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Kuchinad K, Park JR, Han D, Saha S, Moore R, Beach MC. Which clinician responses to emotion are associated with more positive patient experiences of communication? PATIENT EDUCATION AND COUNSELING 2024; 124:108241. [PMID: 38537316 DOI: 10.1016/j.pec.2024.108241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/12/2024] [Accepted: 03/03/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVES To identify communication strategies that may improve clinician-patient interactions, we assessed the association between clinician response to emotion and patient ratings of communication. METHODS From a cohort of 1817 clinician-patient encounters, we designed a retrospective case-control study by identifying 69 patients who rated their interpersonal care as low-quality and 69 patients who rated their care as high-quality. We used the Verona Coding Definitions of Emotional Sequences (VR-CoDES) to identify patient emotional expressions and clinician responses. Using mixed-effects logistic regression, we evaluated the association between clinician responses to patients' emotions and patient ratings of their interpersonal care. RESULTS In adjusted analyses, explicit responses that reduced space for further emotional communication were associated with high ratings of care (OR 1.94, 95% CI 1.25, 2.99); non-explicit responses providing additional space were associated with low ratings (OR 0.54, 95% CI 0.36-0.82). In terms of specific response types, neutral/passive responses were associated with low ratings (OR 0.59, 95% CI 0.39-0.90), whereas giving information/advice was associated with high ratings (OR, 95% 1.91 CI 1.17-3.1). CONCLUSIONS Patients may prefer responses to their expressed emotions that demonstrate clinician engagement, with or without expressions of empathy. PRACTICE IMPLICATIONS These findings may inform educational interventions to improve clinician-patient communication.
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Affiliation(s)
- Kamini Kuchinad
- Department of Rheumatology, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Jenny Rose Park
- Oregon Health and Science University, Portland, OR, United States
| | - Dingfen Han
- Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Somnath Saha
- Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Richard Moore
- Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Mary Catherine Beach
- Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore, MD, United States; Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, United States; Center for Health Equity, Johns Hopkins University, Baltimore, MD, United States.
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2
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Tomozawa C, Kaneko M, Sasaki M, Miyake H. Clients' experiences of empathy in genetic counseling for hereditary breast and ovarian cancer: A qualitative study in Japan. J Genet Couns 2024. [PMID: 38773682 DOI: 10.1002/jgc4.1920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 04/30/2024] [Accepted: 05/08/2024] [Indexed: 05/24/2024]
Abstract
Empathy is a significant element in genetic counseling for building relationships with the clients and addressing their issues. However, there are few reports on the experiences of the clients about their perceived empathy in genetic counseling. Cancer genetic counseling needs have been rapidly evolving with the expansion of clinical comprehensive genomic profiling and genetic diagnosis approaches for hereditary cancers. Therefore, this study aimed to reveal empathy perceptions of the clients during cancer genetic counseling. Semi-structured interviews were conducted, and a grounded theory approach was used for data analysis. A total of 13 participants were recruited from organizations for patients with cancer, among whom 11 were patients with hereditary breast and ovarian cancer (HBOC) and two were relatives of patients with HBOC. Data analysis was organized into five categories related to experiences with empathy: (i) prior context to perceive empathy (ii) understanding and consideration, (iii) bedside manner, and (iv) impacted area of perceived empathy; and (v) no empathy. This study highlights the fact that empathy experiences of the clients differ depending on the situation and state of mind. Taken together, this study provides new insights on how to deliver empathic care.
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Affiliation(s)
- Chikako Tomozawa
- Division of Life Sciences, Department of Genetic Counseling, Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan
| | - Mikiko Kaneko
- Department of Clinical Genetics, The Jikei University Hospital, Tokyo, Japan
| | - Motoko Sasaki
- Division of Life Sciences, Department of Genetic Counseling, Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan
- Genetics Division, Institute for Human Life Science, Ochanomizu University, Tokyo, Japan
| | - Hidehiko Miyake
- Division of Life Sciences, Department of Genetic Counseling, Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan
- Genetics Division, Institute for Human Life Science, Ochanomizu University, Tokyo, Japan
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3
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Campos CFC, Olivo CR, Martins MDA, Tempski PZ. Physicians' attention to patients' communication cues can improve patient satisfaction with care and perception of physicians' empathy. Clinics (Sao Paulo) 2024; 79:100377. [PMID: 38703716 PMCID: PMC11087704 DOI: 10.1016/j.clinsp.2024.100377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/25/2024] [Accepted: 04/18/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND The pathway that links good communication skills and better health outcomes is still unclear. However, it is known that the way that physicians and patients communicate with each other has direct consequences on more "proximal outcomes", such as perceptions of physician empathy and patient satisfaction. However, which specific communication skills lead to those patient outcomes is still unknown. In this study, the authors aimed to analyze which specific patient and physician communication skills are correlated to patients' satisfaction with care and patient-perceived physician empathy. METHODS The authors classified and quantified verbal and nonverbal communication of second-year internal medicine residents and their patients through video recordings of their consultations. Patients also rated their satisfaction with care and the physician's empathy for them. RESULTS Using a linear regression model, the authors identified that patients' and physicians' expressions of disapproval, physicians' disruptions, and patients' use of content questions negatively correlated to patients' satisfaction and patient-perceived physician empathy. Conversely, patient affective behaviors and the physician's provision of advice/suggestion were positively correlated to at least one of the patient-measured outcomes. CONCLUSION Our findings point to the importance of physicians' attentiveness to patients' communication cues. Training physicians to interpret those cues could help develop more satisfactory and empathic therapeutic relationships.
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Affiliation(s)
- Carlos Frederico Confort Campos
- The Centre for Medical and Health Sciences Education, University of Auckland, Auckland, New Zealand; Center for Development of Medical Education, Universidade de São Paulo, Sao Paulo, SP, Brazil.
| | - Clarice Rosa Olivo
- Center for Development of Medical Education, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | | | - Patricia Zen Tempski
- Center for Development of Medical Education, Universidade de São Paulo, Sao Paulo, SP, Brazil
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4
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Baliga MS, Marakala V, Madathil LP, George T, D'souza RF, Palatty PL. Ethical and moral principles for oncology healthcare workers: A brief report from a Bioethics consortium emphasizing on need for education. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:145. [PMID: 38784285 PMCID: PMC11114567 DOI: 10.4103/jehp.jehp_1048_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/02/2023] [Indexed: 05/25/2024]
Abstract
The medical sub-specialty of Oncology presents diverse ethical dilemmas, often challenging cancer healthcare workers with difficult-to-handle clinical scenarios that are tough from a personal and professional perspective. Making decisions on patient care in various circumstances is a defining obligation of an oncologist and those duty-based judgments entail more than just selecting the best treatment or solution. Ethics is an essential and inseparable aspect of clinical medicine and the oncologists as well as the allied health care workers are ethically committed to helping the patient, avoiding or minimizing harm, and respecting the patient's values and choices. This review provides an overview of ethics and clinical ethics and the four main ethical principles of autonomy, beneficence, non-maleficence, and justice are stated and explained. At times there are frequently contradictions between ethical principles in patient care scenarios, especially between beneficence and autonomy. In addition, truth-telling, professionalism, empathy, and cultural competence; which are recently considered important in cancer care, are also addressed from an Indian perspective.
