Exploring empathy as a variable in the evaluation of professional development programs for palliative care nurses

Weekly Email Reminders Increase Nursing Students' Use of Empathic Communication: A Randomized Controlled Trial

BACKGROUND

Empathic communication has numerous patient benefits, yet many nurses do not possess or utilize empathic communication skills.

PURPOSE

This study compared the efficacy of 2 low-cost, low-resource-intensive interventions to increase nursing students' use of empathic communication.

METHODS

The study was a randomized controlled trial with a pretest, posttest, and 3-month follow-up test. Participants were assigned to 1 of 4 groups: weekly empathic communication email reminders, an empathic communication quick reference guide, both, or neither.

RESULTS

All groups showed a significant increase in empathic communication between the pretest and posttest. The group that received emails only showed a significant increase above and beyond the control group. None of the groups significantly increased or decreased their empathic communication between the posttest and 3-month follow-up test.

CONCLUSIONS

Weekly empathic communication email reminders can increase nursing students' use of empathic communication above and beyond traditional lectures and class activities.

Effect of a 2-day communication skills training on nursing and midwifery students' empathy: a randomised controlled trial

INTRODUCTION

Empathy is crucial to the fundamental aim and achievement of nursing and midwifery goals. Researchers agree on the positive role empathy plays in interpersonal relationships when providing healthcare. Models of good communication have been developed to assist nurses, midwives and doctors to improve their ability to communicate with patients. This study investigated the effect of a 2-day communication skills training (CST) on nursing and midwifery students' empathy in a randomised controlled trial.

METHODS

The two groups had a baseline data collection at the same time. The intervention group had a CST, followed by post-test on day 3. The control group had post-test on day 4 just before their CST. The empathy outcome was measured with Jefferson Scales of Empathy-Health Professions Student version. Both groups had a follow-up test at the same time 6 months after the CST.

RESULTS

In this study, there was no statistically significant difference in the scores of empathy between the groups F(1, 171)=0.18, p=0.675. The intervention group had baseline T1 (M=109.8, SD=9.8, d=0.160), and post-test T2 (M=111.9, SD=9.0, d=0.201), whereas the control group had baseline T1 (M=107.9, SD=11.46, d=0.160), and post-test T2 (M=110.0, SD=11.0, d=0.201). Baseline data were collected on 15 June 2013.

CONCLUSIONS

This study has shown that empathy may not be enhanced within a short period after CST.

HOW TO MEASURE THE EMPATHY LEVEL OF UNDERGRADUATE NURSING STUDENTS? AN INTEGRATIVE REVIEW

ABSTRACT Objective: analyze available evidence in the literature on the measuring of empathy levels in nursing undergraduates. Method: integrative literature review developed in the databases PubMed, Web of Science, CINAHL and LILACS in September 2017. Results: among the 40 primary studies analyzed, 21 questionnaires were identified to measure the empathy levels of nursing undergraduates. Conclusion: different tools exist that are considered reliable to analyze the empathy level among nursing undergraduates.

The Impact of Patient and Family Advisors on Critical Care Nurses' Empathy

OBJECTIVE

The objective of this study was to determine if patient and family advisors' (PFAs) collaboration in an educational program could increase the empathy levels of intensive care unit (ICU) nurses.

BACKGROUND

Data suggest that nurse empathy is on the decline. Ensuring that nurses consistently empathize with patients and families helps create positive patient experiences.

METHODS

Thirty nurses participated in a PFA-designed educational intervention using simulation-based role playing. The Toronto Empathy Questionnaire (TEQ) was used to measure empathy before and after the intervention.

RESULTS

The TEQ empathy scores increased significantly after nurses completed the PFA-designed educational program. Younger nurses (<30 years) improved on average 3.03 ± 3.6 points compared with older nurses (>30 years), who improved, on average, only 0.43 ± 2.06 points (t24.4 = 2.46, P = .021). For the changes in TEQ scores from preintervention to postintervention, age was significantly associated with improvements in TEQ scores.

CONCLUSIONS

Patient and family advisors can positively impact empathy among ICU nurses.

The use of expressive methods for developing empathic skills

Empathy is one of the fundamental concepts in nursing, and it is an ability that can be learned. Various education models have been tested for improving empathic skills. Research has focused on using oral presentations, videos, modeling, practiced negotiation based on experiences, and psychodrama methods, such as role playing, as ways to improve empathy in participants. This study looked at the use of expressive arts to improve empathic skills of nursing students. The study was conducted with 48 students who were separated into five different groups. All groups lasted for two hours, and met for 12 weeks. Expressive art and psychodrama methods were used in the group studies. The Scale of Empathic Skill was administered to participants before and after the group studies. Before the group study took place, the average score for empathic skill was 127.97 (SD = 21.26). After the group study, it increased to 138.87 (SD = 20.40). The average score for empathic skill increased after the group (t = 3.996, p = .000). Results show that expressive methods are easier, more effective, and enjoyable processes in nursing training.

