Developing empathy in nursing students: a cohort longitudinal study

Evaluation of the effectiveness of a video-based educational intervention on perinatal mental health related stigma reduction strategies for healthcare professionals: A single group pre-test-post-test pilot study

BACKGROUND

Healthcare professionals have a role to play in reducing perinatal mental health related stigma.

AIM

To assess the effectiveness of a video-based educational intervention developed to provide guidance to healthcare professionals on perinatal mental health related stigma reduction strategies.

DESIGN

A single group pre-test-post-test pilot study with no control group.

SETTING(S)

A university affiliated maternity hospital in Ireland PARTICIPANTS: A convenience sample of registered midwives, nurses and doctors (n = 60) recruited from October 2020-January 2021.

INTERVENTION

A twenty-minute video-based educational intervention.

METHODS

Respondents (n = 60) completed a pre-test (time point one) and post-test (time point-two) questionnaire, and a three-month follow-up post-test questionnaire (time point-three) (n = 39). The questionnaire included the Mental Illness Clinicians' Attitudes Scale, Reported and Intended Behaviour Scale, Reynolds Empathy Scale and open-ended questions. Wilcoxon Signed Rank Test was selected to evaluate the pre-test post-test scores.

RESULTS

The difference in mean Mental Illness: Clinicians' Attitudes-4 scores were statistically significant between time points one and three (z = 3.27, df=36, P = 0.0007) suggesting more positive attitudes towards people with mental health conditions after the intervention. The mean total score for the Reported and Intended Behaviour Scale increased from 18.7 (SD 1.87) at time point one to 19.2 (SD 1.60) at time point two (z= -3.368, df=59, P = 0.0004) suggesting an increase in positive intended behaviours towards those with mental health issues immediately following the intervention. These findings were also corroborated by responses to open-ended survey questions.

CONCLUSIONS

Further research with a larger sample of healthcare professionals evaluated over a longer period would provide further evidence for the sustainability of the intervention.

TWEETABLEABSTRACT

A video-based intervention can increase healthcare professionals' knowledge of perinatal #mentalhealth related stigma reduction strategies @Journal. Link to article.

Are pediatric practicum experiences a beneficial component of registered nurse education programs? Nursing students and new graduates weigh in: A qualitative descriptive research study

BACKGROUND

In Canada, the British Columbia College of Nurses and Midwives requires baccalaureate registered nurse education programs to deliver a generalist curriculum meeting entry-level competencies. To fulfill this requirement, nursing programs ensure the provision of practice opportunities for hands-on experience with patients of all ages through practicum. Current literature suggests the limited availability of clinical placement opportunities in pediatric settings. This may reduce the opportunity for nursing students to become acquainted with the unique needs of infants, children, and adolescents as part of their nursing education.

AIM

This study aimed to explore students' and new graduates' experiences of acute and community pediatric clinical practicum as part of their British Columbia nursing education program.

SETTINGS, PARTICIPANTS, AND METHODS

This study utilized a qualitative descriptive approach. Fifteen online semi-structured interviews were conducted with thirteen undergraduate nursing students and two recent graduates. Participants in this study were distributed across the province of British Columbia, representing the North, the Interior, and the Lower Mainland. Data were analyzed using thematic analysis.

RESULTS

The key themes of relational practice and exposure to lived experiences (and their related subthemes) are explored in detail. Both themes encapsulate the importance that nursing students ascribe to the pediatric practicum experience as part of their nursing education.

CONCLUSION

The result of this study deduced that the pediatric practicum experience provided nursing students with learning opportunities they may not get elsewhere such as: building relationships with children, adolescents, and their families within the context of care and developing awareness of the lived experiences of health and illness with each patient encounters. This unique perspective of nursing students may prove valuable for the planning and delivery of clinical learning in nursing education programs.

Empathy in Nursing Students: A Scoping Review

Purpose: Empathy is essential for nursing students as they progress through their education. To date, few review studies explored empathy in nursing students. This review examined empathy in nursing students, including how to promote empathy, factors contributing to empathy, and the evaluation of empathy. Design: The eligible population included undergraduate nursing students. The concept of interest was empathy related to nursing students. The context was undergraduate nursing programs. Eligible studies included quantitative, qualitative, and mixed-method studies. The protocol was registered in Open Science Framework (OSF). Review Methods: Joanna Briggs Institute Reviewers' Manual guided this scoping review protocol. MEDLINE with Full text (EBSCO), Scopus, ScienceDirect (Elsevier), and PubMed were used for the electronic database search. The findings were analyzed with descriptive statistics and thematic analysis. Findings: A total of 94 articles were included for analysis. Three main themes emerged: (1) approaches to promoting empathy, (2) contributing factors to empathy, and (3) evaluation of empathy. Conclusions: Empathy is cultivated in nursing in numerous ways, highlighting the need to incorporate it into the nursing curriculum. There is also controversy regarding the relationship between empathy and individual characteristics. This finding highlights the need for more effective empathy-promoting educational training that considers these personal characteristics.

Levels and predictors of empathy, self-awareness, and perceived stress among nursing students: a cross sectional study

BACKGROUND

High levels of empathy and self-awareness and low level of stress among nursing students are the core elements of improving patients' care and outcomes. The purpose of this study is to assess the levels, relationships, and predictors of empathy, self-awareness, and perceived stress in a sample of undergraduate Jordanian nursing students.

METHODS

A descriptive cross-sectional design was employed to collect data from 330 students using a web-based survey.

RESULTS

The total mean scores of empathy, self-awareness, and perceived stress were 75.75, 40.17, and 55.65, respectively. Students who are studying in public universities, with higher GPA, who have no intention to leave nursing, and who are satisfied with nursing; reported higher level of empathy. Students with lower income level, who have no intention to leave nursing, and who are satisfied with nursing; reported higher level of self-awareness. Female students, those who sleeping 6 h and less, did not get a balanced diet or perform exercise, studying in public universities, lower GPA, have intention to leave nursing, and did not satisfy with nursing; reported higher level of perceived stress.

CONCLUSIONS

Nursing students reported adequate empathy level, low self-awareness level, and moderate perceived stress level. Students who are satisfied and have no intention to leave nursing reported higher level of empathy, self-awareness, and perceived stress. It is necessary to conduct interventional programs that enhance students' well-being especially empathy and self-awareness, and reduce the level of their stress.

Emotional Engagement and Caring Relationships: The Assessment of Emotion Regulation Repertoires of Nurses

In spite of the importance of emotion regulation for nurses' well-being, little is known about which strategies nurses habitually use, how these strategies combine in order to regulate their emotional distress, and how these are related to their caregiving orientations. The current study aimed to explore the emotion regulation repertoires that characterize health-care providers and to investigate the association between these repertoires and caregiving orientations in a sample of nurses. Firstly, a confirmatory factor analyses was run to test the suitability of the Regulation of Emotion System Survey for the assessment of six emotion regulation strategies among health-care providers. Subsequently, the latent profiles analysis was employed to explore emotion regulation repertoires. Three repertoires emerged: The Average, the Suppression Propensity and the Engagement Propensity profiles. The participants of the last two groups relied on Expressive Suppression and Engagement, respectively, more often than others. Nurses were more likely to be placed within the Engagement Propensity group when compared to the first responders, and higher levels of hyperactivation of the Caregiving System were associated with this repertoire. A greater reliance on Expressive Engagement among nurses was discussed in terms of the fact that nurses usually have a longer and more care-oriented relationships with patients than first responders.