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Affiliation(s)
- Manjeshwar S. Baliga
- Department of Education, International Program, International Chair in Bioethics, World Medical Association Cooperating Centre (Formerly UNESCO Chair in Bioethics University of Haifa), Melbourne, Australia
- The Bioethics SAARC Nodal Centre, International Network Bioethics, Amrita Institute of Medical Sciences, Kochi, Ernakulam, Kerala, India
- Bioethics Education and Research Unit, Mangalore Institute of Oncology, Pumpwell, Mangalore, Karnataka, India
| | - Vijaya Marakala
- Department of Biochemistry, College of Medicine and Health Sciences, National University of Science and Technology, Sohar, Oman
| | - Lal P. Madathil
- Department of Education, International Program, International Chair in Bioethics, World Medical Association Cooperating Centre (Formerly UNESCO Chair in Bioethics University of Haifa), Melbourne, Australia
- The Bioethics SAARC Nodal Centre, International Network Bioethics, Amrita Institute of Medical Sciences, Kochi, Ernakulam, Kerala, India
| | - Thomas George
- Internal Medicine, Coney Island Hospital, 2601 Ocean Pkwy, Brooklyn, New York, USA
| | - Russell F. D'souza
- Department of Education, International Program, International Chair in Bioethics, World Medical Association Cooperating Centre (Formerly UNESCO Chair in Bioethics University of Haifa), Melbourne, Australia
| | - Princy L. Palatty
- The Bioethics SAARC Nodal Centre, International Network Bioethics, Amrita Institute of Medical Sciences, Kochi, Ernakulam, Kerala, India
- Department of Pharmacology, Amrita School of Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Ernakulam, Kerala, India
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5
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Bhyat F, Makkink A, Henrico K. Holistic Person-Centered Care in Radiotherapy: Protocol for a Scoping Review. JMIR Res Protoc 2024; 13:e51338. [PMID: 38569177 PMCID: PMC11024745 DOI: 10.2196/51338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/11/2023] [Accepted: 12/17/2023] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Several types of health care professionals are responsible for the care of patients with cancer throughout their engagement with the health care system. One such type is the radiotherapist. The radiotherapist not only administers treatment but is also directly involved with the patient during treatment. Despite this direct contact with the patient, the narrative tends to focus more on technical tasks than the actual patient. This task-focused interaction is often due to the highly sophisticated equipment and complex radiotherapy treatment processes involved. This often results in not meeting the psychosocial needs of the patient, and patients have acknowledged noncompliance and delayed treatment as a result. OBJECTIVE The scoping review aims to explore, chart, and map the available literature on holistic person-centered care in radiotherapy and to identify and present key concepts, definitions, methodologies, knowledge gaps, and evidence related to holistic person-centered care in radiotherapy. METHODS This protocol was developed using previously described methodological frameworks for scoping studies. The review will include both peer-reviewed and gray literature regarding holistic, person-centered care in radiotherapy. A comprehensive search strategy has been developed for MEDLINE (Ovid), which will be translated into the other included databases: Scopus, CINAHL (EBSCO), MEDLINE (PubMed), Embase (Elsevier), Cochrane Library, and the Directory of Open Access Journals. Gray literature searching will include Google (Google Books and Google Scholar), ProQuest, the WorldWideScience website, the OpenGrey website, and various university dissertation and thesis repositories. The title and abstract screening, full-text review, and relevant data extraction will be performed independently by all 3 reviewers using the Covidence (Veritas Health Innovation) software, which will also be used to guide the resolution of conflicts. Sources selected will be imported into ATLAS.ti (ATLAS.ti Scientific Software Development GmbH) for analysis, which will consist of content analysis, narrative analysis, and descriptive synthesis. Results will be presented using narrative, diagrammatic, and tabular formats. RESULTS The review is expected to identify research gaps that will inform current and future holistic, person-centered care in radiotherapy. The review commenced in November 2023, and the formal literature search was completed by the end of February 2024. Final results are expected to be published in a peer-reviewed journal by 2025. CONCLUSIONS The findings of this review are expected to provide a wide variety of strategies aimed at providing holistic, person-centered care in radiotherapy, as well as to identify some gaps in the literature. These findings will be used to inform future studies aimed at designing, developing, evaluating, and implementing strategies toward improved holistic, person-centered care in radiotherapy. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51338.
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Affiliation(s)
- Fatima Bhyat
- Department of Medical Imaging and Radiation Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Andrew Makkink
- Department of Emergency Medical Care, University of Johannesburg, Johannesburg, South Africa
| | - Karien Henrico
- Department of Emergency Medical Care, University of Johannesburg, Johannesburg, South Africa
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6
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Pusa S, Baxter R, Andersson S, Fromme EK, Paladino J, Sandgren A. Core Competencies for Serious Illness Conversations: An Integrative Systematic Review. J Palliat Care 2024:8258597241245022. [PMID: 38557369 DOI: 10.1177/08258597241245022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Objective: The Serious Illness Care Program was developed to support goals and values discussions between seriously ill patients and their clinicians. The core competencies, that is, the essential clinical conversation skills that are described as requisite for effective serious illness conversations (SICs) in practice, have not yet been explicated. This integrative systematic review aimed to identify core competencies for SICs in the context of the Serious Illness Care Program. Methods: Articles published between January 2014 and March 2023 were identified in MEDLINE, PsycINFO, CINAHL, and PubMed databases. In total, 313 records underwent title and abstract screening, and 96 full-text articles were assessed for eligibility. The articles were critically appraised using the Joanna Briggs Institute Critical Appraisal Guidelines, and data were analyzed using thematic synthesis. Results: In total, 53 articles were included. Clinicians' core competencies for SICs were described in 3 themes: conversation resources, intrapersonal capabilities, and interpersonal capabilities. Conversation resources included using the conversation guide as a tool, together with applying appropriate communication skills to support better communication. Intrapersonal capabilities included calibrating one's own attitudes and mindset as well as confidence and self-assurance to engage in SICs. Interpersonal capabilities focused on the clinician's ability to interact with patients and family members to foster a mutually trusting relationship, including empathetic communication with attention and adherence to patient and family members views, goals, needs, and preferences. Conclusions: Clinicians need to efficiently combine conversation resources with intrapersonal and interpersonal skills to successfully conduct and interact in SICs.
