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Mauersberger H, Springer A, Fotopoulou A, Blaison C, Hess U. Pet dogs succeed where human companions fail: The presence of pet dogs reduces pain. Acta Psychol (Amst) 2024; 249:104418. [PMID: 39153318 DOI: 10.1016/j.actpsy.2024.104418] [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: 03/16/2024] [Revised: 07/03/2024] [Accepted: 07/17/2024] [Indexed: 08/19/2024] Open
Abstract
Social support from family and friends, albeit associated with beneficial health effects, does not always help to cope with pain. This may be because humans elicit mixed expectations of social support and evaluative judgment. The present studies aimed to test whether pet dogs are a more beneficial source of support in a painful situation than human companions because they are not evaluative. For this, 74 (Study 1) and 50 (Study 2) women completed a cold-pressor task in the presence of either their own (S1) or an unfamiliar (S2) dog, a friend (S1), or an unknown human companion (S2), or alone. In both studies, participants reported less pain and exhibited less pain behavior in the presence of dogs compared to human companions. Reactions to pain were moderated by attitudes towards dogs in S2. This suggests that pet dogs may help individuals to cope with painful situations, especially if the individual in pain generally feels affectionate towards dogs.
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Affiliation(s)
| | - Anne Springer
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Basel, Switzerland
| | - Aikaterini Fotopoulou
- Research Department of Clinical, Educational, and Health Psychology, University College London, London, United Kingdom
| | | | - Ursula Hess
- Department of Psychology, Humboldt-University, Berlin, Germany
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Small WR, Wiesenfeld B, Brandfield-Harvey B, Jonassen Z, Mandal S, Stevens ER, Major VJ, Lostraglio E, Szerencsy A, Jones S, Aphinyanaphongs Y, Johnson SB, Nov O, Mann D. Large Language Model-Based Responses to Patients' In-Basket Messages. JAMA Netw Open 2024; 7:e2422399. [PMID: 39012633 PMCID: PMC11252893 DOI: 10.1001/jamanetworkopen.2024.22399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/16/2024] [Indexed: 07/17/2024] Open
Abstract
Importance Virtual patient-physician communications have increased since 2020 and negatively impacted primary care physician (PCP) well-being. Generative artificial intelligence (GenAI) drafts of patient messages could potentially reduce health care professional (HCP) workload and improve communication quality, but only if the drafts are considered useful. Objectives To assess PCPs' perceptions of GenAI drafts and to examine linguistic characteristics associated with equity and perceived empathy. Design, Setting, and Participants This cross-sectional quality improvement study tested the hypothesis that PCPs' ratings of GenAI drafts (created using the electronic health record [EHR] standard prompts) would be equivalent to HCP-generated responses on 3 dimensions. The study was conducted at NYU Langone Health using private patient-HCP communications at 3 internal medicine practices piloting GenAI. Exposures Randomly assigned patient messages coupled with either an HCP message or the draft GenAI response. Main Outcomes and Measures PCPs rated responses' information content quality (eg, relevance), using a Likert scale, communication quality (eg, verbosity), using a Likert scale, and whether they would use the draft or start anew (usable vs unusable). Branching logic further probed for empathy, personalization, and professionalism of responses. Computational linguistics methods assessed content differences in HCP vs GenAI responses, focusing on equity and empathy. Results A total of 16 PCPs (8 [50.0%] female) reviewed 344 messages (175 GenAI drafted; 169 HCP drafted). Both GenAI and HCP responses were rated favorably. GenAI responses were rated higher for communication style than HCP responses (mean [SD], 3.70 [1.15] vs 3.38 [1.20]; P = .01, U = 12 568.5) but were similar to HCPs on information content (mean [SD], 3.53 [1.26] vs 3.41 [1.27]; P = .37; U = 13 981.0) and usable draft proportion (mean [SD], 0.69 [0.48] vs 0.65 [0.47], P = .49, t = -0.6842). Usable GenAI responses were considered more empathetic than usable HCP responses (32 of 86 [37.2%] vs 13 of 79 [16.5%]; difference, 125.5%), possibly attributable to more subjective (mean [SD], 0.54 [0.16] vs 0.31 [0.23]; P < .001; difference, 74.2%) and positive (mean [SD] polarity, 0.21 [0.14] vs 0.13 [0.25]; P = .02; difference, 61.5%) language; they were also numerically longer (mean [SD] word count, 90.5 [32.0] vs 65.4 [62.6]; difference, 38.4%), but the difference was not statistically significant (P = .07) and more linguistically complex (mean [SD] score, 125.2 [47.8] vs 95.4 [58.8]; P = .002; difference, 31.2%). Conclusions In this cross-sectional study of PCP perceptions of an EHR-integrated GenAI chatbot, GenAI was found to communicate information better and with more empathy than HCPs, highlighting its potential to enhance patient-HCP communication. However, GenAI drafts were less readable than HCPs', a significant concern for patients with low health or English literacy.
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Affiliation(s)
| | | | | | - Zoe Jonassen
- NYU Grossman School of Medicine, New York, New York
| | | | | | | | | | | | - Simon Jones
- NYU Grossman School of Medicine, New York, New York
| | | | | | - Oded Nov
- NYU Tandon School of Engineering, New York, New York
| | - Devin Mann
- NYU Grossman School of Medicine, New York, New York
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Krahé C, Koukoutsakis A, Fotopoulou A. Updating beliefs about pain following advice: Trustworthiness of social advice predicts pain expectations and experience. Cognition 2024; 246:105756. [PMID: 38442585 PMCID: PMC7616089 DOI: 10.1016/j.cognition.2024.105756] [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: 02/10/2023] [Revised: 02/09/2024] [Accepted: 02/20/2024] [Indexed: 03/07/2024]
Abstract
Prior expectations influence pain experience. These expectations, in turn, rely on prior pain experience, but they may also be socially influenced. Yet, most research has focused on self rather than social expectations about pain, and hardly any studies examined their combined effects on pain. Here, we adopted a Bayesian learning perspective to investigate how explicitly communicated social expectations ('advice about pain tolerance') affect own pain expectations, and ultimately pain tolerance, under varying conditions of social epistemic uncertainty (trustworthiness of the advice). N = 72 female participants took part in a coldpressor (cold water) task before (self-learning baseline) and after (socially-influenced learning) receiving advice about their likely pain tolerance from a confederate, the trustworthiness of whom was experimentally manipulated. We used path analysis to test the hypothesis that social advice from a highly trustworthy confederate would influence participants' expectations about pain more than advice from a less trustworthy source, and that the degree of this social influence would in turn predict pain tolerance. We further used a simplified, Bayesian learning, computational approach for explicit belief updating to examine the role of latent parameters of precision optimisation in how participants subsequently changed their future pain expectations (prospective posterior beliefs) based on the combined effect of the confederate's advice on their own pain expectations, and their own task experience. Results confirmed that participants adjusted their pain expectations towards the confederate's advice more in the high- vs. low-trustworthiness condition, and this advice taking predicted their pain tolerance. Furthermore, the confederate's trustworthiness influenced how participants weighted the confederate's advice in relation to their own expectations and task experience in forming prospective posterior beliefs. When participants received advice from a less trustworthy confederate, their own sensory experience was weighted more highly than their socially-influenced prior expectations. Thus, explicit social advice appears to impact pain by influencing one's own pain expectations, but low social trustworthiness leads to these expectations becoming more malleable to novel, sensory learning.
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Affiliation(s)
- Charlotte Krahé
- Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.
| | - Athanasios Koukoutsakis
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Aikaterini Fotopoulou
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
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Ozcan H, Dinçer Y, Poturoğlu B, Kaya S. The comparison of spiritual well-being and empathic tendencies in midwifery students: A cross-sectional study from Turkey. Heliyon 2024; 10:e28691. [PMID: 38623233 PMCID: PMC11016607 DOI: 10.1016/j.heliyon.2024.e28691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 03/06/2024] [Accepted: 03/22/2024] [Indexed: 04/17/2024] Open
Abstract
This study aimed to investigate the relationship between spiritual well-being and empathic tendencies of midwifery students and the affecting factors. The sample of this descriptive-correlation type study, one of the descriptive research methods, included 237 midwifery students. The data were collected using the Descriptive Information Form, the Empathic Tendency Scale, and the Spiritual Well-Being Scale. Empathic tendency was higher among those who chose the midwifery department voluntarily, those who liked the department, those who felt that the department was suitable for them, those who participated in social and scientific activities, those who wanted to progress in the profession, those who wanted to work in the field and those who followed publications related to the field; Spiritual well-being was higher among those who felt that the department was suitable for them, those who participated in social and scientific activities, those who wanted to progress in the profession, those who participated in activities that provided the development of the profession, those who wanted to work in the field and those who followed publications related to the field. It was determined that the empathic tendencies and spiritual well-being of midwifery students were at a moderate level, and as a result of the comparison of Empathic Tendency Scale and Spiritual Well-being scale scores, there was a significant positive relationship between them.
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Affiliation(s)
- Handan Ozcan
- University of Health Sciences, Faculty of Health Sciences, Department of Midwifery, Turkey
| | - Yeliz Dinçer
- Zonguldak Bulent Ecevit University, Faculty of Health Sciences, Department of Obstetrics and Gynecology Nursing, Turkey
| | - Büşra Poturoğlu
- University of Health Sciences Faculty of Health Sciences, Istanbul, Turkey
| | - Sümeyyenur Kaya
- University of Health Sciences Faculty of Health Sciences, Istanbul, Turkey
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Affiliation(s)
| | - Jamie Chen
- Hackensack Meridian School of Medicine, Nutley, New Jersey
| | - Bryan Pilkington
- Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, New Jersey
- School of Health and Medical Sciences, Seton Hall University, Nutley, New Jersey
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6
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Sim SH, Kim GM, Kim EJ, Chang SJ. Types of Empathy Among Certified Caregivers of Older Adults with Dementia. J Multidiscip Healthc 2023; 16:2715-2731. [PMID: 37724316 PMCID: PMC10505375 DOI: 10.2147/jmdh.s417315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 08/10/2023] [Indexed: 09/20/2023] Open
Abstract
Purpose This study identifies the unique phenomena and subjectivity of empathy as exhibited by certified caregivers. Methods Q-methodology was used to define types and describe the characteristics of empathy in certified caregivers. After in-depth interviews with 10 certified caregivers and a review of the related literature, the final 38 Q-samples were selected by collecting experts' opinions. These Q-samples were sorted by 30 certified caregivers (P-samples). The PC-QUNAL program was used to analyze the Q-sort data. Results Seven distinctive Q-factors for the empathy of certified caregivers were identified: I. Information-oriented cognition, II. Sensory communication, III. Compassion, IV. Performance-seeking through self-reflection, V. Intuitive empathy, VI. Role-centered sincerity, and VII. Passive obligation. The empathy of certified caregivers caring for older adults with dementia showed various characteristics according to each of their subjective values and judgments. Conclusion This study's results help identify the empathy types and characteristics of certified caregivers caring for older adults with dementia and may contribute to improving the quality of care.