Gaining an Empathetic Insight into Parenting: Evaluating Infant Simulator Dolls for Professional Learning

The development of an empathetic approach when working with parents and families is fundamental to both social work and children's nursing; however, opportunities to develop this are limited. RealCare Baby infant simulator dolls were used with the aim of enabling students to gain an empathetic insight into parenting. A qualitative, evaluation study involving semistructured interviews with 10 social work and 11 children's nursing students was undertaken to evaluate experiences and views of infant simulator dolls, in relation to professional learning. Using reflexive thematic analysis of interview data, six key themes were identified: (1) positive experiences, (2) challenges, (3) impact on self, (4) empathy toward parents, (5) realism and (6) learning by reflection. All themes were evident from the participants' accounts in the context of the parenting experience. In addition to the overall positive impact on students, practical and technical challenges were also identified. However, despite these difficulties, participants valued the learning experience gained from caring for a doll and many articulated how an empathetic understanding of the parenting role was enhanced. This will potentially enable social work and children's nursing students to support parents more sensitively and empathetically.

A Systematic Review of the Application of Simulation to Promote Empathy in Nursing Education

SUMMARY STATEMENT

This systematic review aimed to identify, appraise, and synthesize evidence for the effectiveness of simulation modalities in promoting nursing students' empathy. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis was followed with 20 studies included. The Medical Education Research Study Quality Instrument (MERSQI) was used to evaluate the quality of the publications. The mean MERSQI score was 10.95 with an SD of 1.62, which was above the average in the literature.Five simulation modalities were identified: standardized patient, simulated suit, manikin, virtual simulation, and virtual reality simulation. Most of the studies (n = 15) reported significant differences in the measured outcomes after their simulation activities, including all 5 simulation modalities, but the most effective modality was the simulation suit. The simulation suit replicates the lived experiences of others, which enhances perspective taking by "turning the student into the patient" through the physical and sensory effects of simulated suits. However, outcome measures were limited to self-report instruments in the studies.

Social support, empathy and compassion fatigue among clinical nurses: structural equation modeling

BACKGROUND

Clinical nurses are at high risk for compassion fatigue. Empathy is a prerequisite for compassion fatigue, and social support is an important variable in the process of reducing individual stress. However, the role of social support in the relationship between empathy and compassion fatigue remains unclear. This study explored whether social support mediates the relationship between empathy and compassion fatigue among clinical nurses.

METHODS

A total of 992 clinical nurses were recruited through convenience sampling for a cross-sectional study in Central China. They completed the General Information Questionnaire, Perceived Social Support Scale, Professional Quality of Life Scale, and Jefferson Scale of Empathy. SPSS was used to conduct descriptive statistical analyses. Pearson's or Spearman's correlation analyses and AMOS were employed to build a structural equation model (SEM) to verify the mediating effect of social support on the relationship between empathy and compassion fatigue.

RESULTS

The results indicated that the standardized direct effect of empathy on compassion fatigue was 0.127, and the standardized indirect effect of empathy on compassion fatigue through social support was 0.136. The mediation effect ratio between empathy and compassion fatigue was 51.7%.

CONCLUSIONS

Our findings show that social support mediates the relationship between empathy and compassion fatigue among clinical nurses. This finding suggests that increasing nurses' social support can decrease the prevalence of compassion fatigue. Nursing managers should provide training related to flexibly adjusting empathy and educating nurses to establish effective social networks with family, friends, and colleagues to prevent compassion fatigue.

The effect of drama-supported, patient role-play experience on empathy and altruism levels in nursing students: A randomized controlled study

AIM

This study aims to determine the effect of drama-supported, patient role-play experiences on the empathy and altruism levels of nursing students.

BACKGROUND

Empathy, one of the most important skills of the nursing profession, has an important place in the patient-nurse relationship. To be empathetic, which is acknowledged as the most basic motivation of altruistic behavior, requires recognizing emotional states and understanding the needs of others.

DESIGN

The format of this study was a pre-test-post-test, regular parallel-group, randomized, controlled experiment.

METHODS

The study data were collected between October 2021 and February 2022. The research was carried out with second-year students at Necmettin Erbakan University, Faculty of Nursing, who did not have any history of hospitalization or any chronic diseases. All subjects agreed to participate in the study (n = 52, intervention group=26, control group 26). Data were collected using a Descriptive Characteristics Form, the Altruism Scale and the Jefferson Scale of Empathy for Nursing Students (JSENS). After a three-hour drama workshop, participants in the intervention group acted out the role of a bed-bound patient in the laboratory environment and no intervention was applied to the control group. A series of Mixed ANOVAs were conducted for the analysis of the data.

RESULTS

The mean age of participants was 19.94 years (SD = ± 1.31) and 83.7 % of the participants were women. The intervention group showed a significant increase in altruism compared with the control group, as evidenced by higher scores in the Altruism Scale Total Score and a significant group*time interaction effect. However, in the JSENS Total Score, including the perspective taking and standing in patient's shoes sub-dimensions, no differences were observed based on group, time and group * time interactions.

CONCLUSION

The patient role-play experience increased the empathy and altruism levels of nursing students, but the effect was not evident at the three-month follow-up.

Empathy, emotional intelligence and interprofessional skills in healthcare education

According to the World Health Organization (WHO), health professionals maintain the health of citizens through evidence-based medicine and caring. Students enroled in health professional programmes are required to have successfully attained all core learning outcomes by reaching key milestones throughout the course of their studies, demonstrating they have developed the required graduate skills and attributes upon completion of the programme. While some of the knowledge, skills and competencies that make up these learning outcomes are very discipline specific, there are more general professional skills across all disciplines which are difficult to define, such as empathy, emotional intelligence and interprofessional skills. These are at the heart of all health professional programmes that once defined, can be mapped through curricula and further evaluated. Literature will be presented on these three professional skills: empathy, emotional intelligence, and interprofessional skills, based on studies that focussed primarily in health professional programmes and highlight some of the key findings and issues at undergraduate and postgraduate levels. The paper will present the need for these skills to be defined and then mapped through curricula so that students are better supported in their professional development. Empathy, emotional intelligence and interprofessional skills transcend the discipline specific skills and as such it is important that all educators consider how best these may be fostered. Efforts should also be made to further the integration of these professional skills within curricula to produce health professionals with an enhanced focus on person-centred care.

The impact of emotional intelligence on life satisfaction among Chinese nurses: A chain mediating model

Introduction

Nurses' life satisfaction exerts a positive impact on their professional careers, and it seriously affects their physical and mental health. Low life satisfaction has become a key factor in the global shortage of nurses. Emotional intelligence may protect nurses from negative emotions that can affect the care they provide, as well as their life satisfaction. In this study, we aims to explore the impact of emotional intelligence on life satisfaction, and even verify the chain mediating effect of self-efficacy and resilience on this relationship among Chineses nurses.