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Affiliation(s)
- Susanna Pusa
- Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Rebecca Baxter
- Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Sofia Andersson
- Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Erik K Fromme
- Ariadne Labs, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Joanna Paladino
- Ariadne Labs, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Anna Sandgren
- Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
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7
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Luetke Lanfer H, Reifegerste D, Weber W, Memenga P, Baumann E, Geulen J, Klein S, Müller A, Hahne A, Weg-Remers S. Digital clinical empathy in a live chat: multiple findings from a formative qualitative study and usability tests. BMC Health Serv Res 2024; 24:314. [PMID: 38459522 PMCID: PMC10921626 DOI: 10.1186/s12913-024-10785-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/26/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Clinical empathy is considered a crucial element in patient-centered care. The advent of digital technology in healthcare has introduced new dynamics to empathy which needs to be explored in the context of the technology, particularly within the context of written live chats. Given the growing prevalence of written live chats, this study aimed to explore and evaluate techniques of digital clinical empathy within a familial cancer-focused live chat, focusing on how health professionals can (a) understand, (b) communicate, and (c) act upon users' perspectives and emotional states. METHODS The study utilized a qualitative approach in two research phases. It examined the expected and implemented techniques and effectiveness of digital clinical empathy in a live chat service, involving semi-structured interviews with health professionals (n = 9), focus group discussions with potential users (n = 42), and two rounds of usability tests between health professionals (n = 9) and users (n = 18). Data were examined using qualitative content analysis. RESULTS Expected techniques of digital clinical empathy, as articulated by both users and health professionals, involve reciprocal engagement, timely responses, genuine authenticity, and a balance between professionalism and informality, all while going beyond immediate queries to facilitate informed decision-making. Usability tests confirm these complexities and introduce new challenges, such as balancing timely, authentic responses with effective, personalized information management and carefully framed referrals. CONCLUSIONS The study reveals that the digital realm adds layers of complexity to the practice of clinical empathy. It underscores the importance of ongoing adaptation and suggests that future developments could benefit from a hybrid model that integrates the strengths of both AI and human health professionals to meet evolving user needs and maintain high-quality, empathetic healthcare interactions.
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Affiliation(s)
- Hanna Luetke Lanfer
- School of Public Health, Bielefeld University, Universitaetsstrasse 25, 33615, Bielefeld, Germany.
| | - Doreen Reifegerste
- School of Public Health, Bielefeld University, Universitaetsstrasse 25, 33615, Bielefeld, Germany
| | - Winja Weber
- German Cancer Research Center (DKFZ), Division Cancer Information Service, Heidelberg, Germany
| | - Paula Memenga
- Department of Journalism and Communication Research, Hanover University of Music, Drama and Media, Hanover, Germany
| | - Eva Baumann
- Department of Journalism and Communication Research, Hanover University of Music, Drama and Media, Hanover, Germany
| | - Julia Geulen
- German Cancer Research Center (DKFZ), Division Cancer Information Service, Heidelberg, Germany
| | - Stefanie Klein
- German Cancer Research Center (DKFZ), Division Cancer Information Service, Heidelberg, Germany
| | | | | | - Susanne Weg-Remers
- German Cancer Research Center (DKFZ), Division Cancer Information Service, Heidelberg, Germany
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8
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Tranberg M, Ekedahl H, Fürst CJ, Engellau J. The influence of "bad news" and "neutral/good news" on patients' perception of physician empathy during oncology consultations. Cancer Med 2024; 13:e6903. [PMID: 38164055 PMCID: PMC10807689 DOI: 10.1002/cam4.6903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 11/20/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVES Being met with empathy increases information sharing, treatment coherence, and helps patients to recover faster. However, we do not know how the content of the conversation about disease progression, new treatments, or other issues concerning serious illness affects patients' perceptions of the physician's empathy, and thus, the quality of the conversation. This study aimed to test the hypothesis that patients will rate their physician lower following a "bad news" consultation using the consultation and relational empathy (CARE) measure. METHODS A total of 186 outpatients from the Department of Oncology were recruited for this study. After meeting with a patient, the physician filled out a form, placing the patient in either the "bad news" group, or the "neutral/good news" group along with information about the patient and the consultation. The patient was given the CARE measure after the visit. RESULTS The patients who had received bad news rated their physicians a significantly lower score on the CARE measure, even though the effect size was small, than those who had neutral/good news. On average, bad news consultations were 11 min longer. CONCLUSIONS Physicians need to be aware of the patients' need to be known and understood, in addition to having skills to attend to emotional cues and concerns, since the current study's finding could be a sign either of the content being projected onto the physician or that the physician is focused on the message rather than on the patient.
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Affiliation(s)
- Mattias Tranberg
- Division of Palliative Care, Department of Clinical Sciences LundLund UniversityLundSweden
- The Institute for Palliative Care at Lund University and Region SkåneLundSweden
| | - Henrik Ekedahl
- Department of OncologySkåne University HospitalLundSweden
| | - Carl Johan Fürst
- Division of Palliative Care, Department of Clinical Sciences LundLund UniversityLundSweden
- The Institute for Palliative Care at Lund University and Region SkåneLundSweden
| | - Jacob Engellau
- Department of OncologySkåne University HospitalLundSweden
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Frydman JL, Gelfman LP, Farquhar D, Ramaswamy R, Dow LA. Goals, Values, and Priorities of Hospitalized Patients: Using a Structured Communication Tool to Engage Medical Students in Serious Illness Communication. J Palliat Med 2024; 27:99-103. [PMID: 37878370 DOI: 10.1089/jpm.2023.0281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Background: To build third-year medical students' serious illness communication skills, we implemented a structured communication tool-the VALUES tool-focused on patients' goals, values, and priorities and described students' experiences using this tool. Methods: Medical students participated in a social worker-led VALUES didactic and discussion with a patient on the palliative care consult service and, subsequently, completed an anonymous survey about their comfort with the VALUES tool and its usefulness for learning (5-point Likert scales). Results: Of the 142 medical students who participated in the VALUES didactic, 37 completed the survey (26%). The VALUES tool was rated highly in terms of usefulness (mean 4.5; standard deviation [SD] 0.7) and rated lower in terms of overall comfort (mean 3.7; SD 0.7). Conclusion: Our project explored the integration of a VALUES tool into medical student education, and we show that the tool is well rated by learners in terms of comfort and usefulness.
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Affiliation(s)
- Julia L Frydman
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Laura P Gelfman
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Geriatric Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, USA
| | - Diane Farquhar
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ravishankar Ramaswamy
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Lindsay A Dow
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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10
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Kochems K, de Graaf E, Hesselmann GM, Ausems MJE, Teunissen SCCM. Healthcare professionals' perceived barriers in providing palliative care in primary care and nursing homes: a survey study. Palliat Care Soc Pract 2023; 17:26323524231216994. [PMID: 38148895 PMCID: PMC10750550 DOI: 10.1177/26323524231216994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 11/07/2023] [Indexed: 12/28/2023] Open
Abstract
Background Palliative care in primary care and nursing home settings is becoming increasingly important. A multidimensional palliative care approach, provided by a multiprofessional team, is essential to meeting patients' and relatives' values, wishes, and needs. Factors that hamper the provision of palliative care in this context have not yet been fully explored. Objectives To identify the barriers to providing palliative care for patients at home or in nursing homes as perceived by healthcare professionals. Design Cross-sectional survey study. Methods A convenience sample of nurses, doctors, chaplains, and rehabilitation therapists working in primary care and at nursing homes in the Netherlands is used. The primary outcome is barriers, defined as statements with ⩾20% negative response. The survey contained 56 statements on palliative reasoning, communication, and multiprofessional collaboration. Data were analyzed using descriptive statistics. Results In total, 249 healthcare professionals completed the survey (66% completion rate). The main barriers identified in the provision of palliative care were the use of measurement tools (43%), consultation of an expert (31%), estimation of life expectancy (29%), and documentation in the electronic health record (21% and 37%). In primary care, mainly organizational barriers were identified, whereas in nursing homes, most barriers were related to care content. Chaplains and rehabilitation therapists perceived the most barriers. Conclusion In primary care and nursing homes, there are barriers to the provision of palliative care. The provision of palliative care depends on the identification of patients with palliative care needs and is influenced by individual healthcare professionals, possibilities for consultation, and the electronic health record. An unambiguous and systematic approach within the multiprofessional team is needed, which should be patient-driven and tailored to the setting.
