraswati’s Satyarth Prakash, which discusses different types of Avidyas, a key concept in Indian philosophy that can be translated as ignorance or unwisdom, which is seen as a fundamental cause of suffering and bondage. It is certainly a significant factor in a person’s personality and behaviour. The major aim of this character analysis is not only to establish the link between Indian ancient texts and criminological behavioural patterns but also to reconceptualize evil through the lenses of Vedic hermeneutics. Vedic hermeneutics is the study of interpreting and understanding the ancient Vedic texts of Hinduism, where an important aspect is the recognition of different levels of meaning within the texts.

Enhancing empathy through virtual reality: Developing a universal design training application for students.

The lack of empathy towards disability is a significant societal issue that hampers inclusivity and understanding. Many struggle to comprehend the daily challenges and experiences faced by people with disabilities, leading to ignorance, prejudice, and exclusion. However, empathy plays a pivotal role in addressing this problem and serves as the foundation for developing and creating better products, services, and environments. This article explores the potential of developing virtual reality (VR) applications to enhance students' empathy towards individuals with disabilities. By increasing empathy levels, students are expected to gain significant qualifications in universal design (UD). The full application development process covers the most suitable head-mounted display (HMD) set. The implementation methodology using the Unity programming platform, the approach adopted for conducting classes using the developed VR application, and the deployment stage. Testing was successfully conducted on a student population, receiving positive user feedback. Through the integration of VR technology, the authors thoroughly describe how to address the empathy gap and equip students with essential skills for inclusive and accessible design. The findings presented in this study provide valuable guidance for educators and developers interested in harnessing VR's potential to foster empathy and advance universal design practices. With the presented methodology and proposed application, the authors demonstrate the effectiveness of VR applications in elevating students' empathy levels, consequently enhancing their qualifications in universal design. Med Pr. 2023;74(3):199-210.

Importance of Communication in Obstetric Practice

BACKGROUND: Communication is an art, a complex of methods of speaking, transmitting, perceiving information, and intentions. The elements of communication have an impact on the subjects and the processes taking place. Obstetric care has its specifics and is sensitive to the content of information, the participants in the process of communication, and the way of perception. AIM: The aim of this study is to differentiate the communication relationships of healthcare professionals in obstetric structures with patients, improving the safety of obstetric care. The subject of the study is medical specialists and patients from three obstetric structures in Sofia. Varna. Sociological methods of survey and observation are used. METHODS: The data are processed using sociological methods that are used in survey. The data are processed with Microsoft Word and Excel. RESULTS AND DISCUSSION: A survey was conducted among 206 respondents-healthcare professionals and patients. About 38.09% of healthcare professionals rated communication as very good and 36.07% of patients as good. The problems in communication for the medics are as follows: large administrative activity; workload; incompleteness of the information received; and lack of time for communication. In patients, problems refer to misunderstanding of the information received, insufficient time to communicate with doctors, lack of empathy, and poor attitude. According to pregnant women, the leading factors for good obstetric care are personal attention, good communication with specialists, detailed information, and support. CONCLUSION: Healthcare professionals must be able to conduct proper and patient-centered communication to provide them with the care that they want and need. Using the right communication strategies can help patients feel heard, and encourage them to provide accurate and relevant information so they can assist during the healing process.

Lived Experiences of Adolescents Living With Primary Chronic Pain

BackgroundPrimary chronic pain (PCP), a relatively new classification, characterizes pain that is not a secondary response to an underlying primary condition such as trauma or cancer. This study explored the lived experience of adolescents with a diagnosis of PCP. MethodA qualitative methodology, Interpretative Description (ID), was used to guide our study. ID uses a constructivist approach and allows for clinician experience to guide a theoretical scaffold of inquiry, which can be refined as the data collection progresses. We interviewed fifteen adolescents (n = 15) living with PCP. ResultsAll participants in this sample reported struggling with diagnostic uncertainty, depression, and anxiety. Adding to their distress was the fact that our participants perceived that health care professionals did not believe them when they described their pain and its intensity. ConclusionsWhile significant research is being conducted on PCP, participants believe there is a lack of knowledge about PCP as a diagnosis and thus there are limited resources and a lack of empathy and understanding for these adolescents.