Method

The Emotional Intelligence Scale, the General Self, Efficacy Scale, the Connor-Davidson Resilience Scale, and the Satisfaction with Life Scale were used to survey 709 nurses in southwest China. To analyze mediating effects, SPSS 26.0 and Process V3.3 were used for statistical processing.

Result

Emotional intelligence positively predicted life satisfaction. Meanwhile, it was also found that emotional intelligence and life satisfaction were continuously mediated by self-efficacy and resilience, and the indirect effect value was 0.033, accounting for 17.37%.

Conclusion

This study reveals how emotional intelligence affects nurses' life satisfaction. The results of this study have certain implications for nurses to better balance their career and life. Nursing managers should provide nurses with a favorable working environment from the perspective of positive psychology, improve their sense of self-efficacy and resilience, ultimately improve their life satisfaction.

Effectiveness of Narrative Photography in Increasing Nursing Students' Empathy: A Pretest-Posttest Study

BACKGROUND

Narrative photography is a method that can enhance nursing students' empathy when caring for individuals with HIV.

METHOD

This quasiexperimental pre-test-posttest study included 28 first-year nursing students from a public university in Barcelona, Spain. Empathy was assessed using the Spanish validated version of the Interpersonal Reactivity Index.

RESULTS

Empathy scores were higher in the intervention group (p = .01). Women scored higher on empathy and also on the fantasy, empathic concern, and personal distress dimensions. A significant relationship was found between the perspective taking dimension and students choosing nursing as their first option at university. Having no experience in the health field was associated with higher scores on the empathic concern dimension (p = .027).

CONCLUSION

Narrative photography is an effective learning method to promote nursing students' empathy when caring for individuals with HIV. [J Nurs Educ. 2022;61(12):701-705.].

Arab nursing students' perception of the emotional experience of patient care: A phenomenological study

BACKGROUND

A shared emotional response helps with understanding what other people are feeling and/or thinking; and it is a vital skill in clinical settings. Collectivist communities place more emphasis on the emotional components of their feelings in comparison to the cognitive aspects of their emotions.

PURPOSE

This study aimed to explore the emotions experienced by students at their first clinical placement.

METHODS

A hermeneutic phenomenological approach was used among nine baccalaureate students.

RESULTS

Three major themes emerged from the data: overwhelming emotions; unbalanced perception of professional identity; and adjustment and adaptation.

CONCLUSIONS AND DISCUSSION

It is evident that nursing students from collectivist communities encounter challenges in dealing with their emotions and managing their patients' emotions; however, they were capable of empathizing with their patients using the two components of their empathy; affective (emotion) and cognitive (cognition), with prominence given to the affective part. As countries become increasingly multi-cultural, which in turn influences the characteristics of people entering pre-registration nursing programs, nursing leaders are invited to address both dimensions of empathy as part of the nursing curriculum. Attention should also be given in clinical settings to appropriate channeling of clinical empathy to cultivate a professional identity.

The influence of active listening on parents' perceptions of clinical empathy in a stuttering assessment: A preliminary study

PURPOSE

The primary purpose of this preliminary study was to explore whether a clinician's use of active listening skills (i.e., client-directed eye gaze and paraphrasing) influenced parents' perceptions of clinical empathy in a stuttering assessment. A secondary purpose was to determine whether parent age, education, or parent concern predicted perceived clinical empathy.

METHOD

Participants (n = 51 parents/guardians of children who stutter) watched two counter-balanced videos of a clinician demonstrating either high or low frequency use of active listening skills during the clinician's initial assessment with a standardized patient actor portraying a parent of a child who stutters. After each video, parents rated the clinician's empathy and active listening skills via the Jefferson Scale of Physician Empathy for Observers (JSPEO; Hojat et al., 2017) and the Counselor Activity Self-Efficacy Scales - Modified (Victorino & Hinkle, 2018). Participants then completed a demographic questionnaire and rated their concern about their child's stuttering.

RESULTS

Paired t-tests demonstrated significantly higher ratings of perceived clinical empathy in the high frequency active listening condition compared to the low frequency condition (d = 0.548). Simple linear regression analyses indicated parent age or level of education did not predict perceived clinical empathy. An independent samples t-test indicated that parent concern about stuttering did not predict perceived clinical empathy.

CONCLUSIONS

Preliminary findings suggest that the clinician was viewed as significantly more understanding, concerned, and caring (i.e., perceived as empathic) when active listening skills were used. Parents' ratings of empathy on the JSPEO, based on high levels of active listening by the clinician, were not associated with parents' ages, education levels, or concern about their children's stuttering. This may reflect the value of active listening in clinical relationships regardless of variables specific to the recipient (e.g., parent of a child who stutters). Given that parents are more apt to share thoughts and emotions about their child's communication with clinicians who demonstrate empathic qualities, this preliminary study suggests that the use of active listening skills warrant emphasis in clinical training.

Empathy Training for Caregivers of Older People: A Systematic Review

OBJECTIVES

To identify empathy training models and the effects on psychological concerns in paid and unpaid caregivers of older people.

METHODS

A systematic review was conducted. Searches for relevant articles were performed in the Embase, LILACS, PsycInfo, Pubmed, Scopus and Web of Science databases using the following search strategy: "Empathy AND (Education OR Training OR Intervention) AND Caregiver." No restrictions were imposed regarding language or year of publication.

RESULTS

Empathy training for caregivers of older people were performed in six studies, three of which identified a significant increase in empathy levels and consequent reduction in psychological concerns. Empathy training focused on aspects of empathy and/or the caregiver had significant effects on the outcome variables. Moreover, training conducted online, by telephone and/or in person can generate satisfactory results. The other three studies that conducted training with a focus on aspects of dementia and/or old age did not present any effect on the outcome variables.

CONCLUSIONS

Empathy training for caregivers of older people can increase levels of this ability, especially in the cognitive domain, as well as diminish psychological concerns caused by the negative impact of providing care.

CLINICAL IMPLICATIONS

Empathy training directed at empathic abilities and/or aspects of providing care can be effective at increasing levels of this ability. Moreover, training in different care contexts can minimize the negative impacts of providing care.

Focus Group Findings to Support the Preliminary Development of the Augmented Reality Education Experience (AREduX)

Dementia is considered a global health priority with projections of the disease set to increase dramatically across the world. Current support for persons living with dementia (PLWD) relies on long-term care and local service centers to provide education and support. Augmented reality-based programs continue to gain momentum across health sectors, becoming an innovative approach that provides an opportunity to have a visceral experience, which can deepen understanding and provide an embodied perspective of other groups within a relatively short time frame. There is increasing interest in developing approaches to aid patient care outcomes for PLWD and their caregivers. Hence, healthcare providers (HCPs) who are appropriately trained and equipped to provide quality care to PLWD are essential and of international concern. The purpose of this research program is to develop an augmented reality (AR) education experience (AREduX), a proof of concept prototype in the form of a digital resource that uses AR to simulate the physical and cognitive symptoms that PLWD experience. The findings from a stakeholder focus group will allow for the preliminary development of the AREduX.