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Affiliation(s)
- Katrin Kochems
- Center of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, Utrecht 3508 GA, The Netherlands
| | - Everlien de Graaf
- Center of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | - Saskia C. C. M. Teunissen
- Center of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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11
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Zhang X, Pang HF, Duan Z. Educational efficacy of medical humanities in empathy of medical students and healthcare professionals: a systematic review and meta-analysis. BMC MEDICAL EDUCATION 2023; 23:925. [PMID: 38057775 DOI: 10.1186/s12909-023-04932-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 12/04/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Medical humanities education is an important part of medical education. The purpose of this study was to determine the effectiveness of medical humanities in improving empathy among medical students and healthcare professionals. METHODS PubMed, Embase, EBSCO-ERIC, Web of Science were searched systematically for studies in the English language. The last retrieval date is May 1, 2023. Best Evidence Medical Education (BEME) Global Rating Scale and Kirkpatrick-based results were used to evaluate the quality of literature. In this study, a meta-analysis of continuous data was conducted. RESULTS The pooled results by single-arm test meta-analysis showed a benefit with medical humanities programs in empathy (SMD 1.33; 95% CI 0.69-1.96). For single-arm trials of medical humanities program interventions of less than 4 months, 4 months to 12 months, and more than one year, the standardized mean differences(SMD) between post-test and pre-test were 1.74 (P < 0.05), 1.26 (P < 0.05), and 0.13 (P = 0.46), respectively. The results showed a significant difference in the effect of medical humanities programs on male and female empathy (SMD - 1.10; 95% CI -2.08 - -0.13). The SMDs for the study of course, the course combined reflective writing, and the course combined reflective writing and practice as intervention modalities for medical humanities programs were 1.15 (P < 0.05), 1.64 (P < 0.05), and 1.50 (P < 0.05), respectively. CONCLUSION Medical humanities programs as a whole can improve the empathy of medical students and health professionals. However, different intervention durations and different intervention methods produce different intervention effects.
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Affiliation(s)
- Xin Zhang
- School of Mangement, Shanxi Medical University, TaiYuan, 030001, China
| | - Hui-Fang Pang
- Shanxi Cardiovascular Disease Hospital, TaiYuan, 030024, China
| | - Zhiguang Duan
- School of Mangement, Shanxi Medical University, TaiYuan, 030001, China.
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12
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Keikhaee R, Sanaat Z, Mousavi S, Shaghaghi A. Cross-Cultural Adaptation and Psychometric Validation of the Interview Satisfaction Questionnaire (ISQ) to Assess Unmet Health Communication Needs of Iranian Breast Cancer Patients. HEALTH COMMUNICATION 2023:1-11. [PMID: 38053361 DOI: 10.1080/10410236.2023.2288712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Autonomous and patient-centered health communication (PCHC) between a healthcare provider (HCP) and a client (HCC) is a critical fundament for successful healthcare outcomes. A standard and validated data collection tool for studying the satisfaction of Iranian breast cancer patients (BCPs) with various aspects of their health communication with HCPs does not exist. The current study assessed the application, feasibility, and cultural appropriateness of the Persian-translated version of the interview satisfaction questionnaire (ISQ) in the Iranian context. A standard translation/back-translation procedure was used to prepare a preliminary Persian version of the ISQ (ISQ-P) which was then evaluated for content and face validity by a panel of experts. The study data were collected from 200 breast cancer patients and used to estimate the internal consistency measure of Cronbach's alpha and intra-class correlation coefficient. Confirmatory factor analysis (CFA) was performed to verify the compatibility of the instrument's identified dimensions with the original ISQ's factor structure. The calculated content validity index (CVI = 0.89), content validity ratio (CVR = 0.49), and Cronbach's alpha coefficient (0.79) indicated the appropriateness of the ISQ-P for its intended purpose. The CFA's outputs (root mean square error of approximation (RMSEA) = 0.09, comparative fit index (CFI) = 0.954, Tucker-Lewis index (TLI) = 0.931, standardized root mean square residual (SRMR) = 0.04) affirmed the fitness of the study data to the original 4-factor conceptual model. The study findings supported the suitability of ISQ-P for assessing health communication episodes by Persian-speaking BCPs. However, due to cultural variation, cross-border diversity of health systems, and organizational circumstances, further validity and reliability appraisal of the ISQ-P in distinct sub-samples is recommended.
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Affiliation(s)
- Razieh Keikhaee
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences
| | - Zohreh Sanaat
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences
| | - Saeid Mousavi
- Department of Bio-Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences
| | - Abdolreza Shaghaghi
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences
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13
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Westendorp J, Geerse OP, van der Lee ML, Schoones JW, van Vliet MHM, Wit T, Evers AWM, van Vliet LM. Harmful communication behaviors in cancer care: A systematic review of patients and family caregivers perspectives. Psychooncology 2023; 32:1827-1838. [PMID: 37957777 DOI: 10.1002/pon.6247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/13/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE Issues regarding clinician communication remain an important source of complaints within healthcare. This systematic review aims to determine cancer patients' and their family caregivers' views on which clinicians' communication behaviors can harm (i.e. eliciting negative feelings/consequences for patients/family caregivers). METHODS We searched for all types of peer-reviewed studies that determined adult (≥18 years) cancer patients' and/or family caregivers' perspectives on which clinicians' communication behaviors can harm in several databases (PubMed, Embase, Web of Science, Cochrane Library, Emcare, PsycINFO and Academic Search Premier), supplemented by expert-consultation. Studies were screened using the Artificial intelligence screening tool of ASReview and data was analyzed using Thematic Analysis. To assess the quality of the studies the Qualsyst critical appraisal tool was used. RESULTS A total of 47 studies were included. Four main themes of harmful communication behaviors were identified: (1) Lack of tailored information provision (e.g. giving too little or too much/specific information) (2) Lack of tailored decision making (ranging from; patient exclusion, to the patients' responsibility, and/or haste) (3) Lack of feeling seen and heard (seen as a disease, not as a human being; not listened to concerns and emotions) (4) Lack of feeling held and remembered (forgotten agreements; lack of care continuity). CONCLUSIONS Our results reveal an overview of patients' and family caregivers' perspectives on which clinicians' communication behaviors can harm. Harm could be prevented when information and decision involvement are tailored and patients' and family caregivers' needs to feel seen, heard, held and remembered are met.