Multifaceted Empathy Test (MET): Validity evidence for the Brazilian population concerning the computer-based (face-to-face) and online versions.

The lack of empathy is associated with several psychological and behavioral disorders, and it is important to assess this construct broadly, through multi-methods. To conduct a psychometric analysis of the Brazilian version of the Multifaceted Empathy Test (MET), a computerized task that assesses emotional and cognitive empathy. The samples were recruited from the community using the snowball method (phase 1: face-to-face; N = 142) and through social media (phase 2: online; N = 519). The participants completed the MET and the Interpersonal Reactivity Index (IRI) to assess the convergent validity between the instruments. To assess validity with correlated constructs (resilient coping and stress), the Brief Resilient Coping Scale and Perceived Stress Scale were used. A task was also implemented in the face-to-face application to assess facial emotions. The retest was applied 25 days later to a portion of the sample (face-to-face: N = 31; online: N = 102). It was observed adequate test-retest reliability for most items (ICC = 0.49-0.98), satisfactory infit and outfit indexes, discriminatory ability between sexes, weak convergent validity with empathy measures (r = 0.17-0.36), and correlate constructs (r = 0.12-0.46). MET presented good psychometric indicators, confirming its use in face-to-face/computer-based and online formats in clinical and research contexts. However, weaknesses were found regarding the cognitive subscale, demanding future studies to address larger samples to enable more robust conclusions concerning its adequacy. Further research on the instrument's internal structure can also contribute to its improvement.

SWOT -AHP AS A METHOD OF PUBLIC SERVICE STRATEGY

SWOT-AHP helps companies to develop and plan strategic alternatives to overcome all the challenges faced. The purpose of this study is to determine the public service strategy of the Makassar Laboratory Center. This research is a quantitative research, using the SWOT-AHP approach to determine the right strategy in improving organizational performance. Data is collected from the documentation results and then analyzed according to SWOT-AHP stages. The results of data processing show that in the item of strength, having an international standard TB lab is the most dominant strength possessed by BBLK Makassar, in the item of weakness, the biggest weakness is the organizational culture that still tends to be negative (rigid, individual, passive, lack of empathy in providing services, so efforts need to be made for the organization to carry out public services based on public excellent. While the most dominant opportunity to be utilized is information technology support, while the biggest threat faced by BBLK Makassar is the entry of foreign investors in laboratory services that have more sophisticated systems and equipment (the threat of global competition in the AFTA era). After the SWOT-AHP analysis, 4 strategies emerged, namely: increasing the promotion and technology-based information services, building an integrated information technology system, improving the quality and quantity of human resources, and maximizing tool utilization by adding new types of examinations.

P-461 Patients need fertility specialists to improve communication depth, quality and frequency in order to promote transparency, understanding and empathy with the patient