A discourse analysis of health provider interactions with parents who are reluctant to vaccinate

OBJECTIVE

Vaccine hesitancy is a persistent barrier to vaccination uptake, and health professionals report interactions with such parents to be difficult. Using discourse analytic techniques, we examine the foundation of a therapeutic relationship: the display of empathy and attempts to build rapport, in consultations between immunisation specialists and vaccine reluctant parents.

METHODS

Consultations between consenting clinicians and parents in two Specialist Immunisation Clinics in Australia were recorded. Twelve conversations between the clinicians and parents were analysed using interactional sociolinguistic (IS) discourse analytic methods.

RESULTS

This paper takes a case study approach by citing two interactions that exemplify the interactional work of the consultants as they strive to engender mutual understanding and goodwill, noting examples of discursive choices that demonstrate empathy and the building of rapport.

CONCLUSION

Awareness of discourse strategies that interweave relational and clinical goals enable a more nuanced understanding of communication skills that support a guiding partnership in vaccine related decisions with parents.

PRACTICAL IMPLICATIONS

Through highlighting the strategic interactional work that displays empathy and builds rapport, we can inform educational approaches and build a repertoire of communication choices that strengthen the communication skills of health professionals.

The effect of affective learning on alexithymia, empathy, and attitude toward disabled persons in nursing students: A randomized controlled study

PURPOSE

To evaluate the effect of affective learning on alexithymia, empathy, and attitude toward disabled persons in nursing students.

DESIGN AND METHODS

This prospective, randomized, controlled trial study was implemented among 70 nursing students. Based on transformative learning theory, the affective learning method was applied to the intervention group. Toronto Alexithymia Scale (TAS), Empathic Tendency Scale (ETS), and Attitudes Toward Disabled Person Scale (ATDPS) were administered to both groups.

RESULTS

The intervention group showed a statistically and significantly lower score at TAS and higher score at ATDPS compared to the control group, whereas no statistically significant difference was found in ETS score.

PRACTICE IMPLICATIONS

Affective learning methods could be implemented in the nursing course for improving students' attitude toward disabled persons, and reducing alexithymia.

Relationship Between Emotional Intelligence, Self-Acceptance, and Positive Coping Styles Among Chinese Psychiatric Nurses in Shandong

Background

Nurses are facing increasing pressure due to the progressing of society, broadening of nursing service connotation, and increasing of the masses’ demand for medical treatment. Psychiatric nurses face suicides, violence, and lost along with other accidents involving patients with mental disorders under higher psychological pressure. A coping style, which is affected by individual emotions and cognition, is an essential psychological resource that allows individuals to regulate stress. The purpose of this study was to investigate the correlation between self-acceptance and the positive coping style of psychiatric nurses, and investigate the mediating role of emotional intelligence.

Methods

A total of 813 psychiatric nurses from six natural regions in Shandong Province were investigated using the Self-Acceptance Questionnaire (SAQ), Emotional Intelligence Scale (EIS), Simplified Coping Style Questionnaire (SCSQ), and self-compiled general information questionnaire.

Results

The total EIS score of psychiatric nurses was 3.848 ± 0.459. The highest score was for others’ emotional management (4.071 ± 0.548) and the lowest was for emotion perception (3.684 ± 0.483). EIS and positive coping style were statistically significant based on age, work experience, professional title, education level, and gender (p < 0.05, p < 0.01). Self-acceptance was statistically significant only for professional titles (F = 3.258, p = 0.021). Self-acceptance and emotional intelligence were positively correlated with positive coping style (r = 0.361, p < 0.01; r = 0.492, p < 0.01, respectively). The factors were also positively correlated with each other (r = 0.316, p < 0.01). Self-emotion management, others’ emotional management, emotion perception, self-acceptance, and education level jointly predicted positive coping styles (R² = 0.305, F = 60.476, p = 0.000). Emotional intelligence partially mediated the relationship between self-acceptance and positive coping styles, with a mediating effect of 16.3%.

Conclusion

Emotional intelligence and self-acceptance can promote positive coping styles and improve psychiatric nurses’ mental health.

The effectiveness of empathy training in health care: a meta-analysis of training content and methods

OBJECTIVES

The meta-analysis examined the question of whether empathy training is effective in health care and whether specific training content and methods can be found to account for its effectiveness.

METHODS

We included 13 out of 50 studies (total N = 1315) that fulfilled the search criteria. R version 4.0.5 with the esc, meta, metafor, and dmetar packages and SPSS28 were used to conduct the meta-analysis based on the random-effects model. The effect sizes were calculated using Hedge`s g, and heterogeneity was tested using Cochran's Q. In addition, the multicollinearity of the moderators was checked.

RESULTS

The overall effect size (Hedge´s g = 0.58, s = 0.10, p = 0.00) indicated a moderate effect of empathy training. There was a significant heterogeneity (I² = 76.9%, Q = 84.82, p=0.00), thus we examined whether individual training methods have influenced effect sizes, which could not be confirmed (F _(8,4) = 0.98, p = 0.55). The same applied to the training contents (F _(6,6) = 0.27, p = 0.93).

CONCLUSIONS

The present study showed that empathy training could be effective. This confirmed previous findings and supported the use of such training. However, according to our results, no significant moderators could be found, i.e., the training contents or methods did not contribute to the effect sizes. For meaningful findings, a comparison of different training components should definitely be made, and it should be investigated whether empathy training spread over a period of time is more effective and sustainable than one-time training.

The role of empathy in ethics of radiological protection

Radiological protection is often considered a matter of scientific and technological facts only, not of value judgements. This perception is now gradually changing, especially with ICRP Publication 138, which addressed the ethical foundation of the system of radiological protection. It identified values which have guided the Commission's recommendations over the decades, but have not always been made explicit. Four core values are discussed (beneficence/non-maleficence, prudence, justice, dignity) as well as three procedural values (accountability, transparency, inclusivity). The latter are considered critical to the practical implementation of the system of radiological protection. Here we are exploring empathy as a procedural values complementing the three identified in ICRP Publication 138. Empathy can be defined as the 'capability (or disposition) to immerse oneself in and to reflect upon the experiences, perspectives and contexts of others'. It is often understood as a skill that one either has or has not, but research has shown it can be taught and therefore can be required as an attitude of those working in health care, education, design, and technology. We suggest it is an essential prerequisite to the assessment and management of any radiological situation and the health problems accruing from it. The concerns of people affected, their needs and wishes need to be taken seriously from the very beginning of any decision-making process. Even if they are considered unfounded and exaggerated, the insights they provide will be valuable for the understanding of the overall situation. Without empathy, our practice of beneficence and non-maleficence as well as solidarity would be oddly limited.

Grief as a mediator of the relationship between empathy and compassion fatigue

OBJECTIVE

Oncology nurses are at high risk of developing compassion fatigue (CF) because of the persistent exposure to patients' suffering and death. Empathy is a prerequisite cognitive reaction for CF. Nurses with greater empathy levels are more prone to develop an emotional connection with patients. However, it is this kind of close bonds that led nurses to experience a deep sense of grief. Cumulative grief may eventually develop into CF. This study examined the levels of grief, empathy and CF, evaluated the correlation among empathy, grief and CF, and verified the role grief as a mediator of the relationship between empathy and CF.