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Affiliation(s)
- Janine Westendorp
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Olaf P Geerse
- Department of Medical Oncology, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Pulmonary Diseases, Amsterdam UMC, Amsterdam, The Netherlands
| | - Marije L van der Lee
- Scientific Research Department, Helen Dowling Institute, Centre for Psycho-Oncology, Bilthoven, The Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Jan W Schoones
- Directorate of Research Policy, Leiden University Medical Center, Leiden, The Netherlands
| | - Milon H M van Vliet
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Tamara Wit
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Andrea W M Evers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
- Medical Delta, Leiden University, TU Delft and Erasmus University, Leiden, The Netherlands
| | - Liesbeth M van Vliet
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
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Barker ME, Leach KT, Levett-Jones T. Patient's views of empathic and compassionate healthcare interactions: A scoping review. NURSE EDUCATION TODAY 2023; 131:105957. [PMID: 37734368 DOI: 10.1016/j.nedt.2023.105957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/09/2023] [Accepted: 09/03/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Compassion and empathy are integral to safe and effective patient care. However, to date, most studies have focused on exploring, defining, measuring and analysing empathy and compassion from the perspective of researchers or clinicians. There has been limited attention to the perspectives of patients. OBJECTIVE The objective of this scoping review was to map the literature to identify patients' views of healthcare provider behaviours that exemplify empathic and compassionate interactions. METHOD This review used the Joanna Briggs Institute scoping review methodology. A comprehensive search of eight electronic databases was conducted with English language studies published in the last 10 years considered for inclusion. RESULTS Database searching resulted in 459 records for initial screening. After de-duplication and conducting a title and abstract review, 32 full-text articles were screened for eligibility. A total of 14 studies met the inclusion criteria and were critically reviewed using the Mixed Methods Appraisal Tool. The included papers profiled studies that had been conducted in clinical settings across seven countries. The healthcare encounters described in the papers were with a range of healthcare providers. Two overarching and interconnected categories of behaviours were identified as indicative of empathic/compassionate encounters: (1) communication skills such as listening, touch, body language, eye contact and positive demeanour; and (2) helping behaviours demonstrated by small acts of kindness that go beyond routine healthcare. CONCLUSION Given the breadth of studies describing the positive impact of empathy/compassion on people's physical and psychosocial wellbeing, the results from this review are valuable and shed new light on patients' views and experiences. The results provide a deeper understanding of healthcare provider behaviours that exemplify empathic and compassionate healthcare interactions and can be used to inform the education and training of healthcare providers from all disciplines.
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15
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Chou WYS, Gaysynsky A. A relationship-centered approach to addressing mistrust. JOURNAL OF COMMUNICATION IN HEALTHCARE 2023; 16:320-323. [PMID: 37732639 DOI: 10.1080/17538068.2023.2258683] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Affiliation(s)
- Wen-Ying Sylvia Chou
- Health Communication and Informatics Research Branch, Behavioral Research Program, National Cancer Institute, Rockville, MD, USA
| | - Anna Gaysynsky
- Health Communication and Informatics Research Branch, Behavioral Research Program, National Cancer Institute, Rockville, MD, USA
- ICF Next, Rockville, MD, USA
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16
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Gertsman S, Ene IC, Palmert S, Liu A, Makkar M, Shao I, Shapiro J, Williams C. Clinical empathy as perceived by patients with chronic illness in Canada: a qualitative focus group study. CMAJ Open 2023; 11:E859-E868. [PMID: 37751921 PMCID: PMC10521922 DOI: 10.9778/cmajo.20220211] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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. INTERPRETATION 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.
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Affiliation(s)
- Shira Gertsman
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont.
| | - Ioana Cezara Ene
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Sasha Palmert
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Amy Liu
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Mallika Makkar
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Ian Shao
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Johanna Shapiro
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Connie Williams
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
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van Dijke J, van Nistelrooij I, Bos P, Duyndam J. Engaging otherness: care ethics radical perspectives on empathy. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2023; 26:385-399. [PMID: 37171745 PMCID: PMC10425473 DOI: 10.1007/s11019-023-10152-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/08/2023] [Indexed: 05/13/2023]
Abstract
Throughout the years, care ethicists have raised concerns that prevalent definitions of empathy fail to adequately address the problem of otherness. They have proposed alternative conceptualizations of empathy that aim to acknowledge individual differences, help to extend care beyond one's inner circle, and develop a critical awareness of biases and prejudices. We explore three such alternatives: Noddings' concept of engrossment, Meyers' account of broad empathy, and Baart's concept of perspective-shifting. Based on these accounts, we explain that care ethics promotes a conceptualization of empathy that is radical in its commitment to engage otherness and that is characterized by being: (1) receptive and open, (2) broad and deep in scope, (3) relational and interactive, (4) mature and multifaceted, (5) critical and reflective, (6) disruptive and transformative. This type of empathy is both demanding and rewarding, as it may inspire health professionals to rethink empathy, its challenges, and its contribution to good care and as it may enrich empathy education and professional empathy practices in health care.
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Affiliation(s)
- Jolanda van Dijke
- University of Humanistic Studies, Kromme Nieuwegracht 29, Utrecht, 3512 HD The Netherlands
| | | | - Pien Bos
- Research Methodology, University of Humanistic Studies, Utrecht, The Netherlands
| | - Joachim Duyndam
- Philosophy, University of Humanistic Studies, Utrecht, The Netherlands
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18
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Saketkoo LA, Russell AM, Patterson KC, Obi ON, Drent M. Sarcoidosis and frailty: recognizing factors that foster holistic resilience. Curr Opin Pulm Med 2023:00063198-990000000-00099. [PMID: 37522560 DOI: 10.1097/mcp.0000000000000990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
PURPOSE OF REVIEW Sarcoidosis is a multiorgan system disease exerting significant impact on biophysical, social, psychological and emotional well-being. Mortality and disability correlate to accessible, timely, expert care for sarcoidosis and its related complications. Across health conditions, positive healthcare interactions and interventions can rehabilitate unfavourable factors tied to concepts of 'frailty'. Here, we set out to introduce concepts related to frailty and their impact in the context of sarcoidosis. RECENT FINDINGS Studies examining frailty across other multiorgan and single organ-based diseases that mirror organ involvement in sarcoidosis demonstrate findings that bear relevance in sarcoidosis. Namely, factors predisposing a person to frailty are a multifactorial phenomenon which are also reflected in the lived experience of sarcoidosis; and that early diagnosis, intervention and prevention may alter a course towards more favourable health outcomes. SUMMARY Factors predisposing to frailty in other health conditions may also signal a risk in sarcoidosis. In turn, proactive health preservation - regardless of age - may lead to improved biopsychosocial reserve and health-related quality of life. Fortifying holistic resilience in sarcoidosis is anticipated to reduce risk of the occurrence and prolongation of health-related complications, and facilitate swifter recovery from biophysical complications as well as from psychosocial and emotional stressors.