Abstract Study question What are the key pain-points that patients experience during fertility treatments? Based on patient perception, how can fertility clinics improve their standard of care? Summary answer Most patients would like to receive regular updates and more detailed explanation from their doctor, yet this happened in only half of the cases. What is known already IVF treatments have an emotional, psychological and economical toll on patients. On previous studies, half the women reported that infertility is the most upsetting experience of their lives, approximately 20% of the males and females had dysfunctional emotional distress or personal difficulties. Patient’s needs, pain points, expectations and education, therefore, require further research. Study design, size, duration An electronic survey was dispensed via the Embie mobile application or e-mail to women registered to Embie who have given their consent for communication. 98 women completed the survey from December 26th 2022 to January 15th 2023. The respondent profile was: White, Well-educated, from USA, 70% aged 31-40, 44% aged 31-35, heterosexual, tech oriented (100% Embie users), no kids, middle and upper middle class. Participants/materials, setting, methods The survey contained questions on demographics, IVF history, understanding of how patients choose their fertility clinic, how they educate themselves on their treatment options, how they communicate with their healthcare providers, awareness of AI, how they fund their treatment, their expectations for the clinic's equipment, usage of new advanced technologies and level of involvement in their fertility care. Main results and the role of chance Pricing is a pain-point for IVF patients, yet it does not affect their clinic choice, which is primarily linked to clinic location and doctor reputation. Most patients are willing to pay for modern technology. 58% of respondents state that the doctor discusses with them their chances of having a successful pregnancy, yet only 16% of women confidently know their chances of taking home a healthy baby. >90% of patients state that they would like to receive regular updates and detailed explanation from their doctor, yet this happened in only half of the cases. “Transparency of the process and decision making” is the most important tool for patients to empower themselves, followed by “answering my questions in detail”. While 60% feel comfortable approaching the doctor with questions, 40% state they search for an answer prior to asking the doctor. Almost all patients expand their knowledge before and after discussions with the doctors by Internet and by approaching experienced peers. Patients expect high-tech in clinics and are ready to pay for that. 92% of patients describe at least 1 pain point with their clinic: primarily communication: inconsistent communication (39%), lack of transparency (17%), lack of understanding (12%) and lack of empathy (4%). Limitations, reasons for caution The respondents mostly came from the USA and represented a non-diverse group. These findings may not generalize to other geographies or socio-economic groups. Wider implications of the findings The more the healthcare provider shares and involves the patient, the better the education they receive, and the less likely they will seek alternative information elsewhere which may be less medically accurate. Healthcare providers must educate themselves on the latest innovative technologies to meet patient expectations. Trial registration number n/a

“A Lack of Empathy:” A qualitative study of Black people seeking treatment for opioid use disorder

Racial inequities in the treatment of opioid use disorder (OUD) are an urgent and insidious issue, especially in the context of the national opioid overdose crisis. Medications for opioid use disorder (MOUD) are the standard of care and indisputably reduce morbidity and mortality from OUD. However, a racial treatment gap persists, with Black patients less likely to receive MOUD when compared to white patients. In this study, we seek to evaluate the experiences of Black individuals with OUD in seeking treatment. Qualitative semi-structured interviews were conducted with 25 participants who self-identified as Black or African-American and had been diagnosed with OUD in Philadelphia, Pennsylvania. Many participants described that their first experiences using buprenorphine involved using non-prescribed buprenorphine to self-manage withdrawal. Participants who had experienced buprenorphine treatment found it to be an effective treatment. Participants perceived the delivery of methadone maintenance treatment to be overly restrictive and unforgiving. The stigma of having a substance use disorder was felt to be compounded by the stigma of being a Black patient, leading to marginalization and discrimination during healthcare encounters. Participants desired compassionate, dignified, and individualized care in their OUD treatment. Given increasing rates of opioid overdoses among Black Americans and persistent disparities in treatment by race and ethnicity, our findings demonstrate the need for interventions that both promote equitable accessibility and flexible delivery of MOUD and interventions that reduce the stigma experienced by Black individuals while seeking addiction treatment.

Imaging correlates of premorbid personality in the Frontotemporal Dementia ‐ Amyotrophic Lateral Sclerosis (FTD‐ALS) spectrum

AbstractBackgroundFrontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) belong to the same neurodegenerative spectrum. Factors determining phenotypic expression are unknown; however, it is common observation that personality differs between phenotypes: ALS patients tend to display a pleasant and nice attitude, while FTD patients frequently exhibit antisocial behaviours and lack of empathy. We therefore aimed at testing if FTD and ALS patients have different premorbid personalities, and, consequently, different organizations in the brain networks involved in social behaviour and motor function.MethodWe recruited FTD and ALS patients presenting to Modena University Hospital Neurology Clinics. Patients’ premorbid personality was assessed through the NEO Personality Inventory 3, which evaluates five main personality factors (Neuroticism, Extraversion, Openness, Agreeableness, Conscientiousness). Brain MRI scan including T1‐weighted and resting state fMRI sequences was performed. Data were analysed with voxel‐based morphometry and probabilistic independent component analysis.Result50 patients (30 FTD, 17 ALS, and 3 FTD‐ALS) were recruited. A significant difference in premorbid personality emerged in the Openness and Extraversion domains, meaning that ALS patients – in their premorbid life – showed higher sociability, loquacity and optimism and were more prone to new experience, ideas, and emotions than FTD patients, respectively. Structural imaging analysis showed a positive correlation between premorbid Neuroticism and grey matter density of the hippocampus bilaterally (left>right) across all patients. Group comparisons of fMRI data showed greater functional connectivity (FC) in ALS compared to FTD patients within the Salience Network (SN) in the right insula, putamen, nucleus accumbens, and the left thalamus. FC within the SN positively correlated with premorbid Openness across all patients.ConclusionPremorbid personality differs between patients with ALS and FTD, and relates to different degrees of FC within the Salience Network. This suggests that premorbid personality may represent a vulnerability marker to the development of specific phenotypes along the FTD‐ALS spectrum.

Abstract 15: Breast Cancer Patient Experiences in the Botswana Health System: Is it Time for Patient Navigators?

Abstract Purpose: New models of care are required to support women with breast cancer due to rising incidence and mortality in sub-Saharan Africa. We evaluated experiences of breast cancer patients and their caregivers in Botswana to identify opportunities to improve service provision. Methods: Focus Group Discussions (FGD) were conducted to gather insights on the experiences of breast cancer patients navigating the healthcare system. A purposive sampling technique was employed to recruit participants from the oncology ward of Princess Marina Hospital in Gaborone, Botswana. FGDs included 7 female breast cancer patients and 7 caregivers (2 male and 5 females). A semi-structured interview guide with probes was used to collect data. Results: Key emergent themes included patients’ experiences with healthcare professionals; delays in diagnosis; experiences with cancer treatment; information needs; views on cancer resources; the role of caregivers and attitudes towards cancer research. Patients reported experiencing poor communication or a lack of empathy from healthcare providers when receiving a diagnosis. Social support and spiritual beliefs were important to patients in handling the diagnosis. Delays in diagnosis were reported due to logistical challenges, poor appointment and referral systems, as well as delayed or missing laboratory results. Similar experiences with cancer treatment were reported including a lack of timely access to treatment and poor communication regarding chemotherapy and adverse effects. Patient and caregiver information needs, therefore, largely focused on a desire to understand chemotherapy side-effects and the biological nature of breast cancer. Discussions regarding availability of cancer resources revealed a lack of basic services to maximize patient comfort and difficulties accessing specialized cancer care infrastructure. Caregivers were found to have a largely positive role in providing emotional and practical support. Patients and caregivers appreciated the utility of cancer research in improving treatment. Conclusion: A number of barriers exist across the cascade of care for breast cancer patients in the Botswana health system. Although patient navigator programs may not address all barriers, they have potential utility in the context of improving communication, meeting information needs and providing emotional or practical support by addressing logistical barriers to cancer diagnosis and treatment in Botswana. Citation Format: Kirthana Sharma, Leyla Baghirova, G Gulubane, Shaheen Abkenari, Tapologo Leselwa, Morongwa Legwaila, Reena Antony, Refeletswe Lebelonyane, Peter Vuylsteke, Richard Marlink, Tendani Gaolathe, Tiny Masupe. Breast Cancer Patient Experiences in the Botswana Health System: Is it Time for Patient Navigators? [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 15.