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Affiliation(s)
- So-Hyeong Sim
- Department of Nursing, Gangneung-Wonju National University, Wonju, South Korea
| | - Geun Myun Kim
- Department of Nursing, Gangneung-Wonju National University, Wonju, South Korea
| | - Eun Joo Kim
- Department of Nursing, Gangneung-Wonju National University, Wonju, South Korea
| | - Soo Jung Chang
- Department of Nursing, Gangneung-Wonju National University, Wonju, South Korea
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Pierson SR, Ngoue M, Lam R, Rajagopalan D, Ring D, Ramtin S. When Musculoskeletal Clinicians Respond to Empathetic Opportunities, do Patients Perceive Greater Empathy? Clin Orthop Relat Res 2023; 481:1771-1780. [PMID: 36853843 PMCID: PMC10427050 DOI: 10.1097/corr.0000000000002614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/05/2023] [Accepted: 02/06/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Patient use of verbal and nonverbal communication to signal what is most important to them can be considered empathetic opportunities. Orthopaedic surgeons may have mixed feelings toward empathetic opportunities, on one hand wanting the patient to know that they care, and on the other hand fearing offense, prolonged visit duration, or discussions for which they feel ill prepared. Evidence that action about empathetic opportunities does not harm the patient's experience or appreciably prolong the visit could increase the use of these communication tactics with potential for improved experience and outcomes of care. QUESTIONS/PURPOSES Using transcripts from musculoskeletal specialty care visits in prior studies, we asked: (1) Are there factors, including clinician attentiveness to empathetic opportunities, associated with patient perception of clinician empathy? (2) Are there factors associated with the number of patient-initiated empathetic opportunities? (3) Are there factors associated with clinician acknowledgment of empathetic opportunities? (4) Are there factors associated with the frequency with which clinicians elicited empathetic opportunities? METHODS This study was a retrospective, secondary analysis of transcripts from prior studies of audio and video recordings of patient visits with musculoskeletal specialists. Three trained observers identified empathetic opportunities in 80% (209 of 261) of transcripts of adult patient musculoskeletal specialty care visits, with any uncertainties or disagreements resolved by discussion and a final decision by the senior author. Patient statements considered consistent with empathetic opportunities included relation of emotion, expression of worries or concerns, description of loss of valued activities or loss of important roles or identities, relation of a troubling psychologic or social event, and elaboration on daily life. Clinician-initiated empathetic opportunities were considered clinician inquiries about these factors. Clinician acknowledgment of empathetic opportunities included encouragement, affirmation or reassurance, or supportive statements. Participants completed post-visit surveys of perceived clinician empathy, symptoms of depression, and health anxiety. Factors associated with perceived clinician empathy, number of empathetic opportunities, clinician responses to these opportunities, and the frequency with which clinicians elicited empathetic opportunities were sought in bivariate and multivariable analyses. RESULTS After controlling for potentially confounding variables such as working status and pain self-efficacy scores in the multivariable analysis, no factors were associated with patient perception of clinician empathy, including attentiveness to empathetic opportunities. Patient-initiated empathetic opportunities were modestly associated with longer visit duration (correlation coefficient 0.037 [95% confidence interval 0.023 to 0.050]; p < 0.001). Clinician acknowledgment of empathetic opportunities was modestly associated with longer visit duration (correlation coefficient 0.06 [95% CI 0.03 to 0.09]; p < 0.001). Clinician-initiated empathetic opportunities were modestly associated with younger patient age (correlation coefficient -0.025 [95% CI -0.037 to -0.014]; p < 0.001) and strongly associated with one specific interviewing clinician as well as other clinicians (correlation coefficient -1.3 [95% CI -2.2 to -0.42]; p = 0.004 and -0.53 [95% CI -0.95 to -0.12]; p = 0.01). CONCLUSION Musculoskeletal specialists can respond to empathic opportunities without harming efficiency, throughput, or patient experience. CLINICAL RELEVANCE Given the evidence that patients prioritize feeling heard and understood, and evidence that a trusting patient-clinician relationship is protective and healthful, the results of this study can motivate specialists to train and practice effective communication tactics.
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Affiliation(s)
- S. Ryan Pierson
- The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Marielle Ngoue
- The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Ryan Lam
- The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Dayal Rajagopalan
- The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - David Ring
- The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Sina Ramtin
- The University of Texas at Austin Dell Medical School, Austin, TX, USA
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8
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Bard JT, Chung HK, Shaia JK, Wellman LL, Elzie CA. Increased medical student understanding of dementia through virtual embodiment. GERONTOLOGY & GERIATRICS EDUCATION 2023; 44:211-222. [PMID: 35451921 DOI: 10.1080/02701960.2022.2067850] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Given the growing prevalence of Alzheimer's disease (AD), we assessed the impact of virtually embodying someone with progressive AD. This pilot explored students' understanding of individuals' needs with dementia, as well as, the efficacy of virtual reality (VR) as a curricular tool. Second-year medical students (n = 150) completed a pre-survey, Embodied Labs, Inc. Beatriz Lab VR module, and a post-survey. Most students knew someone with dementia (72%), were a family member of someone with dementia (52%) or had worked with a patient (61%) with dementia. Using paired survey questions, students reported significant increases in understanding how their lives would be affected by dementia (71% vs. 94%) and the needs of a person with dementia (64% vs. 95%) after VR. They reported increased understanding of being a caregiver of someone with dementia (24% vs. 81%) and the impact it can have on the entire family (64% vs. 97%). Overall students agreed this simulation made them think about their approach to clinical skills (94%) and should be utilized more in the curriculum (76%). This pilot study indicated that this VR experience can be used to advance understanding of a person's experiences with dementia and that integrating VR into the medical curricula should be considered.
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Affiliation(s)
- Jason T Bard
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Hannah K Chung
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Jacqueline K Shaia
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Laurie L Wellman
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Carrie A Elzie
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia, USA
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McParlin Z, Cerritelli F, Manzotti A, Friston KJ, Esteves JE. Therapeutic touch and therapeutic alliance in pediatric care and neonatology: An active inference framework. Front Pediatr 2023; 11:961075. [PMID: 36923275 PMCID: PMC10009260 DOI: 10.3389/fped.2023.961075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 02/07/2023] [Indexed: 03/03/2023] Open
Abstract
Therapeutic affective touch has been recognized as essential for survival, nurturing supportive interpersonal interactions, accelerating recovery-including reducing hospitalisations, and promoting overall health and building robust therapeutic alliances. Through the lens of active inference, we present an integrative model, combining therapeutic touch and communication, to achieve biobehavioural synchrony. This model speaks to how the brain develops a generative model required for recovery, developing successful therapeutic alliances, and regulating allostasis within paediatric manual therapy. We apply active inference to explain the neurophysiological and behavioural mechanisms that underwrite the development and maintenance of synchronous relationships through touch. This paper foregrounds the crucial role of therapeutic touch in developing a solid therapeutic alliance, the clinical effectiveness of paediatric care, and triadic synchrony between health care practitioner, caregiver, and infant in a variety of clinical situations. We start by providing a brief overview of the significance and clinical role of touch in the development of social interactions in infants; facilitating a positive therapeutic alliance and restoring homeostasis through touch to allow a more efficient process of allostatic regulation. Moreover, we explain the role of CT tactile afferents in achieving positive clinical outcomes and updating prior beliefs. We then discuss how touch is implemented in treatment sessions to promote cooperative interactions in the clinic and facilitate theory of mind. This underwrites biobehavioural synchrony, epistemic trust, empathy, and the resolution of uncertainty. The ensuing framework is underpinned by a critical application of the active inference framework to the fields of pediatrics and neonatology.
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Affiliation(s)
- Zoe McParlin
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
| | - Francesco Cerritelli
- Division of Neonatology, “V. Buzzi” Children's Hospital, ASST-FBF-Sacco, Milan, Italy
| | - Andrea Manzotti
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
- Division of Neonatology, “V. Buzzi” Children's Hospital, ASST-FBF-Sacco, Milan, Italy
- Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Karl J Friston
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, Queen Square, London, United Kingdom
| | - Jorge E Esteves
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
- Malta ICOM Educational, Malta, Finland
- Research Department, University College of Osteopathy, Research Department, London, United Kingdom
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10
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Lizzio-Wilson M, Thomas EF, Louis WR, Crane MF, Kho M, Molenberghs P, Wibisono S, Minto K, Amiot CE, Decety J, Breen LJ, Noonan K, Forbat L, Allen F. Using Latent Profile Analysis to Understand Health Practitioners' Attitudes Toward Voluntary Assisted Dying. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228221149453. [PMID: 36826344 DOI: 10.1177/00302228221149453] [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: 02/25/2023]
Abstract
Prior work has documented considerable diversity among health practitioners regarding their support for voluntary assisted dying (VAD). We examined whether their attitudes are characterised by different combinations of personal support, normative support by other health practitioners, and whether they are predisposed to vicariously experience others' emotions (i.e., empathy). We also examined whether these profiles experienced different mental health outcomes (i.e., burnout and posttraumatic stress) in relation to VAD. To test this, 104 Australian health practitioners were surveyed after VAD was legalised in Victoria, Australia in 2019. Results indicated that practitioners' attitudes were characterised by three profiles: 1) strong personal and normative support (strong VAD supporters), 2) moderate personal and normative support (moderate VAD supporters), and 3) lower personal and normative support (apprehensive practitioners). However, each profile reported similar mental health outcomes. Findings suggest that the normative environments in which health practitioners operate may explain their diverse attitudes on VAD.
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Affiliation(s)
- Morgana Lizzio-Wilson
- Department of Psychology, The University of Exeter, Exeter, UK
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia
| | - Emma F Thomas
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia
| | - Winnifred R Louis
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Monique F Crane
- Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Madison Kho
- Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | | | - Susilo Wibisono
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Kiara Minto
- School of Historical and Philosophical Inquiry, University of Queensland, Brisbane, QLD, Australia
| | - Catherine E Amiot
- Département de Psychologie, Université du Québec à Montréal, Montreal, QC, Canada
| | - Jean Decety
- Department of Psychology, The University of Chicago, Chicago, IL, USA
| | - Lauren J Breen
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Kerrie Noonan
- Death Literacy Institute, University of Western Sydney, Penrith South, NSW, Australia
| | - Liz Forbat
- Faculty of Social Sciences, University of Stirling, Stirling, UK
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11
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Schweitzer DR, Ting J, von Hippel W. Diagnostic reasoning is associated with lower physician satisfaction with patient communication. Intern Med J 2023; 53:250-254. [PMID: 34647682 DOI: 10.1111/imj.15580] [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: 08/05/2021] [Revised: 09/09/2021] [Accepted: 10/06/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Prior research suggests that the quality of communication between doctors and patients influences the quality of medical care and adherence to treatment regimens, but little is known about factors that contribute to successful interactions between doctors and patients. AIM To examine the quality of communication across the different medical specialties. METHODS A survey questionnaire was undertaken at a large metropolitan-based hospital in Brisbane, Australia. In this initial study we surveyed 67 doctors across various specialties on a range of social cognition and personality measures. We then rated each of the specialties on the degree to which they rely on both procedures and diagnostics, as well as the extent to which they involve patient communication. RESULTS A regression analysis using spss 26.0 was undertaken to ascertain if doctor's satisfaction with their communication was related to these three aspects of the various specialties. Results revealed that communication satisfaction was negatively related to the degree to which the specialty relies on diagnostics. No relationship emerged between reliance on procedures and communication satisfaction. Last, communication frequency was positively related to communication satisfaction. CONCLUSIONS We propose two possible accounts for this finding regarding diagnostics: (i) the cognitive demands of diagnosis disrupt communication; and/or (ii) diagnoses are interpreted by patients as opinions with which they are sometimes motivated to disagree. Further research is needed to replicate these findings and establish the underlying mechanism.