Measurement of empathy in nursing research: systematic review

AIM

This paper is a report of a systematic review to identify, critique and synthesize nursing studies of the measurement of empathy in nursing research.

BACKGROUND

The profound impact of empathy on quality nursing care has been recognized. Reported empathy levels among nurses range from low to well-developed and there is clearly debate about what constitutes empathy and how it can be measured and improved.

DATA SOURCES

Searches were made of the CINAHL, MEDLINE and PsycINFO databases, using the terms 'empathy', 'tool', 'scale', 'measure', 'nurse', and 'nursing', singly or in combination to identify literature published in the English language between 1987 and 2007.

METHODS

A systematic review was carried out. The included papers were critically reviewed, relevant data were extracted, and a narrative synthesis was conducted.

RESULTS

Thirty papers representing 29 studies met the inclusion criteria. Three types of studies were identified: descriptive studies (n = 12), studies of empathy and patient outcomes (n = 6), and evaluational studies (n = 11). Twenty scales were used, with more than one tool being applied in some studies, suggesting the need for a systematic review of empathy measures in nursing research. A range of settings were studied but some, such as genetic healthcare, have been neglected.

CONCLUSION

Despite numerous tools being used in nursing research to assess empathy, there appears to be no consistency, suggesting the need to evaluate the rigour of empathy tools appropriately, either to inform education or for application in clinical settings.

The content and effects of palliative care courses for nurses: A literature review

OBJECTIVES

The present literature review describes the literature (1990-2005) that concerns the effects of courses in palliative care at the pre- and postgraduate levels.

DATA SOURCES

A search was made for literature from the period between 1990 and 2005 using CINAHL, Pubmed and Psychlit, supplemented with a search for relevant systematic reviews from the Cochrane Library.

DESIGN

The research questions were directed on the areas of expertise and skills, the didactical methods, the effects of the courses and the standards to measure these effects.

RESULTS

The studies were all focused on general palliative care. Out of 27 studies 21 reported positive effects for communication, attitude, empathy and pain. Six of these 21 positive trails were studies with good quality designs, whereas 15 had moderate designs. The six studies with a lack of effects was one study with good quality and five studies with moderate quality designs. The effects on patients were described in only a few cases. There was still frequent use of self-constructed rating scales, where data about validity and reliability were lacking or where these aspects were not studied.

CONCLUSIONS

The most successful were integrated courses focused on several themes with a variety of didactical methods.

Esthetic abilities: a way to describe abilities of expert nurses in palliative home care

AIM

The aim of this paper is to focus on the abilities needed to create the caring relation in palliative home care and to find ways to describe these abilities and skills from an esthetic perspective.

BACKGROUND

Nurses in Palliative home care have to create a functioning relationship between themselves the patient and the patient's next of kin, this puts special demands on the nurse. A number of abilities, such as creativity, intuition, empathy and self-knowledge are mentioned in literature related to the caring relation. Many nursing theorists have referred to the art and esthetic of nursing when trying to describe these abilities.

METHODS

Data were collected using semi-structured interviews with eight expert nurses in palliative home care. The transcribed interviews were analysed using qualitative content analyses.

FINDINGS

Three main categories where found: The will to do good, Knowledge and Perceptiveness. Subcategories that can be seen as abilities where found in the main categories knowledge and perceptiveness.

CONCLUSIONS

The main categories can be seen as expressions for abilities, personal qualities and skills needed to create the caring relation in palliative home care. We found interesting connections between the three main categories and the concepts of esthetics, ethics and science. We also found that nurses develop in a way, i.e. similar to an artist.

RELEVANCE TO CLINICAL PRACTICE

The concepts brought forward in this paper could be used in clinical supervision and education as well as in clinical practice. If nurses think about the three aspects: Knowledge, the will to do good and perceptiveness, the chance for a positive relation between the nurse and the patient, and the patient's next of kin might increase. One could speculate that perceptiveness is a vital ability in order to achieve the expert level of nursing and that this perspective should be taken in consideration when recruiting nurses and in curriculum development.