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Affiliation(s)
- Lesley Ann Saketkoo
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center
- University Medical Center - Comprehensive Pulmonary Hypertension Center and Interstitial Lung Disease Clinic Programs
- Louisiana State University School of Medicine, Section of Pulmonary Medicine
- Tulane University School of Medicine, Undergraduate Honors Department, New Orleans, Louisiana, USA
| | - Anne-Marie Russell
- Exeter Respiratory Innovations Center, University of Exeter, Exeter
- Royal Devon and Exeter NHS Foundation Trust, Devon
- Imperial College Healthcare NHS Trust, London
| | - Karen C Patterson
- Brighton & Sussex Medical School, Department of Clinical & Experimental Medicine, Falmer, UK
| | - Ogugua Ndili Obi
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Marjolein Drent
- Interstitial Lung Diseases (ILD) Center of Excellence, Department of Pulmonology, St. Antonius Hospital, Nieuwegein
- Department of Pharmacology and Toxicology, Faculty of Health and Life Sciences, Maastricht University, Maastricht
- ILD CARE Foundation Research Team, Ede, The Netherlands
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19
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Tomozawa C, Kaneko M, Sasaki M, Miyake H. Clients' and genetic counselors' perceptions of empathy in Japan: A pilot study of simulated consultations of genetic counseling. PLoS One 2023; 18:e0288881. [PMID: 37467241 DOI: 10.1371/journal.pone.0288881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/06/2023] [Indexed: 07/21/2023] Open
Abstract
The rapidly increasing availability of genetic testing is driving the acceleration of genetic counseling implementation. Empathy is important in medical encounters in general and forms a core component of a successful genetic counseling session; however, empirical evidence on empathy in genetic counseling is minimal. This study aimed to explore the perceptions of empathy in simulated genetic counseling consultations from the perspectives of clients and genetic counselors. Semi-structured interviews and interpersonal process recall were used with participants of simulated genetic counseling consultations to elicit their experiences of empathy. A constructivist grounded theory was used for data analysis. A total of 15 participants, including 10 clients and 5 genetic counselors, participated in 10 simulated counseling sessions. The genetic counselors attempted to demonstrate empathy and were sensitive toward detecting changes in clients. Meanwhile, the clients' perceptions represented their feelings and thoughts elicited through the counselors' empathic approaches. This was the first process study to examine empathy in simulated genetic counseling sessions. Our model of communication of empathy is a process in which counselors try to address implicit aspects of clients, and clients are provided with time and a safe place for introspection, which contributes to discussions on building good relationships with patients. There is also a suggestion of the utility of simulated consultations for healthcare providers to learn empathic communication.
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Affiliation(s)
- Chikako Tomozawa
- Division of Life Sciences, Department of Genetic Counseling, Graduate School of Humanities and Sciences, Ochanomizu University, Bunkyo-ku, Tokyo, Japan
| | - Mikiko Kaneko
- Department of Clinical Genetics, The Jikei University Hospital, Minato-ku, Tokyo, Japan
| | - Motoko Sasaki
- Division of Life Sciences, Department of Genetic Counseling, Graduate School of Humanities and Sciences, Ochanomizu University, Bunkyo-ku, Tokyo, Japan
- Genetics Division, Institute for Human Life Science, Ochanomizu University, Bunkyo-ku, Tokyo, Japan
| | - Hidehiko Miyake
- Division of Life Sciences, Department of Genetic Counseling, Graduate School of Humanities and Sciences, Ochanomizu University, Bunkyo-ku, Tokyo, Japan
- Genetics Division, Institute for Human Life Science, Ochanomizu University, Bunkyo-ku, Tokyo, Japan
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Kittang J, Ohlsson-Nevo E, Schröder A. Quality of care in the oncological outpatient setting: Individual interviews with people receiving cancer treatment. Eur J Oncol Nurs 2023; 64:102335. [PMID: 37290164 DOI: 10.1016/j.ejon.2023.102335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/24/2023] [Accepted: 04/29/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE To describe how patients receiving cancer treatment perceive quality of care in the oncological outpatient settings. METHOD A strategic sample of 20 adult patients with cancer treated in four oncological outpatient settings in four hospitals in Sweden participated in the study. Participants were interviewed using a semi-structured interview guide with open-ended questions. The interviews were audio-recorded, and the transcripts were analysed using a phenomenographic approach. RESULTS Three descriptive categories emerged from the data: The patient's care is designed to meet individual needs, The patient's dignity is respected, and The patient feels safe and secure with the care. Overall, quality of care in the oncological outpatient setting is perceived as something positive and described in normative terms by the participants. CONCLUSION The results emphasises that in order to achieve quality of care it is important to the patients that they are able to meet with the same well-educated, professional, caring and sensible health care professionals every time.
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Affiliation(s)
- Jeanette Kittang
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Box 1613, SE-701 16, Örebro, Sweden; Department of Oncology, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden.
| | - Emma Ohlsson-Nevo
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Box 1613, SE-701 16, Örebro, Sweden; Department of Oncology, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden
| | - Agneta Schröder
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Box 1613, SE-701 16, Örebro, Sweden; Department of Health Sciences, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Gjøvik, Norway
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21
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Dutt H, Dean A, Kamal RS, Allan AL. Importance of Incorporating the Perspectives of People with Cancer into Oncology Education: A Scoping Review. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231219394. [PMID: 38116493 PMCID: PMC10729629 DOI: 10.1177/23821205231219394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023]
Abstract
Background With the shift towards person-centered care (PCC) in oncology, there is a need for parallel evolution of oncology education programs to prepare the next generation of health professionals to deliver effective PCC. These programs should be designed utilizing perspectives from individuals who have lived experience with cancer to ensure that changes to education curricula translate to improved PCC in the clinic. Objectives Our goal was to identify existing literature describing such programs as well as identify gaps for further development. Methods Keywords were agreed upon and searched across Ovid Medline, Ovid Embase, ERIC, Google Scholar, and MedEdPORTAL databases. Duplicates were removed, unique articles were screened for relevance by title and abstract, and a full text review of each article was completed for validation. Included articles describe methods for involving people with cancer in developing and/or delivering oncology-focused education programs. Results In total, 15 articles describing 12 unique oncology education programs from 7 different countries were identified, reviewed, and summarized. These programs involved learners undertaking undergraduate medical education, postgraduate medical education, continuing medical education, or training as nurses or radiation therapists. Current literature indicates that classroom-based sessions, experiential or simulated learning modalities, and/or asynchronous online modules can all feasibly be created with the integration of perspectives/narratives of people with cancer. Furthermore, involving people with cancer directly in the design and/or delivery of these education programs may contribute to improved patient experiences. Conclusions Including the perspectives of people with cancer directly in oncology curriculum development and delivery can improve established pedagogical approaches and enhance learner confidence and competency in delivering PCC. We provide recommendations for stepwise implementation of patient perspectives into oncology education, with the hope that future programs will better prepare and motivate learners to provide PCC aimed at improving cancer care, quality of life, and disease outcomes.