Relatives’ lived experiences of losing a loved one to COVID-19: an interpretative phenomenological analysis

During the COVID-19 pandemic, restrictions to prevent its spread were formed, thereby hindering patients’ relatives from maintaining contact with and visiting their loved ones, even saying goodbye at the end of life. This study aimed to gain an in-depth understanding of bereaved relatives’ experiences of losing a loved one to COVID-19. Eight in-depth interviews were conducted and analysed using an interpretative phenomenological approach. The results revealed two superordinate themes: (a) the lonely and painful loss and (b) the double crises. The relatives were oscillating between hope and despair. During the time of their loved one’s illness, they felt powerless, excluded, lonely and vulnerable. The death was unexpected, and it was painful to not be able to say goodbye in person or when the life support was terminated. Furthermore, the relatives were in crisis at the same time as the health care system was in crisis. Sometimes the relatives did not receive information, and they felt like bystanders waiting for answers. The health care professionals’ attitudes were of importance in supporting the relatives. If there was a lack of empathy and understanding for the relative’s situation, feelings of frustration and not being respected emerged. To meet relatives’ needs when losing a loved one during circumstances such as the COVID-19 pandemic, the healthcare system needs to develop routines pertaining to providing adequate information, supporting relatives’ need to say goodbye, and coping with ethical dilemmas, such as when there are insufficient life support machines for patients.

Opioid-related policy changes: Experiences and perspectives from people who use opioids to manage non-cancer chronic pain.

People who use prescription opioids to manage non-cancer chronic pain are particularly vulnerable to opioid-related policy change. This study aims to better understand what prescription opioids provide this population, what concerns they have in the context of new and changing opioid policies, such as the recently implemented prescription drug monitoring program in Victoria, Australia, their experiences of prescription opioid use, chronic pain and what they would like their healthcare to look like. Semi-structured interviews were conducted with 30 people who use opioids to manage chronic non-cancer pain. Prescription opioids played an important role in supporting quality of life and mental health. However, experiences of stigma and lack of empathy from healthcare providers were common. Participants sought accurate information about their medications and expressed a desire for shared decision-making in healthcare. Prescription opioids can play an important role in pain management as well as social and psychological functioning for people living with non-cancer chronic pain. Opioid-related policy changes to medication availability need to consider the potential impacts that reducing, limiting or discontinuing opioids may have on this population. Including the voices of people who use prescription opioids to manage non-cancer chronic pain in respectful, compassionate and meaningful ways.

Analisis Dampak Manajemen Konflik Toxic Friendship Pada Santri di Pondok Pesantren Darul Arifin 2

Being born into social beings makes humans dependent on one another. Building a friendship is a must as a form of human truth as a social being. Sometimes friends come and go according to where and the conditions experienced. However, it is not uncommon for friendships to be successfully built over the years. This study aims to determine the impact of toxic friendship experienced by students at Darul Arifin 2 Islamic Boarding School in terms of mental aspects such as insecurity, crisis of trust, and depression. The research method used in this journal is descriptive qualitative method. Data collection techniques in this study used observation, interviews, and documentation methods. Based on the results of research from interviews with sources, the sources stated that toxic friendship actions at Darul Arifin Islamic Boarding School do exist, in the form of toxic friendship actions, namely, criticism, bullying, no empathy, and body shaming. The results of this study indicate the different conditions experienced by each student in responding to the stimulus given by toxic friendship. The toxic friendship behavior experienced by students of Darul Arifin 2 Islamic Boarding School is dominant in the form of criticism and lack of empathy, then the impact experienced is dominant in feeling insecure and low self-confidence.