METHODS

Participants were 794 Chinese oncology nurses in a cross-sectional study. We measures consisted a demographic questionnaire, the Interpersonal Reactivity Index, the Texas Revised Inventory of Grief-Present, and the Professional Quality of Life Scale.

RESULTS

Oncology nurses showed moderate levels of empathy and grief, moderate to high levels of CF. Perspective taking was negatively related to grief and secondary traumatic stress (STS). Empathic concern was negatively related to burnout (BO). Personal distress was positively related to grief, STS and BO. Grief was positively related to STS and BO. Grief played a partial mediating role between empathy and STS.

CONCLUSIONS

Oncology nurses commonly experience CF. There is a need to provide interventions and effective supports for oncology nurses to improve their empathy ability, and help them cope with grief and CF.

Evaluation of the Effectiveness of an Empathy Training on Empathy Skills, Life Satisfaction, and Relationship Quality for Chinese Adolescents and Their Mothers: A Mixed Methods Study

Using a pre- and post-test design, this study examined the changes in empathy skills, life satisfaction, and relationship quality among mainland Chinese adolescents (ages 13–15 years) and their mothers ( N = 108 dyads) following an empathy training intervention. Participants completed a 20-day empathy training, including two in-person group training sessions and daily journals on assigned topics. Participants’ mother-child relationship quality, mother-child conflict, life satisfaction, and empathy skills were measured three times, and selected participants were interviewed to explore their experience of the training. The research procedure followed protocols that were approved by an Institutional Review Board. ANOVAs were used to examine quantitative data and inductive analysis was used for qualitative data. The findings suggest that after the training, both adolescents and mothers reported significant benefits in mother-child relationship quality and life satisfaction. However, participants’ empathy skills (i.e., perspective taking and empathic concern skills) did not change. Possible mechanisms of the observed changes included the empathy skills (e.g., perspective taking skills) learned through the training and the reciprocal nature of positive changes within the mother-child dyad. The current study suggests that empathy training may benefit adolescents and their mothers, both within the relationship and in their general life satisfaction.

The Usefulness of a Massive Open Online Course about Postural and Technological Adaptations to Enhance Academic Performance and Empathy in Health Sciences Undergraduates

Massive open online courses (MOOCs) provide accessible and engaging information for Physical Therapy and Occupational Therapy students. The objective of this research was to determine the usefulness in improving academic performance and empathy in health sciences undergraduates, and to test a hypothetical model through structural equation analysis. This research was carried out using a descriptive and quasi-experimental design. It was conducted in a sample of 381 participants: 176 used a MOOC and 205 did not. The results of the Student’s t-test showed statistically significant differences in academic performance between the groups in favor of those students who had realized the MOOC. Participants carried out an evaluation rubric after taking MOOC. Statistically significant differences in empathy were also obtained between the pre (X = 62.06; SD = 4.41) and post (X = 73.77; SD = 9.93) tests. The hypothetical model tested via structural equation modeling was supported by the results. Motivation for the MOOC explained 50% of the variance. The MOOC (participation and realization) explained 58% of academic performance, 35% of cognitive empathy and 48% of affective empathy. The results suggest an association between higher realization and participation in a MOOC and higher levels of academic performance, and cognitive and affective empathy.

The effect of empathy skills of psychiatric nurses on their attitudes and practices towards the use of physical restraint

PURPOSE

The aim of this study was to evaluate the effect of empathy skills of psychiatric nurses on their attitudes and practices towards the use of physical restraint.

DESIGN AND METHODS

This cross-sectional, correlational, descriptive study included 100 nurses (88.49% of the population). Data were collected using a sociodemographic characteristics form, the empathy skills scale (ESS) form B, and the knowledge, attitudes, and practices of staff towards physical restraints questionnaire (KAPS-PR) were used.

FINDINGS

The total mean ESS score was found to be 152.34 ± 24.44, indicating moderate empathy skills. Mean KAPS-PR scores were 29.54 ± 4.43 for the attitude scale and 33.94 ± 3.26 for the practice scale, indicating appropriate attitudes and ideal practices related to physical restraint, respectively. ESS score was significantly higher among nurses with higher educational levels (p = .001) and weakly correlated with KAPS-PR attitude score (r = .25; p < .05).

IMPLICATIONS FOR PRACTICE

Improving the empathy skills of psychiatric nurses could improve their attitudes towards physical restraint, thereby reducing its use.

Empathic approach to reducing the negative attitudes of nursing undergraduate students towards cancer

BACKGROUND

In cases where even professional nurses have difficulty in giving care to cancer patients, student nurses may not be able to provide adequate care and sometimes develop a negative behavior or attitude towards this patient group.

OBJECTIVES

The purpose of the study was to examine the relationship between the attitudes of nursing undergraduate students towards cancer and the empathic approach.

DESIGN

The study was carried out using the cross-sectional research design.

SETTINGS

A university located in the southeast of Turkey between November-December 2020.

PARTICIPANTS

Nursing students from one Turkey nursing school.

METHODS

The research data were collected using the Personal Information Form, Questionnaire for Measuring Attitudes towards Cancer (Cancer Stigma) (QMAC) - Community Version, and Jefferson's Empathy Scale for Nursing Students (JESNS).

RESULTS

240 students volunteered to participate in the study, and the rate of the students' response to the questionnaires was 52%. Of all the nursing students, 66.2% of them were female; 45.4% had a moderate perception of their economic status; 94.2% had no chronic disease; 90.4% had no family history regarding cancer; 67.9% had never been in an oncology clinic, and 59.2 of them had received training on empathy. When nursing students' attitudes towards cancer were examined, it was seen that empathic approach (β = -0.291; p < .01) and chronic disease treatment received (β = 0.174; p = .005) were found to be significant predictors.

CONCLUSIONS

The results revealed that the nursing undergraduate students' negative perception of cancer decreased as their empathic skills increased. In addition, the students' receiving treatment for chronic diseases increased their negative perception of cancer. In order to reduce the negative attitudes of nursing students towards cancer, more trainings, lectures and seminars or clinical skills training regarding the development of empathic skills could be included in the undergraduate nursing curriculum.

Empathy and its associations with age and sociodemographic characteristics in a large UK population sample

OBJECTIVES

Empathy is fundamental to social cognition, driving prosocial behaviour and mental health but associations with aging and other socio-demographic characteristics are unclear. We therefore aimed to characterise associations of these characteristics with two main self-reported components of empathy, namely empathic-concern (feeling compassion) and perspective-taking (understanding others' perspective).

METHODS

We asked participants in an internet-based survey of UK-dwelling adults aged ≥18 years to complete the Interpersonal Reactivity Index subscales measuring empathic concern and perspective taking, and sociodemographic and personality questionnaires. We weighted the sample to be UK population representative and employed multivariable weighted linear regression models.