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Affiliation(s)
| | - Joseph Ting
- Emergency Medicine, Mater Health, Brisbane, Queensland, Australia
| | - William von Hippel
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia
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12
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Wampold BE, Flückiger C. The alliance in mental health care: conceptualization, evidence and clinical applications. World Psychiatry 2023; 22:25-41. [PMID: 36640398 PMCID: PMC9840508 DOI: 10.1002/wps.21035] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/07/2022] [Indexed: 01/15/2023] Open
Abstract
The concept of alliance reflects the collaborative relationship between a clinician and a patient, defined as consisting of three elements: a) the agreement on the goals of treatment; b) the agreement on a task or series of tasks; c) the development of a bond. Although much of the theory and research on the alliance comes from the domain of psychotherapy, the concept is applicable to any practice involving a person seeking help and a socially sanctioned healer. An extensive research evidence suggests that the alliance (typically measured at the third or fourth session) is a robust predictor of the outcomes of various forms of psychotherapy, even when prior symptom improvement and other factors are considered. Both the clinician and the patient bring to the therapy situation different capacities to form an alliance. Factors concerning the patient include, among others, the diagnosis, attachment history and style, motivation, and needs for affiliation. However, the benefits of the alliance have been found to be mostly due to the therapist's contribution, in particular his/her facilitative interpersonal skills, including verbal fluency, communication of hope and positive expectations, persuasiveness, emotional expression; warmth, acceptance and understanding; empathy, and alliance rupture-repair responsiveness. Placebo studies have allowed to experimentally manipulate aspects of the relationship between a therapist and a patient in non-psychotherapy contexts. In these settings, two components of the relationship have emerged: an emotional one (involving being cared for and understood by the clinician) and a cognitive one (including the belief in the competence of the therapist to select and administer an effective treatment). Here we propose a model that describes three pathways through which the alliance creates benefits, named CARE (caring, attentive, real and empathic), EXPECTANCY, and SPECIFIC. Although research and clinical attention have mostly focused on the alliance between a clinician and a patient in face-to-face interactions, there is preliminary evidence concerning the alliance between patients and other clinic staff, systems of care, or the program in Internet-mediated services. These new research areas clearly require further development.
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Affiliation(s)
- Bruce E Wampold
- Modum Bad Psychiatric Center, Vikersund, Norway
- University of Wisconsin-Madison, Madison, WI, USA
| | - Christoph Flückiger
- Department of Psychology, University of Zürich, Zürich, Switzerland
- Department of Psychology, University of Kassel, Kassel, Germany
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Anishchuk S, Kubacki A, Howell Y, van Harten MT, Yarascavitch C, MacGiolla Phadraig C. Can a virtual learning module foster empathy in dental undergraduate students? EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023; 27:118-125. [PMID: 35114039 PMCID: PMC10078759 DOI: 10.1111/eje.12783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 12/20/2021] [Accepted: 01/15/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Empathy is an essential part of patient-centred health care, which positively benefits both patients and clinicians. There is little agreement regarding how best to design and deliver training for healthcare trainees to impart the skills and behaviours of clinical empathy. The study aimed to inform the field by sharing an educational intervention where we aimed to improve empathy amongst dental undergraduate students in Trinity College Dublin using a virtual learning module. METHODS Adopting pre-post-repeat pre-experimental design, dental professional students completed the Jefferson Scale of Empathy (JSE) for Health Professional Students immediately prior to and after a three-week virtual programme designed to increase clinical empathy. Using a three-factor model described for the JSE in the literature, scores were evaluated for internal consistency and paired tests were performed on scores appropriate to their distributions. Seven-point Likert scales were scored to record student experience of training and technology, which are reported descriptively. RESULTS Most of the 37 participants were female (76%) and represented dental science (N = 27) and dental hygiene roles (N = 7). Results revealed a mean JSE-HPS scale score rise from 110.0 (SD = 10.4) to 116.4 (SD = 11.1), which represented a rise of 5.8% (t (36) = 3.6, p = 0.001). The three factors associated with cognitive empathy, namely perspective-taking (T(36) = 3.931, p < 0.001; walking in the patient's shoes T(36) = 2.093, p = 0.043); and compassionate care (Z = 2.469, p = 0.014) were all found to have increased after the intervention. Students reported a positive experience of discipline-specific and generic videos as part of the module. CONCLUSION The study demonstrated that a virtual educational module was associated with an increase in empathy amongst dental undergraduate students. The design of a blended module incorporating the Massive Open Online Course (MOOC) and virtual learning are beneficial and have a promising future.
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Affiliation(s)
- Sviatlana Anishchuk
- Trinity College DublinUniversity of DublinDublin Dental University HospitalDublinIreland
| | - Angela Kubacki
- Trinity College DublinUniversity of DublinDublin Dental University HospitalDublinIreland
- Institute of Medical and Biomedical EducationSt George'sUniversity of LondonLondonIreland
| | - Yvonne Howell
- Trinity College DublinUniversity of DublinDublin Dental University HospitalDublinIreland
| | - Maria T. van Harten
- Trinity College DublinUniversity of DublinDublin Dental University HospitalDublinIreland
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14
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Bollos LACL, Zhao Y, Soriano GP, Tanioka T, Otsuka H, Locsin R. Technologies, Physician's Caring Competency, and Patient Centered Care:A Systematic Review. THE JOURNAL OF MEDICAL INVESTIGATION 2023; 70:307-316. [PMID: 37940512 DOI: 10.2152/jmi.70.307] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
This study aimed to conduct a systematic review to clarify patient understanding, understanding of caring concepts, understanding of technology, competency to express compassion, appropriate involvement in caring, and ethical and moral attitudes and responses toward patients. This systematic review was conducted through an electronic search across PubMed, Google Scholar, MEDLINE, and Science Direct. Authors independently appraised the methodological quality of the studies using the Mixed Method Appraisal Tool. A narrative synthesis approach was used to present these findings. Nine studies met the inclusion criteria and quality appraisal guidelines. Through thematic analysis, four major themes were identified:Technology and caring competency, Technology and patient-centered care, Empathetic skills, and Caring competency. This review has shown that patients choose physicians considering their emotions and communicate well with them, empowering them to take responsibility of their own or their loved ones' healthcare. In the age of technological advancement and availability of vast sources of information, it is expected of physicians to adapt to these character priorities while maintaining their sense of humanness, not only focusing on healing modalities, but also to guide, educate, and appropriately empower their patients toward achieving their healthcare goals. J. Med. Invest. 70 : 307-316, August, 2023.
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Affiliation(s)
| | - Yueren Zhao
- Associate Professor, Department of Psychiatry, Fujita Health University, Aichi, Japan
| | - Gil P Soriano
- PhD Student, Graduate School of Health Sciences, Tokushima University, Tokushima, Japan
- Faculty Member, Department of Nursing, College of Allied Health, National University, Manila, Philippines
| | - Tetsuya Tanioka
- Institute of Biomedical Sciences, Tokushima University, Graduate School, Tokushima, Japan
| | - Hideki Otsuka
- Institute of Biomedical Sciences, Tokushima University, Graduate School, Tokushima, Japan
| | - Rozzano Locsin
- Professor Emeritus, Florida Atlantic University, FL, United States
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Sarasso P, Ronga I, Del Fante E, Barbieri P, Lozzi I, Rosaia N, Cicerale A, Neppi-Modona M, Sacco K. Physical but not virtual presence of others potentiates implicit and explicit learning. Sci Rep 2022; 12:21205. [PMID: 36481679 PMCID: PMC9732282 DOI: 10.1038/s41598-022-25273-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
E-learning activities are becoming more and more common. Whilst it is well known that the physical presence of others motivates individuals to engage in perceptual and learning tasks, systematic investigations comparing the effects of physical and virtual co-presence of others on knowledge acquisition are still scarce. Here we investigate the effects of physical and virtual co-presence of others on explicit and implicit learning. In Experiment 1 (discovery sample), retrieval accuracy in a spatial memory task and EEG indexes (mismatch negativity-MMN) of implicit perceptual learning were recorded when participants were alone or in presence of another individual. In Experiment 2 (replicating sample), we added a "virtual" condition, where the same tasks were performed during a video-conference call. In both experiments, MMN was demonstrated to encode for perceptual learning as revealed by the significant correlation with Bayesian Surprise (a consolidated information-theoretic index of Bayesian learning). Furthermore, In Experiments 1 and 2 physical co-presence systematically ameliorated memorization performances and increased MMN indexes related to implicit learning. These positive effects were absent in the virtual condition, thus suggesting that only physical, but not virtual co-presence is effective in potentiating learning dynamics.
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Affiliation(s)
- Pietro Sarasso
- grid.7605.40000 0001 2336 6580BIP (BraIn Plasticity and Behaviour Changes) Research Group, Department of Psychology, University of Turin, Via Verdi, 10, 10124 Turin, Italy
| | - Irene Ronga
- grid.7605.40000 0001 2336 6580BIP (BraIn Plasticity and Behaviour Changes) Research Group, Department of Psychology, University of Turin, Via Verdi, 10, 10124 Turin, Italy
| | - Elena Del Fante
- grid.7605.40000 0001 2336 6580BIP (BraIn Plasticity and Behaviour Changes) Research Group, Department of Psychology, University of Turin, Via Verdi, 10, 10124 Turin, Italy
| | - Paolo Barbieri
- grid.7605.40000 0001 2336 6580BIP (BraIn Plasticity and Behaviour Changes) Research Group, Department of Psychology, University of Turin, Via Verdi, 10, 10124 Turin, Italy
| | - Irene Lozzi
- grid.7605.40000 0001 2336 6580BIP (BraIn Plasticity and Behaviour Changes) Research Group, Department of Psychology, University of Turin, Via Verdi, 10, 10124 Turin, Italy
| | - Nicola Rosaia
- grid.38142.3c000000041936754XDepartment of Economics, Harvard University, Cambridge, MA USA
| | - Alessandro Cicerale
- grid.7605.40000 0001 2336 6580BIP (BraIn Plasticity and Behaviour Changes) Research Group, Department of Psychology, University of Turin, Via Verdi, 10, 10124 Turin, Italy
| | - Marco Neppi-Modona
- grid.7605.40000 0001 2336 6580BIP (BraIn Plasticity and Behaviour Changes) Research Group, Department of Psychology, University of Turin, Via Verdi, 10, 10124 Turin, Italy
| | - Katiuscia Sacco
- grid.7605.40000 0001 2336 6580BIP (BraIn Plasticity and Behaviour Changes) Research Group, Department of Psychology, University of Turin, Via Verdi, 10, 10124 Turin, Italy
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16
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Do positive emotions prompt people to be more authentic?
The mediation effect of gratitude and empathy dimensions on the relationship between humility state and perceived false self. CURRENT ISSUES IN PERSONALITY PSYCHOLOGY 2022. [DOI: 10.5114/cipp.2022.116363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
BackgroundGratitude, empathy and humility have been defined as personality dispositions, as complex interpersonal emotions, and as states that prompt people to be more pro-social. However, studies on the associations between these emotions and authen-ticity are scarce. The main purpose of this study was to analyze the mediation effect of gratitude and empathy on the asso-ciation between humility and perceived false identity.Participants and procedureThe number of participants who took part in the survey was equal to 220 university students (91% female). Students com-pleted questionnaires concerning humility (BSHS scale), gratitude (GQ scale), empathy (QCAE inventory), and perceived false self (POFS scale).ResultsThe results confirmed significant correlations between gratitude, empathy and authenticity, but not with humility. Further analysis revealed that gratitude and affective and cognitive empathy explain 9% of the perceived false identity level. The findings confirmed the mediation effect of gratitude on the associations between (1) humility and false self, (2) affective empathy and false self, but not between cognitive empathy and false self. The results also indicated that humility may in-fluence authenticity indirectly via gratitude, but not via dimensions of empathy.ConclusionsThe findings confirm the significance of gratitude and cognitive empathy as dispositions that promote a feeling of being authentic. On the other hand, the relationship between affective empathy and false self was positive.