Developing empathy in nurses: an inservice training program

The purpose of this study was to determine whether inservice communication training enhanced the empathic skills of 263 nurses employed at Hacettepe University Hospital. Data were collected using a nurse information form, participants' satisfaction form, and the Empathic Communication Skill B (ECS-B) form developed by Dökmen [Dökmen, U. (1988). A new measurement model of the empathy and developing empathy by using psychodrama. Journal of Education Faculty of Ankara University, 21, 155-190]. The ECS-B was used as both a preintervention and a postintervention measure. The data were expressed as means, percentages, and standard deviations, and were analyzed using Pearson's chi-square test and repeated-measures analysis of variance. The posttest scores of nurses increased from 155.6 to 180.5, and training played a role in enhancing nurses' empathic skills with regard to all variables (P < .05). However, a more comprehensive and continuous training should be planned, and its impact on behavior and patient outcomes should be investigated.

A test instrument for palliative care

This article describes a methodological study concerning the development of a test instrument that can be used for measuring the effects of a course in palliative care on registered nurses and licensed practical nurses. This test instrument is comprised of two parts: an expertise and insight test and a self-efficacy instrument and is tested in three panels. The expertise and insight test appears to be usable for measuring the effects of a course in palliative care. The reliability and validity of the test were found to be adequate for evaluation of the effects of a post-basic palliative care course. The generality of the self-efficacy instrument was reduced because high-scoring items in the area of communication had to be removed. Moreover, the scores of the various categories of respondents discriminate less than expected on the basis of their previous education and the test results. Many respondents, regardless of their background, believed themselves to have a high level of competency. The self-efficacy instrument must therefore be used cautiously.

Communication skills training in healthcare: a review of the literature

This article is based on a literature review carried out as part of a study of communication skills teaching in pre-registration nurse education in England in 2000. The rationale for the study was two-fold: the history of patient dissatisfaction with communications and information-giving in the National Health Service and concern about skills deficits in alumnae of recent educational programmes. A lack of research evaluating communications skills training was found in relation to both pre- and post-registration nursing education, and in other healthcare disciplines. Furthermore, the research that has been done is limited by methodological deficiencies in many cases. Recommendations are made concerning improved methods for future research evaluating communication skills training.

Developing empathy to improve patient care: a pilot study of cancer nurses

Empathy has been identified as an important communication skill that can improve psychological outcomes for patients with cancer and palliative care patients; as such there is a need for cancer nurses to be empathic. The majority of research that has been carried out has been concerned with the definition and measurement of empathy. Exploration into the concept of empathy has shown that there is a need to examine the nature of it and to identify exactly where it succeeds and fails. The questions of how empathy is nurtured and sustained and under what conditions it flourishes and diminishes need to be addressed. This study aimed to investigate how cancer nurses interpret and acquire empathy, and to identify the conditions that influence it. It was also important to establish what cancer nurses considered to be the benefits and disadvantages of expressing empathy. The findings demonstrated that nurses are aware of the concept of empathy and do use their empathic skills; however, there are barriers that could inhibit the expression of empathy, including lack of time, poor environment and communication difficulties. This study highlights the recognition of empathy as a discrete communication skill and the need for more structured courses.

Work of art dialogues: an educational technique by which students discover personal knowledge of empathy

The visual art programme was an approach used to facilitate students' discovery of personal knowledge of empathy. The research programme constituted the first phase of an existing theory course in empathy. It involved a visual-verbal-writing process in which a reproduction of Edvard Munch's The Sick Child was studied and interpreted with a focus on personal knowledge of empathy. Data were collected from two university colleges of health sciences in Sweden during a period of 4 years (1995-1998). Student nurses (n = 428) in the undergraduate programme served as the study population. In the first stage, the students worked alone on written reports. Then, in small-groups, they discussed whether the picture facilitated the discovery of a personal knowledge of empathy. The results showed that the visual art programme stimulated the students to discuss and write about empathy. The ambiguity in the painting and the relaxed study situation was favourable to the students' discovery of their personal knowledge of empathy.

A study of postdiagnosis breast cancer concerns for women living in rural and remote Queensland. Part II: Support issues

This paper presents the recent findings from a study on the postdiagnosis support needs of women with breast cancer living in rural and remote Queensland. The findings presented in this discussion focus on support needs from the perspective of the women experiencing breast cancer as well as health service providers. The tyranny of distance imposes unique hardships, such as separation from family and friends, during a time of great vulnerability for treatment, the need to travel long distances for support and follow-up services, and extra financial burdens, which can combine to cause strains on the marital relationship and family cohesion. Positive indications are, however, that the rural communities operate on strong, informal networks of support. This network of family, friends and community can, and does, play an active role in the provision of emotional and practical support.