HIV and AIDS Specific Stigmas and Discrimination (PLHIV) (Descriptive Analysis Media of the Carlo Story Web Series')

This study aims to identify instances of discrimination and stigma towards PLWHA in the online Carlo’s serial. The next goal is to evaluate the educational topics present in the Carlos’ web series. This study should serve as a reference for anyone interested in conducting communication studies research, especially in the areas of text and movies’ analysis. It is also anticipated that this research will provide a basic overview of the discrimination and stigma that HIV-positive people encounter. Along with serving as a source of inspiration for policymakers and the general public, it can also serve as an inspiration for Indonesian cinema, particularly for short moviess and web series.The research methodology adopted is a constructivist, descriptive qualitative method. The dialogue and set design of Carlo were examined as part of the analysis of the online series. The findings demonstrated that stigma and prejudice toward PLWHA continue to be widespread, including the notion that some groups are more predisposed to contracting HIV and AIDS than others. In this case, the stigma that HIV and AIDS are the result of negative behavior, the presumption that HIV and AIDS are the same as a death sentence, the excessive fear of HIV transmission among health workers, the cynicism and lack of empathy among health workers toward PLWHA patients, and finally the stigma that PLWHA cannot get married or have children are all factors. However, the filmmaker is also charged with encouraging the stigma. The histories of the characters played by more PLHIV who also identify as homosexuals reveal this. The audience will undoubtedly come to believe that HIV and homosexuality are synonymous if this is constantly demonstrated.

The “zipper model of empathy” applied to violence in schizophrenia: A search for social cognitive underpinnings of lack of empathic behavior

BackgroundThe “zipper model of empathy” has been proposed for psychopathy. It postulates that empathic behavior may fail to arise due to impaired facial emotion recognition. In this study, we examined if the model may be of relevance for schizophrenia. MethodsIn a sample of participants with schizophrenia and a history of severe interpersonal violence, associations between measures of social cognition (emotion recognition, theory of mind) and aspects of psychopathy (lack of empathy, lack of remorse) were investigated. A non-violent sample experiencing schizophrenia served as a control group. ResultsCorrelation analyses revealed a specific and statistically significant association between facial emotion recognition and lack of empathy in the violent sample. Follow-up analyses identified that neutral emotions were of particular importance. Logistic regression analyses confirmed that impairments in facial emotion recognition predicted levels of empathy in the violent sample experiencing schizophrenia. ConclusionsOur results suggest that the “zipper model of empathy” may be relevant for schizophrenia. The findings further point to the potential benefit of including social cognitive training in the treatment of persons with schizophrenia and a history of interpersonal aggression.

How satisfactory are empathetic care and robotic assistance in telemedicine services?

ABSTRACT Telemedicine healthcare and assistive robotic technologies are gaining popularity as support systems for traditional healthcare practices. However, there are concerns regarding the use of these digital services due to their lack of empathy and intimacy. This paper investigates the impact of physicians’ empathetic care and telepresence robot assistance on patients’ intimate experience and satisfaction. We employ a multi-method design to achieve our research objective. The first study utilizes a 2 (digital empathetic care: high vs. low) × 2 (telepresence robot assistance: present vs. absent) × 2 (severity of illness: high vs. low) between-subject experimental design involving 287 participants who have used robotic assistance and telemedicine services. The findings from this study confirm that the telepresence robotic assistance and empathetic care by physicians positively impact intimate experience and patient satisfaction significantly more for patients with low severity of illness, thus confirming the significant moderated-moderated mediation effect. The second study employs field data (n = 4629 reviews) to further validate the telepresence robots’ usability in establishing intimate patient experiences in digital settings. The study recommends to healthcare practitioners that empathetic care and robotic assistance are essential factors for building intimate experience and patient satisfaction in telehealthcare services.

Level of shared decision making and associated factors among patients with mental illness in Northwest Ethiopia: Explanatory sequential mixed method study.