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Krebs LD, Hill N, Villa-Roel C, McLane P, Rowe BH, Gupta S. “Not just the asthma”: Understanding the acute asthma experiences of adult women with asthma presenting to the emergency department through photovoice. CANADIAN JOURNAL OF RESPIRATORY, CRITICAL CARE, AND SLEEP MEDICINE 2022. [DOI: 10.1080/24745332.2022.2133756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Lynette D. Krebs
- Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Nicole Hill
- Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada
- Department of Sociology, University of Alberta, Edmonton, Alberta, Canada
| | - Cristina Villa-Roel
- Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Patrick McLane
- Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada
- Strategic Clinical Networks, Alberta Health Services, Edmonton, Alberta, Canada
| | - Brian H. Rowe
- Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Samir Gupta
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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18
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Winter R, Leanage N, Roberts N, Norman RI, Howick J. Experiences of empathy training in healthcare: A systematic review of qualitative studies. PATIENT EDUCATION AND COUNSELING 2022; 105:3017-3037. [PMID: 35811257 DOI: 10.1016/j.pec.2022.06.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 05/27/2022] [Accepted: 06/26/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To synthesise qualitative studies reporting student, practitioner, or patient experiences of empathy-training in healthcare. METHODS We included qualitative studies exploring (i) student or practitioner experiences of empathy training, or (ii) patient experiences of being treated by someone who has undergone empathy training. We used the Critical Appraisal Skills Programme (CASP) tool to assess study quality. Thematic synthesis was used to integrate findings from studies and to generate new insights. RESULTS Our search yielded 2768 citations, of which 23 (1487 participants) met inclusion criteria. Two clusters of themes were identified from included studies. Firstly, themes related to practitioner/trainee professionalism and wellbeing, where the main finding was that participants experienced benefit from therapeutic empathy training. Secondly, themes related to the understanding and treatment of patients, where the main finding was practitioners' deeper recognition of the positive impact of empathic care. CONCLUSIONS This review found that taking part in empathy-focused training can benefit practitioner/student personal growth and professional development, and benefits patient care. This review is limited by the difficulty in defining empathy and heterogeneity amongst included studies. PRACTICE IMPLICATIONS These results support a rationale for empathy training and the development of a framework to ensure training is having the desired effect.
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Affiliation(s)
- Rachel Winter
- Leicester Medical School, College of Life Sciences, University of Leicester, George Davies Centre, Leicester LE1 7RH, United Kingdom.
| | - Navin Leanage
- Leicester Medical School, College of Life Sciences, University of Leicester, George Davies Centre, Leicester LE1 7RH, United Kingdom
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxford OX1 3BG, United Kingdom
| | - Robert I Norman
- Leicester Medical School, College of Life Sciences, University of Leicester, George Davies Centre, Leicester LE1 7RH, United Kingdom
| | - Jeremy Howick
- Faculty of Philosophy, University of Oxford, Oxford OX2 6GG, United Kingdom
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19
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Assing Hvidt E, Ulsø A, Thorngreen CV, Søndergaard J, Andersen CM. Empathy as a learning objective in medical education: using phenomenology of learning theory to explore medical students' learning processes. BMC MEDICAL EDUCATION 2022; 22:628. [PMID: 35982451 PMCID: PMC9389818 DOI: 10.1186/s12909-022-03696-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Clinical empathy has been associated with a range of positive patient- and clinician outcomes. Educating medical students to become empathic physicians has in recent years become a clearly pronounced learning objective in medical education in many countries worldwide. Research knowledge about how medical students experience the learning processes conveyed by empathy-enhancing educational interventions is lacking. Our study aimed to explore Danish medical students' perspectives on which experiences allowed learning processes to take place in relation to empathy and empathic communication with patients. METHODS We conducted a qualitative research study, involving semi-structured interviews with twenty-three Danish medical students across years of curriculum and universities. Braun and Clarke's reflexive thematic analysis (RTA) guided the analytical process, moving on a continuum from inductive to deductive, theoretical approaches. Key concepts in regard to learning processes deriving from Amadeo Giorgi's learning theory were applied to analyse the data. RESULTS Learning processes in relation to clinical empathy occured: 1. when theoretical knowledge about empathy became embodied and contextualied within a clinical context 2. through interpersonal interactions, e.g., with peers, faculty members and clinicians, that conveyed behavior-mobilizing positive and negative affect and 3. when new learning discoveries in 2. and 3. were appropriated as a personalized and adequate behavior that transcends the situational level. CONCLUSION Rather than being an immediate product of knowledge transmission, skill acquisition or training, learning clinical empathy is experienced as a dynamic, temporal process embedded in a daily clinical lifeworld of becoming an increasingly human professional.
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Affiliation(s)
- Elisabeth Assing Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark.
| | - Anne Ulsø
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | | | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | - Christina Maar Andersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
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20
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Sarasso P, Francesetti G, Roubal J, Gecele M, Ronga I, Neppi-Modona M, Sacco K. Beauty and Uncertainty as Transformative Factors: A Free Energy Principle Account of Aesthetic Diagnosis and Intervention in Gestalt Psychotherapy. Front Hum Neurosci 2022; 16:906188. [PMID: 35911596 PMCID: PMC9325967 DOI: 10.3389/fnhum.2022.906188] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
Drawing from field theory, Gestalt therapy conceives psychological suffering and psychotherapy as two intentional field phenomena, where unprocessed and chaotic experiences seek the opportunity to emerge and be assimilated through the contact between the patient and the therapist (i.e., the intentionality of contacting). This therapeutic approach is based on the therapist’s aesthetic experience of his/her embodied presence in the flow of the healing process because (1) the perception of beauty can provide the therapist with feedback on the assimilation of unprocessed experiences; (2) the therapist’s attentional focus on intrinsic aesthetic diagnostic criteria can facilitate the modification of rigid psychopathological fields by supporting the openness to novel experiences. The aim of the present manuscript is to review recent evidence from psychophysiology, neuroaesthetic research, and neurocomputational models of cognition, such as the free energy principle (FEP), which support the notion of the therapeutic potential of aesthetic sensibility in Gestalt psychotherapy. Drawing from neuroimaging data, psychophysiology and recent neurocognitive accounts of aesthetic perception, we propose a novel interpretation of the sense of beauty as a self-generated reward motivating us to assimilate an ever-greater spectrum of sensory and affective states in our predictive representation of ourselves and the world and supporting the intentionality of contact. Expecting beauty, in the psychotherapeutic encounter, can help therapists tolerate uncertainty avoiding impulsive behaviours and to stay tuned to the process of change.
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Affiliation(s)
- Pietro Sarasso
- BraIn Plasticity and Behaviour Changes Research Group, Department of Psychology, University of Turin, Turin, Italy
- *Correspondence: Pietro Sarasso,
| | - Gianni Francesetti
- International Institute for Gestalt Therapy and Psychopathology, Turin Center for Gestalt Therapy, Turin, Italy
| | - Jan Roubal
- Psychotherapy Training Gestalt Studia, Training in Psychotherapy Integration, Center for Psychotherapy Research in Brno, Masaryk University, Brno, Czechia
| | - Michela Gecele
- International Institute for Gestalt Therapy and Psychopathology, Turin Center for Gestalt Therapy, Turin, Italy
| | - Irene Ronga
- BraIn Plasticity and Behaviour Changes Research Group, Department of Psychology, University of Turin, Turin, Italy
| | - Marco Neppi-Modona
- BraIn Plasticity and Behaviour Changes Research Group, Department of Psychology, University of Turin, Turin, Italy
| | - Katiuscia Sacco
- BraIn Plasticity and Behaviour Changes Research Group, Department of Psychology, University of Turin, Turin, Italy
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21
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McCrackin SD, Provencher S, Mendell E, Ristic J. Transparent masks reduce the negative impact of opaque masks on understanding emotional states but not on sharing them. Cogn Res Princ Implic 2022; 7:59. [PMID: 35796906 PMCID: PMC9261140 DOI: 10.1186/s41235-022-00411-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 06/20/2022] [Indexed: 12/04/2022] Open
Abstract
While face masks provide necessary protection against disease spread, they occlude the lower face parts (chin, mouth, nose) and consequently impair the ability to accurately perceive facial emotions. Here we examined how wearing face masks impacted making inferences about emotional states of others (i.e., affective theory of mind; Experiment 1) and sharing of emotions with others (i.e., affective empathy; Experiment 2). We also investigated whether wearing transparent masks ameliorated the occlusion impact of opaque masks. Participants viewed emotional faces presented within matching positive (happy), negative (sad), or neutral contexts. The faces wore opaque masks, transparent masks, or no masks. In Experiment 1, participants rated the protagonists’ emotional valence and intensity. In Experiment 2, they indicated their empathy for the protagonist and the valence of their emotion. Wearing opaque masks impacted both affective theory of mind and affective empathy ratings. Compared to no masks, wearing opaque masks resulted in assumptions that the protagonist was feeling less intense and more neutral emotions. Wearing opaque masks also reduced positive empathy for the protagonist and resulted in more neutral shared valence ratings. Wearing transparent masks restored the affective theory of mind ratings but did not restore empathy ratings. Thus, wearing face masks impairs nonverbal social communication, with transparent masks able to restore some of the negative effects brought about by opaque masks. Implications for the theoretical understanding of socioemotional processing as well as for educational and professional settings are discussed.
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Affiliation(s)
- Sarah D McCrackin
- Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, QC, H3A 1G1, Canada.
| | - Sabrina Provencher
- Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, QC, H3A 1G1, Canada
| | - Ethan Mendell
- Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, QC, H3A 1G1, Canada
| | - Jelena Ristic
- Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, QC, H3A 1G1, Canada.
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22
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McParlin Z, Cerritelli F, Rossettini G, Friston KJ, Esteves JE. Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Biobehavioural Synchrony in Musculoskeletal Care. Front Behav Neurosci 2022; 16:897247. [PMID: 35846789 PMCID: PMC9280207 DOI: 10.3389/fnbeh.2022.897247] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/24/2022] [Indexed: 12/05/2022] Open
Abstract
Touch is recognised as crucial for survival, fostering cooperative communication, accelerating recovery, reducing hospital stays, and promoting overall wellness and the therapeutic alliance. In this hypothesis and theory paper, we present an entwined model that combines touch for alignment and active inference to explain how the brain develops "priors" necessary for the health care provider to engage with the patient effectively. We appeal to active inference to explain the empirically integrative neurophysiological and behavioural mechanisms that underwrite synchronous relationships through touch. Specifically, we offer a formal framework for understanding - and explaining - the role of therapeutic touch and hands-on care in developing a therapeutic alliance and synchrony between health care providers and their patients in musculoskeletal care. We first review the crucial importance of therapeutic touch and its clinical role in facilitating the formation of a solid therapeutic alliance and in regulating allostasis. We then consider how touch is used clinically - to promote cooperative communication, demonstrate empathy, overcome uncertainty, and infer the mental states of others - through the lens of active inference. We conclude that touch plays a crucial role in achieving successful clinical outcomes and adapting previous priors to create intertwined beliefs. The ensuing framework may help healthcare providers in the field of musculoskeletal care to use hands-on care to strengthen the therapeutic alliance, minimise prediction errors (a.k.a., free energy), and thereby promote recovery from physical and psychological impairments.