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Affiliation(s)
- Hanna Dutt
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
- Interdisciplinary Medical Sciences Program, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Arleigh Dean
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
- Interdisciplinary Medical Sciences Program, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Rayyan Syed Kamal
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
- Interdisciplinary Medical Sciences Program, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Alison L. Allan
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
- Department of Anatomy & Cell Biology, and Department of Oncology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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22
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Mulliri A, Lelorain S, Bouvier V, Bara S, Gardy J, Grynberg D, Morello R, Alves A, Dejardin O. Role of empathy in the outcomes of colorectal cancer: protocol for a population-based study in two areas in France (EMPACOL Project). BMJ Open 2022; 12:e066559. [PMID: 36446452 PMCID: PMC9710360 DOI: 10.1136/bmjopen-2022-066559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION The EMPACOL Project aims to investigate the link between healthcare professionals' (HCPs) empathy and the results of the curative treatment of non-metastatic colorectal cancer (CRC). METHODS AND ANALYSIS EMPACOL will be an observational multicentric prospective longitudinal study. It will cover eight centres comprising patients with non-metastatic CRC, uncomplicated at diagnosis in two French areas covered by a cancer register over a 2-year period. As estimated by the two cancer registries, during the 2-year inclusion period, the number of cases of non-metastatic CRCs was approximately 480. With an estimated participation rate of about 50%, we expect around 250 patients will be included in this study. Based on the curative strategy, patients will be divided into three groups: group 1 (surgery alone), group 2 (surgery and adjuvant chemotherapy) and group 3 (neo-adjuvant therapy, surgery and adjuvant chemotherapy). The relationship between HCPs' empathy at the time of announcement and at the end of the strategy, quality of life (QoL) 1 year after the end of treatment and oncological outcomes after 5 years will be investigated. HCPs' empathy and QoL will be assessed using the patient-reported questionnaires, Consultation and Relational Empathy and European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire, respectively. A relationship between HCPs' empathy and early outcomes, particularly digestive and genitourinary sequelae, will also be studied for each treatment group. Post-treatment complications will be assessed using the Clavien-Dindo classification. Patients' anxiety and depression will also be assessed using the Hospital Anxiety and Depression Scale questionnaire. ETHICS AND DISSEMINATION The Institutional Review Board of the University Hospital of Caen and the Ethics Committee (ID RCB: 2022-A00628-35) have approved the study. Patients will be required to provide oral consent for participation. Results of this study will be disseminated by publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT05447611.
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Affiliation(s)
| | | | | | | | - Josephine Gardy
- Centre Francois Baclesse Centre de Lutte Contre le Cancer, Caen, France
| | | | - Rémy Morello
- Unité de biostatistique et recherche clinique, CHU Caen, Caen, France
| | | | - Olivier Dejardin
- INSERM U1086 Anticipe, Centre Hospitalier Universitaire de Caen, Caen, France
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Mroz EL, McDarby M, Arnold RM, Bylund CL, Kutner JS, Pollak KI. Empathic Communication in Specialty Palliative Care Encounters: An Analysis of Opportunities and Responses. J Palliat Med 2022; 25:1622-1628. [PMID: 35426742 PMCID: PMC9836699 DOI: 10.1089/jpm.2021.0664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2022] [Indexed: 01/22/2023] Open
Abstract
Background: Although empathic responding is considered a core competency in specialty palliative care (PC), patterns of empathic communication in PC encounters are not well understood. Objectives: In this secondary analysis, we delineate types and frequency of empathic communication and examine relationships between patient empathic opportunities and clinician responses. Design: We used the Empathic Communication Coding System to analyze empathic opportunities across three types: emotion (i.e., negative affective state), progress (i.e., stated recent positive life event or development), and challenge (i.e., stated problem or recent, negative life-changing event) and clinician responses. Setting/Subjects: Transcripts from a pilot randomized trial of communication coaching in specialty PC encounters (N = 71) audio-recorded by 22 PC clinicians at two sites in the United States: an academic health system and a community-based hospice and PC organization. Results: Empathic opportunities were frequent across encounters; clinicians often responded empathically to those opportunities (e.g., confirming or acknowledging patients' emotions or experiences). Even though challenge empathic opportunities occurred most frequently, clinicians responded empathically more often to progress opportunities (i.e., 93% of the time) than challenge opportunities (i.e., 75% of the time). One in 12 opportunities was impeded by the patient or a family member changing the topic before the clinician could respond. Conclusions: PC patients frequently express emotions, share progress, or divulge challenges as empathic opportunities. Clinicians often convey empathy in response and can differentiate their empathic responses based on the type of empathic opportunity. PC communication research and training should explore which empathic responses promote desired patient outcomes.
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Affiliation(s)
- Emily L. Mroz
- Section of Geriatrics, Department of Internal Medicine, Yale University, New Haven, Connecticut, USA
| | - Meghan McDarby
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Robert M. Arnold
- Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Carma L. Bylund
- Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
| | - Jean S. Kutner
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Kathryn I. Pollak
- Cancer Prevention and Control, Duke Cancer Institute, Duke University, Durham, North Carolina, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
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24
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Korkmaz Doğdu A, Aktaş K, Dursun Ergezen F, Bozkurt SA, Ergezen Y, Kol E. The empathy level and caring behaviors perceptions of nursing students: A cross-sectional and correlational study. Perspect Psychiatr Care 2022; 58:2653-2663. [PMID: 35524462 DOI: 10.1111/ppc.13106] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/11/2022] [Accepted: 04/24/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of the study was to investigate the empathy level and caring behaviors perceptions of nursing students. METHOD This cross-sectional and correlational study was conducted with 276 nursing students. RESULTS The mean Empathic Tendency Scale score was 62.71 ± 5.10 (min. 20 to max. 100), indicating a low level of empathy. The mean of the Caring Assessment Questionnaire was 5.42 ± 0.80 (min. 1 to max. 7), showing a good perception of caring behaviors. There was a positive, low, and significant relationship between empathy and caring behaviors (r = 0.286, p < 0.001). CONCLUSION This study revealed that nursing students have low-level empathy and high-level caring behaviors. PRACTICE IMPLICATIONS Throughout the educational process, the students' caring competencies, which include empathy and caring behaviors, developed. It is suggested that humanistic and value-oriented pedagogical approaches be incorporated into nursing curricula.