RESULTS

In 30,033 respondents, mean empathic concern score was 3.86 (95% confidence interval 3.85, 3.88) and perspective taking was 3.57 (3.56. 3.59); the correlation between these sub-scores was 0.45 (p < 0.001). Empathic concern and perspective taking followed an inverse-u shape trajectory in women with peak between 40 and 50 years whereas in men, perspective taking declines with age but empathic concern increases. In fully adjusted models, greater empathic concern was associated with female gender, non-white ethnicity, having more education, working in health, social-care, or childcare professions, and having higher neuroticism, extroversion, openness to experience and agreeableness traits. Perspective taking was associated with younger age, female gender, more education, employment in health or social-care, neuroticism, openness, and agreeableness.

CONCLUSIONS

Empathic compassion and understanding are distinct dimensions of empathy with differential demographic associations. Perspective taking may decline due to cognitive inflexibility with older age whereas empathic concern increases in older men suggesting it is socially-driven.

Telephone nurses' perceived stress, self-efficacy and empathy in their work with frequent callers

Aim

To examine telephone nurses' perceived stress, self‐efficacy and empathy in their work with answering calls from frequent callers.

Design

The study is a quantitative questionnaire survey study with a comparative design.

Methods

Telephone nurses (N = 199) answered a survey containing three instruments: Perceived Stress Scale, General Self‐Efficacy Scale and Jefferson's Scale of Empathy. Correlation analysis, multiple regression analysis and analysis of variance were performed to test the research questions.

Results

Significant negative correlations were found between stress involving calls from FCs and self‐efficacy (r = −.238), and significant negative correlations between stress involving calls from frequent callers and empathy (r = −.185). It was further revealed that telephone nurses who had worked less than 30 years scored higher on Jefferson's Scale of empathy than those who had worked more than 30 years, F(1, 183) = 4.98, η² = 0.027.

Intensity, dynamics and deficiencies of empathy in medical and non-medical students

BACKGROUND

Empathy is an important competence in the professional development of medical students. The purpose of our study was to compare the levels and scales of empathy in people studying in different educational strategies.

METHODS

The study was conducted between April 2019 and March 2020. Medicine, nursing, midwifery, physiotherapy, psychology, pedagogy and sociology students were the participants of this study. University students preparing for medical professions (n = 1001) and students of programs unrelated to medicine (n = 700) underwent the Empathy Quotient test (EQ-40). We have compared results in both study groups with the use of the distribution of density, analysis of variance and student's t-test.

RESULTS

The average results received by students of the university preparing for medical professions were lower (M = 42.6) than those of the non-medical university students (M = 45.3) and the differences between the universities turned out to be statistically important (t = - 5.15, df = 1699, p < 0.001). As many as 14.6% of the students in the 1st EQ class were preparing for various medical professions while 9% studied social sciences. 18.2% of all medical programme students (n = 412) manifested the lowest empathy class. Our research has revealed that the students with Asperger profile (AP) and high-functioning autism (HFA) studied at universities preparing for medical professions (n = 18) more frequently than at non-medical universities (n = 5).

CONCLUSIONS

We have noticed a serious indicator of erosion in the levels of empathy in medical students and an increase in the number of people with AP and HFA. Empathy decreases in students after the third year of their studies, regardless of the kind of university. We recommend an introduction of career counselling when specialization is being chosen.

Effectiveness of simulation-based interventions at improving empathy among healthcare students: A systematic review and meta-analysis

OBJECTIVE

To examine the effectiveness of simulation-based interventions in improving empathy among healthcare students.

DESIGN

A systematic review and meta-analysis of randomized controlled trials and clinical controlled trials.

DATA SOURCES

Studies in English language were sourced from seven electronic databases (PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus and ProQuest Dissertations & Theses Global) from their respective inception dates until October 2020.

REVIEW METHODS

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Random-effect meta-analyses were conducted. Heterogeneity was assessed using the I² statistics and Cochran's Q chi-squared test. Quality appraisal was conducted using the Cochrane risk of bias tool and the Grades of Recommendation, Assessment, Development, and Evaluation approach. Publication bias was assessed using funnel plots.

RESULTS

Sixteen studies were included in this review. Meta-analysis reported statistically significant small, medium and very large effect sizes for empathy reported by healthcare students (SMD = 0.46, 95% CI: 0.25 to 0.66), simulated patients (SMD = 0.65, 95% CI: 0.41 to 0.89) and other personnel (independent observers, faculty members and examiners) (SMD = 1.27, 95% CI: 0.64 to 1.90) respectively, showing the effectiveness of simulation-based interventions in improving empathy among healthcare students. Subgroup analyses found that role-play was more effective than simulated patient and disease-state simulations. Multi-sessional interventions conducted for up to seven months and group-based simulation delivery were found to be more effective.

CONCLUSION

Educational institutions should conduct regular simulation-based interventions to continuously develop healthcare students' empathy during their academic journey. Future trials should involve students from more diverse healthcare disciplines. Empathy should be measured in a standardized manner and rely less on self-reported measures. Role-play segments and group-based simulations could be added to increase interventions' effectiveness. Studies should conduct longer follow-up assessments to determine the sustainability of students' empathy following intervention. Future research is needed to corroborate the current findings.

Taking ‘A walk through dementia’: exploring care home practitioners’ experiences of using a virtual reality tool to support dementia awareness

Emerging research has outlined the possibility for virtual reality (VR) experiences, which situate users into the perspective of someone living with dementia, to enhance dementia awareness. Currently, there is limited VR research that engages care home practitioners. It is imperative this population has high levels of dementia education given their requirements to provide care and support to residents, many of whom will be living with the condition. This paper reports on an exploratory qualitative study designed to elicit the experiences of care home practitioners who engaged with the VR application: ‘A walk through dementia’. Twenty practitioners, across four care homes in the United Kingdom, watched the VR scenarios and provided their views on the experience and the potential for the VR tool to be developed into a wider training programme to support dementia awareness. Data were collected via focus group discussions. Following an inductive thematic analysis, we constructed three themes. These suggested participants perceived the VR application offered them a convincing and immersive experience that was insightful and evocative, and provided ‘next-level’ dementia-awareness training that enabled them to reflect on care practices. Although the findings highlight important challenges for practitioners and developers wishing to use VR within dementia care, they suggest this application may be an engaging experiential learning tool that can provide care home staff with deeper cognitive and emotional awareness of living with dementia. Further work, drawing on these preliminary insights, is required to ensure the VR tool can be incorporated into a training programme that can positively contribute to the ‘dementia-friendly communities’ agenda.

Compassion Fatigue: Understanding Empathy

In clinical medicine, empathy is considered a central feature of holistic caretaking and successful patient interaction. It is unclear whether characteristics of empathy are innate, learned, or a combination of both. The means to evaluate clinical empathy are ill-defined, but perception of empathy has been shown to influence patient outcomes as well as professional well-being. This article reviews what is known about empathy in a medical setting and how it relates to negative mental health outcomes, such as compassion fatigue.

The Use of Auditory Simulation in Undergraduate Nursing: An Innovative Teaching Strategy to Promote Empathy

ABSTRACT

Auditory hallucination is common in schizophrenia, influencing emotional state and behavior. Most patients experience high levels of distress, paranoia, and depression. After participating in the "Hearing Voices" auditory simulation, which involved rotating through various workstations while listening to distressing voices, nursing students (n = 39) completed the Kiersma-Chen Empathy Scale. All were satisfied with the auditory simulation; 90 percent perceived the experience as beneficial to their role as a registered nurse. This innovative teaching strategy, utilizing simulation, provided an opportunity to experience auditory hallucinations, thereby increasing both understanding and empathy.