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Affiliation(s)
- Zoe McParlin
- Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
| | - Francesco Cerritelli
- Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
| | | | - Karl J. Friston
- Institute of Neurology, Wellcome Centre for Human Neuroimaging, London, United Kingdom
| | - Jorge E. Esteves
- Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
- Malta ICOM Educational, Gzira, Malta
- University College of Osteopathy, London, United Kingdom
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Leuchtenberg S, Gromer D, Käthner I. Videoconferencing versus
face‐to‐face
psychotherapy: Insights from patients and psychotherapists about comparability of therapeutic alliance, empathy and treatment characteristics. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Sophie Leuchtenberg
- Department of Psychology I, Biological Psychology, Clinical Psychology and Psychotherapy University of Würzburg Würzburg Germany
| | - Daniel Gromer
- Department of Psychology I, Biological Psychology, Clinical Psychology and Psychotherapy University of Würzburg Würzburg Germany
| | - Ivo Käthner
- Department of Psychology I, Biological Psychology, Clinical Psychology and Psychotherapy University of Würzburg Würzburg Germany
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24
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Singleton IM, Garfinkel RJ, Malone JB, Temkit MH, Belthur MV. Perceived Physician Empathy in Pediatric Orthopedics: A Cross-Sectional Study. J Patient Exp 2022; 9:23743735221092607. [PMID: 35450088 PMCID: PMC9016577 DOI: 10.1177/23743735221092607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Empathy is the cornerstone of the patient–physician relationship and is
consistently ranked by patients as one of the most important factors in the
quality of their care. In this paper we examine the degree to which perceived
physician empathy is associated with the characteristics of the caregiver
(parent or legal guardian) and physician in pediatric orthopedic surgery. This
was a cross-sectional survey study of 200 English-speaking caregivers of
pediatric patients at a large children's hospital. The Consultation and
Relational Empathy (CARE) Measure was used to measure perceived physician
empathy. Only if the caregiver felt carefully listened to by the physician
(p-value < 0.001), and if the physician showed respect
for what the caregiver had to say (p-value = 0.007) were
statistically significant and positively associated with perceived physician
empathy. The most significant determinant of perceived physician empathy is
whether the caregiver felt listened to during the encounter. Other factors such
as caregiver demographics, health literacy, self-rated mental health, wait time,
and time spent with the physician do not significantly affect perceived
physician empathy.
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Affiliation(s)
- Ian M Singleton
- San Francisco Orthopaedic Residency Program, San Francisco, CA, USA
| | - Rachel J Garfinkel
- Department of Orthopedic Surgery, Henry Ford Health System, Detroit, MI, USA
| | - Jason B Malone
- Department of Orthopedic Surgery, Nemours Children's Health System, Jacksonville, FL, United States
| | - M’Hamed H Temkit
- Department of Orthopedics, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Mohan V Belthur
- Department of Orthopedics, Phoenix Children's Hospital, Phoenix, AZ, USA
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Sapkaroski D, Mundy M, Dimmock MR. Immersive virtual reality simulated learning environment versus role-play for empathic clinical communication training. J Med Radiat Sci 2022; 69:56-65. [PMID: 34706398 PMCID: PMC8892424 DOI: 10.1002/jmrs.555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The use of immersive virtual reality simulated learning environments (VR SLEs) for improving clinical communication can offer desirable qualities including repetition and determinism in a safe environment. The aim of this study was to establish whether the mode of delivery, VR SLE versus clinical role-play, could have a measurable effect on clinical empathic communication skills for MRI scenarios. METHODS A split-cohort study was performed with trainee practitioners (n = 70) and qualified practitioners (n = 9). Participants were randomly assigned to four groups: clinician VR (CVR), clinician role-play (CRP), trainee VR (TVR), and trainee RP (TRP). Clinical communication skills were assessed using two methods: firstly, a self-reported measure - the SE-12 communication questionnaire and, secondly, a training and assessment tool developed by a panel of experts. RESULTS Participants in the VR trainee (TVR) and clinician (CVR) groups reported 11% (P < 0.05) and 7.2% (P < 0.05) improvements in communication confidence post training, whereas trainees assigned to the role-play (TRP) intervention reported a 4.3% (P < 0.05) improvement. Empirical assessment of communication training scores assessing a participant's ability to select empathic statements showed the TVR group performed 5% better on average than their role-play counterparts (P < 0.05). CONCLUSION The accuracy of participant's selection of appropriate empathic responses was shown to differ significantly following the training intervention designed to improve interactions with patients that present for an MRI scan. The results may demonstrate the capacity for immersion into an emotional narrative in a VR environment to increase the user's susceptibility for recalling and selecting empathic terminology.
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Affiliation(s)
- Daniel Sapkaroski
- Department of Medical Imaging & Radiation Sciences, Faculty of Medicine, Nursing & Health Sciences, School of Biomedical SciencesMonash UniversityClaytonVictoriaAustralia
| | - Matthew Mundy
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneMelbourneVictoriaAustralia
| | - Matthew Richard Dimmock
- Department of Medical Imaging & Radiation Sciences, Faculty of Medicine, Nursing & Health Sciences, School of Biomedical SciencesMonash UniversityClaytonVictoriaAustralia
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Abstract
Abstract. With the widespread adoption of masks, there is a need for understanding how facial obstruction affects emotion recognition. We asked 120 participants to identify emotions from faces with and without masks. We also examined if recognition performance was related to autistic traits and personality. Masks impacted recognition of expressions with diagnostic lower face features the most and those with diagnostic upper face features the least. Persons with higher autistic traits were worse at identifying unmasked expressions, while persons with lower extraversion and higher agreeableness were better at recognizing masked expressions. These results show that different features play different roles in emotion recognition and suggest that obscuring features affects social communication differently as a function of autistic traits and personality.
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Affiliation(s)
| | | | | | - Jelena Ristic
- Department of Psychology, McGill University, Montreal, Canada
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Chhabra N, Chhabra S, Archer E. Medical Students' Perspectives on the Factors Affecting Empathy Development During Their Undergraduate Training. MEDICAL SCIENCE EDUCATOR 2022; 32:79-89. [PMID: 35186434 PMCID: PMC8814260 DOI: 10.1007/s40670-021-01487-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 05/09/2023]
Abstract
INTRODUCTION This study investigated the perspectives of medical students on the factors influencing empathy development during their undergraduate training. METHODOLOGY A descriptive phenomenological approach was used to generate illustrations of empathy development and decline that had educational significance and applicability. Individual online semi-structured interviews were conducted to elicit experiential details from twelve final-year medical students. The interview recordings were transcribed verbatim, and data were analysed employing Braun and Clarke's thematic analysis method. RESULTS The self-reported empathic behavior of medical students seemed to have improved with time in medical school. Students attributed their empathy development to real patient encounters, positive role-modelling by teachers, and attainment of confidence and personal maturity. They identified exams, academic overload, time constraints, personal stresses, negative role models, unconducive learning environments, and lack of formal empathy training as barriers to empathy development. CONCLUSION Medical institutes should identify and address the barriers to empathy development and encourage the holistic development of medical students. Furthermore, medical educators should model their behavior accurately for their increasing roles and responsibilities and support the students in their empathic expressions with patients.
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Affiliation(s)
- Namrata Chhabra
- Department of Medical Biochemistry, SSR Medical College, University of Mauritius, Belle Rive, Phoenix, Mauritius
| | - Sahil Chhabra
- Graduate Division, University of California, San Diego, USA
| | - Elize Archer
- Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Challenging the clinically-situated emotion-deficient version of empathy within medicine and medical education research. SOCIAL THEORY & HEALTH 2022; 20:306-324. [PMID: 34840531 PMCID: PMC8607055 DOI: 10.1057/s41285-021-00174-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 12/30/2022]
Abstract
In this paper, we argue that the notion of a clinically-situated empathy (e.g. physician empathy), is potentially problematic as it perpetuates an emotion-deficient version of empathy within medicine and medicine education research. Utilizing classic and contemporary empathy theory from various social science disciplines, we discuss how empathy in the general sense differs conceptually from clinically-situated empathy-paying particular attention to the role of emotional contagion. To highlight this contrast, we draw upon Hojat et al.'s model of physician empathy and how this body of work reflects broader medical-cultural norms that problematize the role and impact of emotions within the clinical encounter. Alternatively, we present a more encompassing model of empathy drawing upon the fields of social-psychology and social-neuroscience in order to bring the notion of "feeling with" and emotional contagion more specifically, into medical education, medical education research, and medicine more generally.
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Fotopoulou A, von Mohr M, Krahé C. Affective regulation through touch: homeostatic and allostatic mechanisms. Curr Opin Behav Sci 2021; 43:80-87. [PMID: 34841013 PMCID: PMC7612031 DOI: 10.1016/j.cobeha.2021.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We focus on social touch as a paradigmatic case of the embodied, cognitive, and metacognitive processes involved in social, affective regulation. Social touch appears to contribute three interrelated but distinct functions to affective regulation. First, it regulates affects by fulfilling embodied predictions about social proximity and attachment. Second, caregiving touch, such as warming an infant, regulates affect by socially enacting homeostatic control and co-regulation of physiological states. Third, affective touch such as gentle stroking or tickling regulates affect by allostatic regulation of the salience and epistemic gain of particular experiences in given contexts and timescales. These three functions of affective touch are most likely mediated, at least partly, by different neurobiological processes, including convergent hedonic, dopaminergic and analgesic, opioidergic pathways for the attachment function, 'calming' autonomic and endocrine pathways for the homeostatic function, while the allostatic function may be mediated by oxytocin release and related 'salience' neuromodulators and circuits.
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Affiliation(s)
- Aikaterini Fotopoulou
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Mariana von Mohr
- Department of Psychology, Royal Holloway University of London, London, UK
| | - Charlotte Krahé
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
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Ardenghi S, Russo S, Bani M, Rampoldi G, Strepparava MG. The role of difficulties in emotion regulation in predicting empathy and patient-centeredness in pre-clinical medical students: a cross-sectional study. PSYCHOL HEALTH MED 2021; 28:1215-1229. [PMID: 34753373 DOI: 10.1080/13548506.2021.2001549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
While empathy and patient-centeredness (PC) are considered core variables in high-quality healthcare education and care, research suggests that empathy and PC decrease during the clinical years of study and that impairments in empathy and PC may be related to difficulties in emotion regulation. There is a growing interest in identifying the psycho-social variables that sustain and foster empathy and PC in medical students throughout their education. This study explored whether and to what extent emotion dysregulation predicted empathy and PC in medical students controlling for gender. Three hundred ninety-eight pre-clinical medical students enrolled at a university in northern Italy completed the Difficulties in Emotion Regulation Scale (DERS), the Interpersonal Reactivity Index (IRI) and the Patient-Practitioner Orientation Scale - 8 Items - Italian version (PPOS-8-IT). All statistically significant correlation coefficients between DERS, IRI and PPOS-8-IT scores were negative (rs from -.130 to -.336, ps ≤ 01), except for IRI Personal Distress and IRI Fantasy Scale that were mainly positively related to DERS scores (rs from .130 to .305, ps ≤ .01). Hierarchical multiple-regression analyses showed that DERS scores accounted for a significant amount of additional variance in both IRI and PPOS-8-IT components above and beyond gender. Emotion dysregulation was positively associated with Personal Distress (βs from .135 to .250, ps ≤ .007), whereas Empathic Concern, Perspective Taking, and the PC components were negatively predicted by emotion regulation difficulties (βs from -.131 to -.309, ps ≤ .005). Female students showed higher levels of all empathy and PC measures than males (ts from -3.49 to -5.54, ps ≤ 001) except for Perspective Taking. Tailored educational approaches that provide medical students with emotion regulation strategies implemented along the pre-clinical curriculum may sustain empathy and PC and equip students to appropriately and functionally face the emotional and interpersonal aspects of the clinical internship experience.