Shared decision-making is a patient-centered and a recovery-oriented mental health system in which consumers are encouraged to actively engage in illness management. Although shared decision-making research in mental health has evolved rapidly in the past two decades, there is a lack of studies examining the level and factors associated with shared decision-making practice in low-income countries like Ethiopia. An institutional-based explanatory sequential mixed method study design was conducted from July 18 to September 18, 2022, at Bahir Dar city specialized hospitals. A systematic random sampling technique was used. The level of shared-decision making was measured by 9-item shared decision-making questionnaire among 423 patients with mental illness. Epicollect5 was used to collect data, which was then exported to the Statistical Package for social science version 25 for analysis. Variables with a P-value < 0.25 were considered candidates for the multivariate logistic regression analysis. The odds ratio with a 95% confidence interval was used to show the strength of the association. An in-depth interview was conducted among ten purposively selected participants. Low shared decision-making practice was found to be 49.2% (95% CI 45.9%-55.7%). The Multivariate analysis showed that low perceived compassionate care (AOR = 4.45; 95%CI 2.52-7.89), low social support (AOR = 1.72; 95% CI 1.06-2.80), and no community-based health insurance (AOR = 1.96; 95%CI l.04-3.69) were positively associated with low shared decision making. The qualitative result showed that the most common barriers to shared decision-making were a lack of empathy and a shortage of mental health workers. Almost half of the patients had low shared decision-making practices. This implies that shared decision-making requires high attention as it is essential for patient-centered care.

Design and evaluation of an augmented reality cyberphysical game for the development of empathic abilities

Emotional deficits such as lack of empathy in children and adolescents are strong predictors of developing antisocial behavior, making inappropriate moral judgments, difficulties in interpersonal relationships or bullying. To promote learning empathic skills, the present work proposes the design of a cyber-physical mobile game with Augmented Reality and Geolocation implemented in a learning model based on tasks and steps. The main focus is on designing scenarios that generate affective, cognitive, reflective and social experiences that favor the expression of prosocial behavior. To verify the effectiveness of our EmpathyAR game, an evaluation was applied to an experimental vs. control group. The results indicate that the game is evaluated positively by the players at the usability level (utility, ease of use and learning and satisfaction) and game experience (positive affect, competence, and immersion). Compared to the control group, which resorted to traditional strategies, we observed that EmpathyAR has a positive impact as a learning strategy on 2 dimensions of the Interpersonal Reactivity Index (IRI) for empathy, i.e. fantasy and empathic concern. For the remaining two IRI dimensions (perspective taking and personal distress) despite not providing statistically significant differences, the results show that EmpathyAR improves the score obtained in these dimensions. At the end of the experimental study the players revealed higher levels of prosocial behavior than those who did not play the game. Finally, these gamification strategies that combine the physical and virtual worlds can be viable alternatives to motivate young students to develop and acquire empathy skills while playing in situated physical contexts.

The dark side of empathy in narcissistic personality disorder.

Narcissistic personality disorder is characterized by self-absorption, grandiosity, exploitation of others and lack of empathy. People with that disorder may switch from an overt form, mainly with grandiosity, to a covert presentation, with fears, hypersensitivity and dependence from others. Empathy represents a key point in detecting people affected by narcissistic personality disorder because, even if it is described as reduced, it plays a fundamental role in exploitation and manipulation. A systematic search of Literature without any language or time restriction, was performed combining thesaurus and free-search indexing terms related to Narcissistic personality disorder and empathy and produced 531 results. Fifty-two papers that analyzed possible issues in the empathic attitude of people with narcissistic personality disorder were included in this narrative review. Empathy is the capability of understating and feeling others emotions. It is not a unitary construct and can be distinguished in cognitive and affective. It might be channeled into prosocial and antisocial behaviors. A crucial trait identified in narcissistic empathy is affective dissonance that is closely related to rivalry as part of the dark tetrad (narcissism, machiavellianism, psychopathy, and sadism). Subjects affected by narcissistic personality disorder show greater impairment in affective aspects while their cognitive part of empathy appears preserved. Saving at least the cognitive aspects of empathy may contribute to therapeutic improvement of affective aspects.