Nursing Students' Perceptions of Smartphone Use in the Clinical Care and Safety of Hospitalised Patients

Smartphones have become an indispensable item for nursing students. The use of these devices in the clinical setting could have various effects on the clinical work of nursing students. This study was to explore nursing students’ perceptions of their lived experiences of smartphone use in the clinical setting, in regard to patient safety. A descriptive phenomenological study was carried out. A total of 24 nursing students from a university in the southeast of Spain participated in this study. There were 10 in-depth interviews and two focal groups from January to May 2020. The data analysis was performed using ATLAS.TI software to identify the emergent topics. The COREQ Checklist was used to prepare the manuscript. Three principal topics were identified that illustrated the nursing students’ experiences and perceptions of smartphone use in the clinical setting (1): Using smartphones in the clinical setting as a personal resource, (2) smartphones as a support mechanism for making clinical decisions, (3) impact of smartphones on patient care. The nursing students perceived smartphones as a support mechanism for making clinical decisions and for patient care. Smartphone use during clinical practicums may influence the quality of patient-centred communication and threaten clinical safety. The results of this study provide knowledge on the use of smartphones by nursing students in the clinical setting, which could help to establish measures that guarantee adequate patient care and responsible use of these devices.

Nurses' Empathetic Behaviors: The Direct and Indirect Effect of Their Spiritual Orientation

Spirituality and its role in nurses' performance has gained much attention from the nursing researchers. But there is still some ambiguity about its role in improving the nurses' empathetic behaviors and factors that mediate this relation. To fill these research gaps, a sample of 247 Muslim nurses in a hospital at Shiraz, Iran, were selected and studied. Data were gathered by distributing the standard questionnaires among all of the nurses. Also, structural equation modeling and ANOVA test were used to analyze the data. It was found that nurses' spiritual orientation has a positive effect on their psychological capital and empathetic behaviors. Also, it was found that their work engagement has been affected by their level of psychological capital. Moreover, there was a significant difference between the spirituality of single and married nurses, in a way that married nurses were more spiritual. As a conclusion, it can be said that nurses' empathetic behaviors are a reflection of their spiritual orientation and marriage status.

Individual Differences and Similarities in the Judgement of Facial Pain: A Mixed Method Study

Accurate assessment of pain by health-care professionals is essential to ensure optimal management of pain. An under-researched area is whether personality characteristics affect perception of pain in others. The aims were (a) to determine whether individual differences are associated with participants’ ability to assess pain, and (b) to determine facial cues used in the assessment of pain. One hundred and twenty-eight undergraduate students participated. They completed questionnaire assessments of empathy, pain catastrophizing, sensory sensitivity and emotional intelligence. They then viewed and rated four adult facial images (no, medium, and high pain—12 images total) using a 0–10 numerical rating scale, and noted the reasons for their ratings. (a) Empathy was the only characteristic associated with accuracy of pain assessment. (b) Descriptions of eyes and mouth, and eyes alone were most commonly associated with assessment accuracy. This was the case despite variations in the expression of pain in the four faces. Future studies could evaluate the effect on accuracy of pain assessment of (a) training empathic skills for pain assessment, and (b) emphasizing attention to the eyes, and eyes and mouth.

Developing an empathy educational model (EEM) for undergraduate nursing students: A Delphi Technique

Despite the growing benefits of empathy education for medical students, there is still a lack of formal empathy courses in the Chinese context. To develop an empathy educational model for undergraduate nursing students, the Delphi technique was used in this study. Experts were selected from different regions of China and invited to participate in the three rounds of consultation, via email. The final empathy educational model was comprised of nine themes and 44 subthemes. The nine themes included: a. Bring the learner to the empathic world; b. Introduce the basic knowledge of empathy; c. Master empathy skills; d. Practice empathy; e. Evaluate empathy ability; f. Follow-up support; g. Distribution of educational hours for teaching empathy; h. Forms of empathy training; and i. Student reflection on empathy education. Consensus was achieved among the experts on empathy educational content, using the Delphi Technique, which can provide a reference for the empathy training of university medical students. It is necessary to have the empathy educational model further applied and evaluated, in conjunction with intervention studies, in the future.

A unique program for nursing students to enhance their mentalization capabilities in relation to clinical thinking

While nurses strive to provide optimal patient-centered care, this is not always straightforward, as some cases are more emotionally charged than others - depending on the patient's mental, emotional, and physical state, and on the nurses themselves. Therefore, in order to provide accurate therapeutic responses while maintaining their own personal well-being, nurses must develop strong mentalization capabilities. We present a unique program for nursing students, specifically targeted at enhancing their mentalization abilities as part of their communication skills for dealing with emotionally charged situations. In the program, he students first learn to identify what leads them to experience increased emotional loads and how this affects their mentalization processes. Next, they learn alternative coping patterns for their benefit, enabling their own emotional regulation while providing optimal care for their patients. Conducted in small groups, this holistic four-year program is led by experienced clinical nurses and psychologists; the learning is based on actual experiences encountered by the students during their clinical experience.

Perceptions of an evidence-based empathy mobile app in post-secondary education

Cognitive empathy (also known as perspective-taking) is an important, teachable, skill. As part of a knowledge translation project, we identified a) interest in an evidence-based cognitive empathy mobile app and b) which faculties believe that cognitive empathy is important for their profession. Students (n = 638) and instructors/professors (n = 38) completed a university-wide survey. Participants in Education, Social Work, and the Health Sciences were among those most interested in the app. The majority of participants said that they would prefer for the app to be free or less than $3 for students. Most participants preferred a one-time payment option. Across 17 faculties, all but one had 60% or more of its sampled members say that cognitive empathy is important for their profession. Results illuminate perceptions of cognitive empathy instruction and technology. Results also provide insight into issues to consider when developing and implementing an educational communication app.

Empathy, emotional intelligence, and communication in Nursing: The moderating effect of the organizational factors

Objective:

to evaluate the relation and the moderating effect of the organizational factors on the attitudes towards communication, empathy, and emotional intelligence in the nurses.

Method:

a cross-sectional study was conducted with a convenience sample of 268 nurses from Valencia, Spain. The attitudes towards communication were evaluated by means of the specifically designed instrument, those towards empathy with the Jefferson’s Scale of Empathy for Nursing Students, and those towards emotional intelligence by means of the Trait Meta-Mood Scale, consisting of 24 items. The effect of the studied variables was assessed by means of ANOVA, multiple linear regression models were applied, and the moderating effect was analyzed using PROCESS.

Results:

there are statistically significant differences based on the type on contract (permanent); and statistically significant differences were found in the cognitive dimension of the attitudes towards communication. Regarding the regression models, the perspective taking dimension of empathy was the main predictive variable tn the dimensions of the attitudes towards communication. Finally, a moderating effect of the type of contract was evidenced in the effect of emotional reparation over the cognitive dimension of the attitudes towards communication.

Conclusion:

the organizational factors exert an influence on the attitudes towards communication, empathy, and emotional intelligence.