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Affiliation(s)
- Stefano Ardenghi
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Selena Russo
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Marco Bani
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Giulia Rampoldi
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Maria Grazia Strepparava
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Department of Mental Health, Clinical Psychology Unit, San Gerardo Hospital, ASST-Monza, Monza, Italy
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Díaz-Narváez V, Oyarzún-Muñoz M, Reyes-Reyes A, Calzadilla-Núñez A, Martínez PT, González-Valenzuela C, Cornejo-Fernández N. Psychometry and empathy levels and its dimensions in postgraduate students of dental specialties. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2021; 25:785-795. [PMID: 33387384 DOI: 10.1111/eje.12658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/09/2020] [Accepted: 12/29/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Empathy is an attribute that has an important role in the dentist-patient therapeutic relationship, clinical care and adherence to treatment, amongst other benefits. The aim of this research was to determine empathy in dentists in the process of specialisation. MATERIALS AND METHODS Through an observational and cross-sectional study, all postgraduate students of Dentistry Faculty of Universidad Andrés Bello (Chile) were analysed (N = 195). The Jefferson Scale of Physician Empathy Scale was applied. RESULTS The results show an adequate reliability of the empathy measure (α = 0.819, ω = 0.928). A three-factor structure is evidenced by confirmatory factor analysis (χ2 /df = 1.445, GFI = 0.952, RMSEA = 0.047) and adequate factor invariance between men and women. Women showed greater empathy on the global scale and in the perspective adoption dimension, with no gender differences found in the dimension Compassionate care and putting oneself in the other's shoes (POOS). The median empathy reaches 120 points. Below, are placed, the specialty of oral rehabilitation (Med = 114.5), surgery (Med = 117) and periodontics (Med. = 117.5). With superior scores, temporomandibular disorder (Med. = 121), endodontics (Med. = 121), Orthodontics and dentofacial orthopedics Med. = 122), Implantology (Med. = 125) and Pediatric dentistry (Med. = 127.5) are located. CONCLUSION Women were more empathetic than men. In general, empathy levels are relatively high, but the common feature in which all students examined in different specialties have low levels in dimension POOS.
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Affiliation(s)
| | | | - Alejandro Reyes-Reyes
- Faculty of Social Sciences and Communications, Universidad Santo Tomás, Concepción, Chile
| | - Aracelis Calzadilla-Núñez
- Health Faculty, Universidad Bernardo OHiggins, Santiago, Chile
- Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco, Chile
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Impact of physician empathy on patient outcomes: a gender analysis. Br J Gen Pract 2021; 72:e99-e107. [PMID: 34990388 PMCID: PMC8763196 DOI: 10.3399/bjgp.2021.0193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 09/20/2021] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Empathy in primary care settings has been linked to improved health outcomes. However, the operationalisation of empathy differs between studies, and, to date, no study has concurrently compared affective, cognitive, and behavioural components of empathy regarding patient outcomes. Moreover, it is unclear how gender interacts with the studied dimensions. AIM To examine the relationship between several empathy dimensions and patient-reported satisfaction, consultation's quality, and patients' trust in their physicians, and to determine whether this relationship is moderated by a physician's gender. DESIGN AND SETTING Analysis of the empathy of 61 primary care physicians in relation to 244 patient experience questionnaires in the French-speaking region of Switzerland. METHOD Sixty-one physicians were video-recorded with two male and two female patients. Six different empathy measures were assessed: two self-reported measures, a facial recognition test, two external observational measures, and a Synchrony of Vocal Mean Fundamental Frequencies (SVMFF), measuring vocally coded emotional arousal. After the consultation, patients indicated their satisfaction with, trust in, and quality of the consultation. RESULTS Female physicians self-rated their empathic concern higher than their male counterparts did, whereas male physicians were more vocally synchronised (in terms of frequencies of speech) to their patients. SVMFF was the only significant predictor of all patient outcomes. Verbal empathy statements were linked to higher satisfaction when the physician was male. CONCLUSION Gender differences were observed more often in self-reported measures of empathy than in external measures, indicating a probable social desirability bias. SVMFF significantly predicted all patient outcomes, and could be used as a cost-effective proxy for relational quality.
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Kim SA, Lee YM, Hamann S, Kim SH. Differences in empathy toward patients between medical and nonmedical students: an fMRI study. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:1207-1227. [PMID: 33877486 PMCID: PMC8056797 DOI: 10.1007/s10459-021-10045-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 03/07/2021] [Indexed: 05/27/2023]
Abstract
There is growing concern about a potential decline in empathy among medical students over time. Despite the importance of empathy toward patients in medicine, it remains unclear the nature of the changes in empathy among medical students. Thus, we systematically investigated affective and cognitive empathy for patients among medical students using neuroscientific approach. Nineteen medical students who completed their fifth-year medical curriculum and 23 age- and sex-matched nonmedical students participated in a functional magnetic resonance imaging study. Inside a brain scanner, all participants read empathy-eliciting scenarios while adopting either the patient or doctor perspective. Brain activation and self-reported ratings during the experience of empathy were obtained. Behavioral results indicated that all participants reported greater emotional negativity and empathic concern in association with the patient perspective condition than with the doctor perspective condition. Functional brain imaging results indicated that neural activity in the posterior superior temporal region implicated in goal-relevant attention reorienting was overall increased under the patient perspective than the doctor perspective condition. Relative to nonmedical students, medical students showed decreased activity in the temporoparietal region implicated in mentalizing under the patient perspective versus doctor perspective condition. Notably, this same region showed increased activity under the doctor versus patient condition in medical students relative to nonmedical students. This study is among the first to investigate the neural mechanisms of empathy among medical students and the current findings point to the cognitive empathy system as the locus of the primary brain differences associated with empathy toward patients.
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Affiliation(s)
- Shin Ah Kim
- Department of Brain and Cognitive Engineering, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, South Korea
| | - Stephan Hamann
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Sang Hee Kim
- Department of Brain and Cognitive Engineering, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, South Korea.
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Tan L, Le MK, Yu CC, Liaw SY, Tierney T, Ho YY, Lim E, Lim D, Ng R, Ngeow C, Low J. Defining clinical empathy: a grounded theory approach from the perspective of healthcare workers and patients in a multicultural setting. BMJ Open 2021; 11:e045224. [PMID: 34521657 PMCID: PMC8442049 DOI: 10.1136/bmjopen-2020-045224] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To define clinical empathy from the perspective of healthcare workers and patients from a multicultural setting. DESIGN Grounded theory approach using focus group discussions. SETTING A health cluster in Singapore consisting of an acute hospital, a community hospital, ambulatory care teams, a medical school and a nursing school. PARTICIPANTS 69 participants including doctors, nurses, medical students, nursing students, patients and allied health workers. MAIN OUTCOME MEASURES A robust definition of clinical empathy. RESULTS The construct of clinical empathy is consistent across doctors, nurses, students, allied health and students. Medical empathy consists of an inner sense of empathy (imaginative, affective and cognitive), empathy behaviour (genuine concern and empathic communication) and a sense of connection (trust and rapport). This construct of clinical empathy is similar to definitions by neuroscientists but challenges a common definition of clinical empathy as a cognitive process with emotional detachment. CONCLUSIONS This paper has defined clinical empathy as 'a sense of connection between the healthcare worker and the patient as a result of perspective taking arising from imaginative, affective and cognitive processes, which are expressed through behaviours and good communication skills that convey genuine concern'. A clear and multidimensional definition of clinical empathy will improve future education and research efforts in the application and impact of clinical empathy.
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Affiliation(s)
- Laurence Tan
- Department of Geriatic Medicine, Khoo Teck Puat Hospital, Singapore
- Geriatric Education and Research Institute Ltd, Singapore
- Lee Kong Chian School of Medicine, Singapore
- The Palliative Care Centre for Excellence in Research and Education, Singapore
- Gericare, Khoo Teck Puat Hospital, Singapore
| | - Mai Khanh Le
- Geriatric Education and Research Institute Ltd, Singapore
| | - Chou Chuen Yu
- Geriatric Education and Research Institute Ltd, Singapore
| | | | | | - Yun Ying Ho
- Lee Kong Chian School of Medicine, Singapore
| | - Evelyn Lim
- School of Health & Social Sciences, Nanyang Polytechnic, Singapore
| | - Daphne Lim
- School of Health & Social Sciences, Nanyang Polytechnic, Singapore
| | - Reuben Ng
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore
- Lloyds Register Foundation Institute for the Public Understanding of Risk, National University of Singapore, Singapore
| | | | - James Low
- Department of Geriatic Medicine, Khoo Teck Puat Hospital, Singapore
- Geriatric Education and Research Institute Ltd, Singapore
- Gericare, Khoo Teck Puat Hospital, Singapore
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von Mohr M, Kirsch LP, Fotopoulou A. Social touch deprivation during COVID-19: effects on psychological wellbeing and craving interpersonal touch. ROYAL SOCIETY OPEN SCIENCE 2021; 8:210287. [PMID: 34527270 PMCID: PMC8424338 DOI: 10.1098/rsos.210287] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 08/23/2021] [Indexed: 05/09/2023]
Abstract
Social touch has positive effects on social affiliation and stress alleviation. However, its ubiquitous presence in human life does not allow the study of social touch deprivation 'in the wild'. Nevertheless, COVID-19-related restrictions such as social distancing allowed the systematic study of the degree to which social distancing affects tactile experiences and mental health. In this study, 1746 participants completed an online survey to examine intimate, friendly and professional touch experiences during COVID-19-related restrictions, their impact on mental health and the extent to which touch deprivation results in craving touch. We found that intimate touch deprivation during COVID-19-related restrictions is associated with higher anxiety and greater loneliness even though this type of touch is still the most experienced during the pandemic. Moreover, intimate touch is reported as the type of touch most craved during this period, thus being more prominent as the days practising social distancing increase. However, our results also show that the degree to which individuals crave touch during this period depends on individual differences in attachment style: the more anxiously attached, the more touch is craved; with the reverse pattern for avoidantly attached. These findings point to the important role of interpersonal and particularly intimate touch in times of distress and uncertainty.
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Affiliation(s)
- Mariana von Mohr
- Lab of Action and Body, Department of Psychology, Royal Holloway, University of London, London, UK
- Departamento de Psicología, Universidad Iberoamericana, México, Mexico
| | - Louise P. Kirsch
- Institute for Intelligent Systems and Robotics (ISIR), Sorbonne Université, Paris, France
- Université de Paris, INCC UMR 8002, 75006, Paris, France
| | - Aikaterini Fotopoulou
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Nasiri M, Amini M, Mani A, Delavari S, Kiani M, Sagheb MM, Tabari P. Assessing empathy in final-year medical students using the Persian version of the Jefferson Scale of Physician Empathy. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:310. [PMID: 34667810 PMCID: PMC8459864 DOI: 10.4103/jehp.jehp_1539_20] [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: 11/28/2020] [Accepted: 01/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND A doctor-patient relationship built on the concept of empathy is so essential to attain the best clinical outcomes in medicine. Since empathy has a positive role in interpersonal relationships and medical outcomes, its assessment is highly crucial. The aim of this study was to assess the empathy in last-year medical students using the Persian version of the Jefferson Scale of Physician Empathy (JSPE) and correlate empathy scores with demographic features. MATERIALS AND METHODS In this cross-sectional study, last-year medical students at Shiraz Medical School, Shiraz, Iran, were recruited for this study. In this research, we used the Persian version of JSPE. The validity and reliability of the Persian version of this tool were confirmed in the previous research. For the analysis of data, we employed descriptive statistics and the independent sample t-test. RESULTS One hundred and eighty-five final-year medical students were included in this study. The maximum score of the questionnaire was 140, and the total mean score of empathy was 98.15 ± 13.29. The females' total mean score (102.05 ± 11.89) was higher than the males' score (93.57 ± 13.46). The difference between the mean score of gender and empathy was significant (P value <.001), but there was no significant difference between empathy and the two other demographic factors (P > 0.05). CONCLUSIONS Although physicians would gain the essential characteristics of empathy during their career, attending professors and other responsible policymakers in medical education should focus more on the factors related to physicians' empathy to train better and more professional physicians.