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Affiliation(s)
| | - Kübra Aktaş
- Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | | | - Semiha Aslı Bozkurt
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Yahya Ergezen
- Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Emine Kol
- Faculty of Nursing, Akdeniz University, Antalya, Turkey
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25
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Hadler RA, Goldshore M, Rosa WE, Nelson J. "What do I need to know about you?": the Patient Dignity Question, age, and proximity to death among patients with cancer. Support Care Cancer 2022; 30:5175-5186. [PMID: 35246729 PMCID: PMC8896848 DOI: 10.1007/s00520-022-06938-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/24/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE The Patient Dignity Question (PDQ), "What do I need to know about you as a person to give you the best care possible?" is a validated instrument designed to assess patient priorities and stressors. Administration of the PDQ has been demonstrated to improve patient-provider relationships. The PDQ has been evaluated in multiple settings, but never as a standard component of palliative care consultation. The primary objectives of this study were to determine the feasibility of PDQ screening in palliative care consultation and to characterize responses. The secondary objective was to determine patient and disease factors associated with PDQ response among patients diagnosed with cancer. METHODS PDQ responses were collected from 2015 to 2017, and patient survival data collected through 2018. A codebook was developed to categorize responses using literature review and template analysis; coding was performed until thematic saturation was achieved. We descriptively analyzed thematic distribution among responders and performed multivariable multinomial regression to determine the association between patient characteristics and PDQ response. RESULTS Response to the PDQ was documented in 2053/5002 consultations (41.1%); 1877 patient responses were included in final analysis. A total of 544 (29.5%) patients referenced illness-related concerns, 879 (46.8%) shared personal insights, and 283 (15.1%) cited interpersonal relationships. Younger patients frequently reported illness-related concerns; older respondents (age > 65) often responded with insights into their identity. Patients' responses evaluated less than 1 year before death were more likely to focus upon identity and interpersonal relationships than illness-related concerns. CONCLUSION The PDQ can be used as a means of eliciting values among patients with cancer. Variations in response pattern suggest that approaches to distress may be tailored to age and proximity to death.
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Affiliation(s)
- R. A. Hadler
- Department of Anesthesia, University of Iowa Carver College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242 USA
| | - M. Goldshore
- Department of Surgery, University of Pennsylvania Health System, 3400 Spruce Street, Philadelphia, PA 19104 USA
| | - W. E. Rosa
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, 7th Fl, New York, NY 10022 USA
| | - J. Nelson
- Division of Supportive Care, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 USA
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26
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Murphy BA, Lilienfeld SO, Algoe SB. Why we Should Reject the Restrictive Isomorphic Matching Definition of Empathy. EMOTION REVIEW 2022. [DOI: 10.1177/17540739221082215] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
A growing cadre of influential scholars has converged on a circumscribed definition of empathy as restricted only to feeling the same emotion that one perceives another is feeling. We argue that this restrictive isomorphic matching (RIM) definition is deeply problematic because (1) it deviates dramatically from traditional conceptualizations of empathy and unmoors the construct from generations of scientific research and clinical practice; (2) insistence on an isomorphic form undercuts much of the functional value of empathy from multiple perspectives of analysis; and (3) combining the opposing concepts of isomorphic matching and self-other awareness implicitly requires motivational content, causing the RIM definition to implicitly require the kind of non-matching emotional content that it explicitly seeks to exclude.
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Affiliation(s)
- Brett A. Murphy
- Psychology and Neuroscience, University of North Carolina at Chapel Hill, NC, USA
| | | | - Sara B. Algoe
- Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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27
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Rosa WE, Banerjee SC, Kastrinos AL, Parker PA. Empathic communication: The premise of inclusive care for historically excluded populations. Cancer 2022; 128:2836-2837. [PMID: 35471553 DOI: 10.1002/cncr.34237] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/29/2022] [Indexed: 11/07/2022]
Affiliation(s)
- William E Rosa
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Smita C Banerjee
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Amanda L Kastrinos
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Patricia A Parker
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
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28
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Schwartz R, Blanch-Hartigan D, Valbuena G, Weil A, Dubey M, Catzen HZ, Hall JA, Sanders JJ. Reply to "Empathic communication: The premise of inclusive care for historically excluded populations". Cancer 2022; 128:2838-2839. [PMID: 35471702 DOI: 10.1002/cncr.34236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/16/2022] [Accepted: 03/29/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Rachel Schwartz
- Stanford University School of Medicine, Stanford, California
| | | | | | - Amy Weil
- Division of General Medicine and Clinical Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - Manisha Dubey
- University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado
| | | | - Judith A Hall
- Department of Psychology, Northeastern University, Boston, Massachusetts
| | - Justin J Sanders
- Division of Palliative Care, Department of Family Medicine, McGill University, Montreal, Quebec, Canada
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29
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Swami NS, Mahal BA, Dee EC. Looking beyond the Western lens: How culture and identity influence perceptions of empathy in patient-clinician relationships. Cancer 2021; 128:1545-1546. [PMID: 34962644 DOI: 10.1002/cncr.34075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Nishwant S Swami
- University of Massachusetts Medical School, Worcester, Massachusetts.,Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Brandon A Mahal
- Department of Radiation Oncology, University of Miami/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
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30
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Schwartz R, Dubey M, Blanch-Hartigan D, Sanders JJ, Hall JA. Physician empathy according to physicians: A multi-specialty qualitative analysis. PATIENT EDUCATION AND COUNSELING 2021; 104:2425-2431. [PMID: 34330597 DOI: 10.1016/j.pec.2021.07.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To explore how physicians in neurology, family medicine, internal medicine, and emergency medicine characterize clinical empathy. METHODS Physicians (N = 94) were asked to describe up to 10 examples of empathic physician behavior. Data were analyzed using template analysis. RESULTS Physicians' descriptions of clinical empathy patterned into three themes: Clinical Performance and Professionalism, Interpersonal Communication, and Clinician Orientation. Clinical Performance and Professionalism subthemes included physician competency and accessibility; intersection with institutional resources; and spending/making/taking time with patients. Interpersonal Communication subthemes involved information sharing; verbal and nonverbal approaches; interpersonal sensitivity; physician self-disclosure; and attention to emotion. Clinician Orientation encompassed general physician demeanor and internal thoughts and feelings that might be unobservable by patients. Physicians varied widely in the themes they mentioned in their definition of empathy. CONCLUSION Physicians hold diverse notions of clinical empathy. These extend beyond traditional affective and cognitive empathy definitions to include structural elements like team-based care and accessibility after hours. Communication behaviors were perceived as important for demonstrating empathy. Some physician descriptions of empathy may not be perceptible to patients. PRACTICE IMPLICATIONS Training physicians to engage in behaviors that both they and patients perceive as empathic may lead to higher patient and physician satisfaction.
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Affiliation(s)
| | - Manisha Dubey
- University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO, USA.
| | | | - Justin J Sanders
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Ariadne Labs, Boston, MA, USA.
| | - Judith A Hall
- Department of Psychology, Northeastern University, Boston, MA, USA.
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31
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van Vliet LM, Back AL. The different faces of empathy in cancer care: From a desired virtue to an evidence-based communication process. Cancer 2021; 127:4137-4139. [PMID: 34351623 DOI: 10.1002/cncr.33833] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/04/2021] [Accepted: 06/21/2021] [Indexed: 11/07/2022]
Affiliation(s)
- Liesbeth M van Vliet
- Department of Health, Medical and Neuropsychology, Leiden University, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
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