Interpersonal communication, empathy, and stress perceived by nursing students who use social networks

AIM

The objective of this study was to explore interpersonal communication, empathy, and stress perceived by nursing students who use social networks.

DESIGN

A cross-sectional study was performed.

METHODS

A convenience sample of 135 nursing students. For data collection, the following instruments were used: The WhatsApp Negative Impact Scale, The Perceived Stress Scale, The Interpersonal Communication Competence Inventory, and the Jefferson Scale of Empathy. Data collection took place in February 2020.

RESULTS

A negative correlation was found between the WhatsApp Negative Impact and the Jefferson Scale of Empathy (rs = -0.204; p = .019). Conversely, a positive correlation was also observed between the Interpersonal Communication Competence Inventory and the Jefferson Scale of Empathy (rs = 0.212; p = .014).

CONCLUSION

Nursing students' use of new technology could be problematic and interfere with their therapeutic communication skills.

IMPACT

This study addresses the problem of social network use in the clinical setting and how this can influence nursing students' therapeutic communication skills with patients. The results of this study have showed that, among nursing students, social network use has a negative impact, showing decreased empathy. Likewise, students who show a greater level of empathy have better interpersonal communication skills. However, significant results were not found between psychological distress and problematic social network use. Therefore, it is necessary to perform additional studies that would further explore this aspect. This study allows us to explore the negative impact of social networks on therapeutic communication, with the aim of developing prevention strategies at university institutions.

From sensation to cognition: a perception-based training intervention for the development of relational competences in young Italian apprentices

Purpose

This study aims to test the effectiveness of a training intervention based on the psychology of perception, delivered to young Italian workers and employees, with low education, hired with an apprenticeship contract and involved in a compulsory training course (duration 32 h; the training intervention reported in the paper covers the first 8 h) whose aim was to let them develop such relational competencies as communication and cooperation with others.

Design/methodology/approach

By making use of optical-geometric illusions and ambiguous figures, participants were accompanied through a training intervention with the dual purpose of undermining their naive certainties about why they see what they see and increasing their awareness of how the perceptual processes work. At the beginning of the intervention, at the end of the 32 h (that is, after about a month) and after about one year from the end of the course, participants were administered a questionnaire to monitor the results of the training course by measuring their “perception awareness”.

Findings

“Perception awareness” increased from the beginning to the end of the course and still scored higher after one year. “Perception awareness” was positively related to communication and cooperation.

Originality/value

Although the literature is full of training courses delivered to improve communication and cooperation with others, little research has been carried out on perception-based training interventions delivered to young adults with low education hired with an apprenticeship contract for which this kind of training is compulsory.

To Identify and Support Youths Who Struggle with Living-Nurses' Suicide Prevention in Psychiatric Outpatient Care

Nurses working in psychiatric care daily encounter youths who are struggling with living. Despite this, nurses' suicide-prevention work is seldom addressed in research or in recommendations for care. The overall aim of this paper is to discuss how nurses, with their caring science perspective, may contribute to suicide prevention. The paper presents how nurses in psychiatric outpatient care may identify and support suicidal youths, according to experts in suicide prevention. The interviews with six experts in suicide prevention resulted in three themes: Engagement necessary but demanding, Acknowledgement of warnings signs and Supportive relationship. The respondents elaborated on how suicide-risk can be assessed. A good rapport with the youths was stressed and the recommended act of care included: to listen openheartedly without interrupting as well as to listen after risk- and protective factors to emphasize or to penetrate. To ask about suicidality as well as to let the person elaborate on what's important for him or her. To endure in the patients' suffering as well as steering the conversations toward hope. The paper also presents warning signs that need to be noticed according to the experts and the literature consensus. Our findings suggest that communication in suicide-prevention is an "art and act" that cannot be reduced to a method or simple guidelines. We argue that the recommended acts of care demand sensitivity and skills and that nurses as well as the domain of caring science may contribute to this competence.

Impact of Virtual Dementia Tour on empathy level of nursing students: A quasi-experimental study

Objective

As a developable ability, empathy is significantly associated with patient-centered care. The authors intended to evaluate the effect of Virtual Dementia Tour (VDT) upon nursing students' empathy level and propose practical rationales for optimizing future dementia care.

Methods

A total of 45 second-year undergraduate nursing students were organized to watch a theme movie entitled Still Alice and participate in an 8-min VDT. Jefferson Scale of Empathy-Health Professional Students (JSE-HPS) was employed for evaluating the empathy level of nursing students. After VDT, all nursing students participated in a structured interview. Descriptive statistics and paired t-tests were performed using SPSS 24.0.

Results

Their empathy levels demonstrated significant overall improvements (106.69 ± 9.49 vs 115.51 ± 10.16, P < 0.01). During the course of VDT, nursing students experienced varying levels of anxiety and frustration. All of them were satisfied with the program since they had gained a deeper understanding of demented patients and the program could change their attitudes toward demented elders.

Conclusion

Watching a specially selected movie and participating in VDT may be an effective method for enhancing empathy and caring during nursing student education.

Developing empathy among first-year university undergraduates through English language course: A phenomenological study

Empathy, as an essential personality trait of human beings, has been studied rigorously in the field of nursing and medical sciences. Nowadays, universities are also endeavoring to develop empathy with particular courses or tailored content among the students. The English language classroom acts as a dynamic platform to impart education for empathy. Yet there is a paucity of research related to the outcomes of such initiatives. The current study revolved around an English language course that is primarily designed to improve students' proficiency in English required for them to be empowered with the compatibility of tertiary education. The secondary focus of the course concerned the cultivation of empathy that is inevitable not only for the academic journey but also for social wellbeing. The present study was designed to investigate the contents, based on theoretical grounds, of the English language classroom and to trace the outcomes of such an empathy-teaching. A phenomenological approach was adopted to conduct the study, in which document analysis and semi-structured interviews with 10 participants shaped the instrumentation of data collection. The current study adopted thematic analysis to analyze the semi-structured interview data. The findings projected that the contents harnessed to cultivate empathy corresponded to the theoretical aspects of empathy development. The semi-structured interview data was a testimony of the nature of empathy practice inculcated among undergraduate students.

Validation of the Toronto Empathy Questionnaire (TEQ) Among Medical Students in China: Analyses Using Three Psychometric Methods

This study aimed to validate the simplified Chinese version of the Toronto Empathy Questionnaire (cTEQ) for use with the Chinese population. The original English version of the TEQ was translated into simplified Chinese based on international criteria. Psychometric analyses were performed based on three psychometric methods: classical test theory (CTT), item response theory (IRT), and Rasch model theory (RMT). Differential item functioning analysis was adopted to check possible item bias caused by responses from different subgroups based on sex and ethnicity. A total of 1296 medical students successfully completed the TEQ through an online survey; 75.2% of respondents were female and the average age was 19 years old. Forty students completed the questionnaire 2 weeks later to assess the test–retest reliability of the questionnaire. Confirmatory factor analysis supported a 3-factor structure of the cTEQ. The CTT analyses confirmed that the cTEQ has sound psychometric properties. However, IRT and RMT analyses suggested some items might need further modifications and revisions.