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Affiliation(s)
- Marzieh Nasiri
- Department of Psychiatry, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mitra Amini
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arash Mani
- Cognitive Neuroscience Research Center for Psychiatry and Behavioral Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Somayeh Delavari
- Center for Educational Research in Medical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahsa Kiani
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Mahdi Sagheb
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parinaz Tabari
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Käthner I, Eidel M, Häge AS, Gram A, Pauli P. Observing physicians acting with different levels of empathy modulates later assessed pain tolerance. Br J Health Psychol 2021; 27:434-448. [PMID: 34374180 DOI: 10.1111/bjhp.12553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 07/22/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The patient-physician relationship is essential for treatment success. Previous studies demonstrated that physicians who behave empathic in their interaction with patients have a positive effect on health outcomes. In this study, we investigated if the mere perception of physicians as empathic/not empathic modulates pain despite an emotionally neutral interaction with the patients. METHODS N = 60 women took part in an experimental study that simulated a clinical interaction. In the paradigm, each participant watched two immersive 360° videos via a head-mounted display from a patient's perspective. The physicians in the videos behaved either empathic or not empathic towards a third person. Importantly, these physicians remained emotionally neutral in the subsequent virtual interaction with the participants. Finally, participants received a controlled, painful pressure stimulus within the narratives of the videos. RESULTS The physicians in the high compared with the low empathy videos were rated as more empathic and more likable, indicating successful experimental manipulation. In spite of later neutral behaviour of physicians, this short observation of physicians' behaviour towards a third person was sufficient to modulate pain tolerance of the participants. CONCLUSIONS The finding of this study that the mere observation of physicians' behaviour towards a third person modulates pain, despite a neutral direct interaction with the participants, has important clinical implications. Further, the proposed paradigm enables investigating aspects of patient-physician communication that are difficult to examine in a clinical setting.
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Affiliation(s)
- Ivo Käthner
- Department of Psychology I, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Germany
| | - Matthias Eidel
- Department of Psychology I, Psychological Intervention, Behaviour Analysis and Regulation of Behaviour, University of Würzburg, Germany
| | - Anne-Sophie Häge
- Department of Psychology I, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Germany
| | - Annika Gram
- Department of Psychology I, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Germany
| | - Paul Pauli
- Department of Psychology I, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Germany.,Center of Mental Health, Medical Faculty, University of Würzburg, Germany
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González-Díaz ES, Silva-Vetri MG, Díaz-Calzadilla P, Calzadilla-Núñez A, Reyes-Reyes A, Díaz-Narváez VP. Empathy levels decline and sex differences in medicine students from the Caribbean. REVISTA DE LA FACULTAD DE MEDICINA 2021. [DOI: 10.15446/revfacmed.v69n4.86227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Empathy is an important trait in the training of medical students, as it has been shown to improve the doctor-patient relationship.
Objective: To evaluate empathy levels decline and possible sex differences in empathy levels in undergraduate medical students from the Universidad Central del Este, Dominican Republic.
Materials and methods: Exploratory cross-sectional study. A Spanish version of the Jefferson Scale of Empathy for Medical Students (S-version) Scale was administered in September 2018 to 1144 1st-year to 5th-year medical students (887 women and 257 men). The reliability of the data was verified using the Cronbach's alpha and the intraclass correlation coefficient (ICC). Data were analyzed using a generalized linear equation model (Type III) and the Wald chi-squared test was used to determine differences in overall empathy levels and the mean scores obtained in each of its three components according to the year of medical training and to sex.
Results. Cronbach's alpha was satisfactory (0.839) and the ICC was 0.834 (F=5.68; p=0.005). Variability of the estimated curves in relation to empathic behavior by course (year of medical training) and sex was observed using linear and non-linear regression equations: between courses: Wald χ2==115.6; p=0.0001, and between men and women: χ2 of Wald =12.85; p=0.001.
Conclusions. There were sex differences regarding empathy levels in the study population; besides, a decline in empathy levels (overall empathy and Compassionate Care component in men, and Walking in the Patient’s Shoes component in men and women) was also observed as students progressed in their medical training. The behavior of these data raises questions regarding the need to determine the factors causing these differences and the decline in empathy levels.
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Chen Y, Xu Y. Exploring the Effect of Social Support and Empathy on User Engagement in Online Mental Health Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6855. [PMID: 34206719 PMCID: PMC8296998 DOI: 10.3390/ijerph18136855] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/10/2021] [Accepted: 06/17/2021] [Indexed: 12/30/2022]
Abstract
It is known that social support and empathy are beneficial for mental health. As a result of the widespread development of social media, online social support and empathy could also influence user behaviors during the development of online communities. However, few studies have examined these effects from the perspective of online mental health communities. These communities appear to be a crucial source for mental health related support, but the spread of online empathy in these communities is not well-understood. This study focused on 22 mental health related subreddits, and matched and compared users (1) who received social support with those who did not receive social support, and users (2) who received more empathic social support with those who received less empathic social support. The results showed that social support and empathy are "contagious". That is, users who received social support at their first post would be more likely to post again and provide support for others; in addition, users who received more empathic support would subsequently express a higher level of empathy to others in the future. Our findings indicate the potential chain reaction of social support and empathy in online mental health communities. Our study also provides insights into how online mental health communities might better assist people to deliver social support that can help others to deal with mental problems.
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Affiliation(s)
| | - Yang Xu
- Department of Information Management, Peking University, Beijing 100871, China;
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40
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Treal T, Jackson PL, Jeuvrey J, Vignais N, Meugnot A. Natural human postural oscillations enhance the empathic response to a facial pain expression in a virtual character. Sci Rep 2021; 11:12493. [PMID: 34127724 PMCID: PMC8203793 DOI: 10.1038/s41598-021-91710-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/21/2021] [Indexed: 01/10/2023] Open
Abstract
Virtual reality platforms producing interactive and highly realistic characters are being used more and more as a research tool in social and affective neuroscience to better capture both the dynamics of emotion communication and the unintentional and automatic nature of emotional processes. While idle motion (i.e., non-communicative movements) is commonly used to create behavioural realism, its use to enhance the perception of emotion expressed by a virtual character is critically lacking. This study examined the influence of naturalistic (i.e., based on human motion capture) idle motion on two aspects (the perception of other’s pain and affective reaction) of an empathic response towards pain expressed by a virtual character. In two experiments, 32 and 34 healthy young adults were presented video clips of a virtual character displaying a facial expression of pain while its body was either static (still condition) or animated with natural postural oscillations (idle condition). The participants in Experiment 1 rated the facial pain expression of the virtual human as more intense, and those in Experiment 2 reported being more touched by its pain expression in the idle condition compared to the still condition, indicating a greater empathic response towards the virtual human’s pain in the presence of natural postural oscillations. These findings are discussed in relation to the models of empathy and biological motion processing. Future investigations will help determine to what extent such naturalistic idle motion could be a key ingredient in enhancing the anthropomorphism of a virtual human and making its emotion appear more genuine.
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Affiliation(s)
- Thomas Treal
- CIAMS, Université Paris-Saclay, 91405, Orsay, France.,CIAMS, Université D'Orléans, 45067, Orléans, France
| | - Philip L Jackson
- École de Psychologie, Université Laval, Québec, Canada.,Centre Interdisciplinaire de Recherche en Réadaptation Et Intégration Sociale (CIRRIS), Québec, Canada.,CERVO Research Center, Québec, Canada
| | - Jean Jeuvrey
- CIAMS, Université Paris-Saclay, 91405, Orsay, France.,CIAMS, Université D'Orléans, 45067, Orléans, France
| | - Nicolas Vignais
- CIAMS, Université Paris-Saclay, 91405, Orsay, France.,CIAMS, Université D'Orléans, 45067, Orléans, France
| | - Aurore Meugnot
- CIAMS, Université Paris-Saclay, 91405, Orsay, France. .,CIAMS, Université D'Orléans, 45067, Orléans, France.
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Wampold BE. Healing in a Social Context: The Importance of Clinician and Patient Relationship. FRONTIERS IN PAIN RESEARCH 2021; 2:684768. [PMID: 35295467 PMCID: PMC8915743 DOI: 10.3389/fpain.2021.684768] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/18/2021] [Indexed: 12/13/2022] Open
Abstract
When a patient presents to a health provider, the course of the disorder is composed of three effects: natural effects, specific effects, and contextual effects. Part of the contextual effect is due to the relationship between the healer and the patient. Social healing appears to be present in eusocial species and particularly well-developed in humans. Evidence for the importance of the relationship in healing is found in placebo studies, including placebo analgesics, medicine, and psychotherapy. Although the theory for how the relationship is therapeutic is not well-developed, four possible mechanisms are discussed. The implications for health care and the treatment of pain are discussed.
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Affiliation(s)
- Bruce E. Wampold
- Modum Bad Psychiatric Center, Research Institute, Vikersund, Norway
- Department of Counseling Psychology, University of Wisconsin-Madison, Madison, WI, United States
- *Correspondence: Bruce E. Wampold
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Weilenmann S, Schnyder U, Keller N, Corda C, Spiller TR, Brugger F, Parkinson B, von Känel R, Pfaltz MC. Self-worth and bonding emotions are related to well-being in health-care providers: a cross-sectional study. BMC MEDICAL EDUCATION 2021; 21:290. [PMID: 34020633 PMCID: PMC8139026 DOI: 10.1186/s12909-021-02731-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 05/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Interacting with patients can elicit a myriad of emotions in health-care providers. This may result in satisfaction or put providers at risk for stress-related conditions such as burnout. The present study attempted to identify emotions that promote provider well-being. Following eudaimonic models of well-being, we tested whether certain types of emotions that reflect fulfilment of basic needs (self-worth, bonding with patients) rather than positive emotions in general (as suggested by hedonic models) are linked to well-being. Specifically, we hypothesized that well-being is associated with positive emotions directed at the self, which reflect self-worth, and positive as well as negative emotions (e.g., worry) directed at the patient, which reflect bonding. However, we expected positive emotions directed at an object/situation (e.g., curiosity for a treatment) to be unrelated to well-being, because they do not reflect fulfilment of basic needs. METHODS Fifty eight physicians, nurses, and psychotherapists participated in the study. First, in qualitative interviews, they reported their emotions directed at the self, the patient, or an object/situation during distressing interactions with patients. These emotions were categorised into positive emotions directed towards the self, the patient, and an object/situation, and negative emotions directed towards the patient that reflect bonding. Second, providers completed questionnaires to assess their hedonic and eudaimonic well-being. The well-being scores of providers who did and did not experience these emotions were compared. RESULTS Providers who experienced positive emotions directed towards the self or the patient had higher well-being than those who did not. Moreover, for the first time, we found evidence for higher well-being in providers reporting negative patient-directed emotions during distressing interactions. There was no difference between providers who did and did not experience positive object/situation-directed emotions. CONCLUSIONS These findings may point towards the importance of "eudaimonic" emotions rather than just positive emotions in interactions with patients. Emotions such as contentment with oneself, joy for the patient's improvement, and, notably, grief or worry for the patient may build a sense of self-worth and strengthen bonding with the patient. This may explain their association with provider well-being.
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Affiliation(s)
- Sonja Weilenmann
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Haldenbachstrasse 18, CH-8091, Zurich, Switzerland.
- University of Zurich, Zurich, Switzerland.
| | | | - Nina Keller
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Haldenbachstrasse 18, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Claudio Corda
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Haldenbachstrasse 18, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Tobias R Spiller
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Haldenbachstrasse 18, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Fabio Brugger
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Haldenbachstrasse 18, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Brian Parkinson
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Haldenbachstrasse 18, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Monique C Pfaltz
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Haldenbachstrasse 18, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
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Hua AY, Wells JL, Brown CL, Levenson RW. Emotional and Cognitive Empathy in Caregivers of Persons with Neurodegenerative Disease: Relationships with Caregiver Mental Health. Clin Psychol Sci 2021; 9:449-466. [PMID: 34194871 PMCID: PMC8240761 DOI: 10.1177/2167702620974368] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Caregiving for a person with dementia or neurodegenerative disease (PWD) is associated with increased rates of depression and anxiety. As the population ages and dementia prevalence increases worldwide, mental health problems related to dementia caregiving will become an even more pressing public health concern. The present study assessed emotional empathy (physiological, behavioral, and self-reported emotional responses to a film depicting others suffering) and two measures of cognitive empathy (identifying the primary emotion experienced by another person; providing continuous ratings of the valence of another person's changing emotions) in relation to mental health (standard questionnaires) in 78 caregivers of PWDs. Greater emotional empathy (self-reported emotional responses) was associated with worse mental health, even after accounting for known risk factors. Neither measure of cognitive empathy was associated with mental health. A relationship between high levels of emotional empathy and poor mental health in caregivers suggests possible risk indicators and intervention targets.
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Affiliation(s)
- Alice Y Hua
- Department of Psychology, University of California, Berkeley
| | - Jenna L Wells
- Department of Psychology, University of California, Berkeley
| | - Casey L Brown
- Department of Psychology, University of California, Berkeley
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Teaching empathy in an interprofessional setting with a focus on decategorization: Introducing I-Team. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.xjep.2020.100395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Baugh RF, Hoogland MA, Baugh AD. The Long-Term Effectiveness of Empathic Interventions in Medical Education: A Systematic Review. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2020; 11:879-890. [PMID: 33244286 PMCID: PMC7685355 DOI: 10.2147/amep.s259718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 07/17/2020] [Indexed: 06/09/2023]
Abstract
The Association of American Medical Colleges recognizes that empathy is an important part of providing excellent patient care and lists empathy as a Core Entrustable Professional Attribute for physicians. This study is a review of the literature focusing on studies with an educational intervention to promote empathy and at least one year follow-up data. After reviewing the 4910 abstracts retrieved from PubMed, PsycInfo, Cochrane, Web of Science, CINAHL, and Embase; the coauthors selected 61 articles for full-text review and completed a medical education research study quality instrument (MERSQI) to ensure all selected studies scored at least 7 or above. Five studies from the US and seven international studies met our inclusion criteria and formed the basis for the study. Few longitudinal studies with a post-intervention follow-up exist to confirm or disprove the effectiveness and durability of empathy training. Of the published studies that do conduct long-term follow-up, study design and measures used to test empathy are inconsistent. Despite the high degree of heterogeneity, the overwhelming majority demonstrated declining empathy over time. Little evidence was identified to support the ability to augment the empathy of physician trainees in sustained fashion. A model is presented which explains the observed changes. Alternative solutions are proposed, including the selection of more prosocial candidates.
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Affiliation(s)
- Reginald F Baugh
- Admissions, University of Toledo College of Medicine and Life Sciences, Toledo, OH43623, USA
| | - Margaret A Hoogland
- Library, University of Toledo College of Medicine and Life Sciences, Toledo, OH43623, USA
| | - Aaron D Baugh
- Pulmonary, Critical Care, Allergy, Sleep Medicine, University of California San Francisco Medical Center, San Francisco, CA94131, USA
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Versey HS, Kakar SA, John-Vanderpool SD, Sanni MO, Willems PS. Correlates of affective empathy, perspective taking, and generativity among a sample of adults. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:2474-2490. [PMID: 32906202 DOI: 10.1002/jcop.22433] [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: 09/20/2019] [Revised: 07/17/2020] [Accepted: 07/20/2020] [Indexed: 06/11/2023]
Abstract
Previous research suggests that empathy can be cultivated by social ideals and relationships with people. The current study examines family importance and religious importance as correlates of affective empathy, perspective taking, and generativity among a sample of adults aged 18 to 35 (N = 722). Given the ethnic and racial diversity represented by Millennials and Generation Z, the moderating role of racial group membership is explored as well. Results indicate that family importance is positively associated with affective empathy, perspective taking, and generativity for the overall sample, though the relationship is particularly strong for non-Hispanic whites. Religious importance is significantly related to affective empathy and generativity (not perspective taking), primarily among Black, Indigenous, and/or People of Color. Due to the increasing visibility of victimization towards socially vulnerable groups, it is important to understand how attitudes oriented towards helping and empathizing with others are fostered. Implications for further research are discussed.
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Affiliation(s)
- H Shellae Versey
- Department of Psychology, Fordham University, Bronx, New York, USA
| | - Saakshi A Kakar
- Department of Psychology, Wesleyan University, Middletown, Connecticut, USA
| | | | - Mubarak O Sanni
- Department of Psychology, Wesleyan University, Middletown, Connecticut, USA
| | - Paul S Willems
- Department of Psychology, Wesleyan University, Middletown, Connecticut, USA
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Starr LT, Magan KC. Model of Empathic Pain Assessment and Treatment in Persons With Dementia. Res Gerontol Nurs 2020; 13:264-276. [PMID: 32286670 DOI: 10.3928/19404921-20200402-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 02/04/2020] [Indexed: 12/21/2022]
Abstract
The current article presents an evidence-based model for understanding clinical empathy's relationship with the assessment and treatment of pain in persons with advanced dementia. A literature review informed creation of an interdisciplinary conceptual framework of clinician empathy in pain assessment and treatment among persons with advanced dementia. Driven by observation of behaviors indicating pain in persons with dementia unable to self-report, the model represents the cognitive, affective, ethical, and behavioral components of clinical empathy involved in assessing and treating pain, relevant patient outcomes, and contextual factors influencing empathy and outcomes; and provides a framework for testing clinical empathy interventions to improve adverse outcomes in persons with advanced dementia. Understanding the relationship between clinician empathy and the assessment and treatment of pain in persons with advanced dementia may improve care quality and help reduce pain behaviors in this patient population. This model may be used to inform pain research in persons with dementia and develop clinical interventions and clinician education programs. [Research in Gerontological Nursing, 13(5), 264-276.].
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Galehdarifard A, Radfar M, Gholami M, Khademi M, Ebrahimzadeh F, Imani-Nasab MH. The effect of knowledge brokering on nurses' empathy with patients receiving cardiac care: a study protocol. BMC Health Serv Res 2020; 20:680. [PMID: 32703257 PMCID: PMC7376315 DOI: 10.1186/s12913-020-05377-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 05/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hospitalization could be an unpleasant experience for patients with cardiovascular disease leading to some negative emotional reactions. These emotions can be managed by nursing empathy. There are different methods for improving empathy, but some evidence indicates a dramatic drop in nurses' empathy. In this study, we aim to provide a protocol for investigating the effect of knowledge brokering on nurses' empathy with patients receiving cardiac care. METHODS This study protocol is developed based on SPIRIT checklist with an experimental design. The study population are nurses working in cardiac wards of three educational hospitals in western Iran, Khorramabad. The quota sampling method is used. The sample size is 100 individuals. The samples will be assigned to two intervention and comparison groups using stratified random allocation method. Permuted block randomization is used in each stratum. To prevent contamination between participants; firstly, the measurements of the comparison group is done. Knowledge brokering intervention is performed in 7 stages based on Dobbins' knowledge translation framework 2009. Monica's Empathy Construct Self-Rating Scale is used for measuring empathy. Statistical analyses are performed using SPSS (SPPS Inc. Chicago, Il, version 21). P value below 0.05 is considered as statistically significant. DISCUSSION To our knowledge, there is no similar study using an experimental design to examine the efficacy of a knowledge brokering method to improve humanistic knowledge. It helps nurses to improve their empathy in caring relationships.
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Affiliation(s)
- Atefeh Galehdarifard
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Moloud Radfar
- Faculty of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Mohammad Gholami
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mojgan Khademi
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Farzad Ebrahimzadeh
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mohammad-Hasan Imani-Nasab
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
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Smith KE, Norman GJ, Decety J. Increases in loneliness during medical school are associated with increases in individuals' likelihood of mislabeling emotions as negative. ACTA ACUST UNITED AC 2020; 22:740-750. [PMID: 32597671 DOI: 10.1037/emo0000773] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Expressions of emotion represent an important and unique source of information about the states of others. Being able to effectively understand expressions of emotions to make inferences about others' internal mental states and use these inferences to guide decision-making and behavior is critical to navigating social relationships. Loneliness, the perception that one lacks social connection, has important functional consequences for how individuals attend to signals of emotions in others. However, it is less clear whether loneliness changes how individuals recognize emotions in others. In medical practitioners, being able to accurately recognize emotional cues from patients is critical to effectively diagnosing and reacting with care to those patients. The current study examines the relationship between changes in loneliness during medical school and students' recognition of emotion in others. Measures of loneliness and emotion recognition were collected from 122 medical students during their first 3 years of medical school at the beginning and end of each academic year. Changes in loneliness were related to changes in emotion detection, with increases in loneliness being associated with decreases in the probability of accurately discriminating sad and angry faces from other expressions, decreases in the probability of mislabeling emotion expressions as happy, and increases in the probability of mislabeling other emotional expressions as pained and angry. This study suggests that changes in loneliness during medical school are associated with increases in students' labeling emotional expressions as negative, possibly by shifting attention to cues of negative emotion and away from cues of positive emotion. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Karen E Smith
- Department of Psychology, Integrative Neuroscience Area, University of Chicago
| | | | - Jean Decety
- Department of Psychology, University of Chicago
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Pérez-Fuentes MDC, Herrera-Peco I, Molero Jurado MDM, Oropesa Ruiz NF, Ayuso-Murillo D, Gázquez Linares JJ. A Cross-Sectional Study of Empathy and Emotion Management: Key to a Work Environment for Humanized Care in Nursing. Front Psychol 2020; 11:706. [PMID: 32477202 PMCID: PMC7237745 DOI: 10.3389/fpsyg.2020.00706] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 03/23/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction At the present time, technological advances have increased the technification of healthcare services, in which high priority is given to efficiency and results achieved, leading healthcare personnel to prioritize administrative and procedural aspects to the detriment of humanization of care and the work environment. Objective This study was intended to continue progress in research on the work environment based on the humanization construct by analyzing the explanatory value of emotional intelligence and empathy in nursing personnel. Materials and Methods The study was quantitative, observational, and cross-sectional. The sample was made up of 338 Spanish nurses with a mean age of 32.20 (SD = 7.54; range 22–56). The instruments employed for analysis were the Healthcare Professional Humanization Scale (HUMAS), Brief Emotional Intelligence Inventory for Adults, and Basic Empathy Scale (BES). Results Mood and stress management—both emotional intelligence components—and cognitive empathy explained over half (51%) of the variability found in humanization of care in a sample of nurses. Furthermore, the mediation models proposed emphasized the mediating role of cognitive empathy in stress management and improvement in mood and its relationship to humanization. Conclusion It is recommended that healthcare professionals reinforce their personal competencies in order to tend to the needs of their patients empathetically and improve emotional competencies for coping successfully with potentially stressful situations.
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Affiliation(s)
- María Del Carmen Pérez-Fuentes
- Department of Psychology, Faculty of Psychology, University of Almería, Almería, Spain.,Department of Psychology, Faculty of Psychology, Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Ivan Herrera-Peco
- Nursing Department, Health Sciences Collegue, Alfonso X el Sabio University, Madrid, Spain
| | | | | | | | - José Jesús Gázquez Linares
- Department of Psychology, Faculty of Psychology, University of Almería, Almería, Spain.,Department of Psychology, Faculty of Psychology, Universidad Autónoma de Chile, Santiago, Chile
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