Empathy Indispensable Patient
Running Head: EMPATHY INDISPENSABLE
Empathy - An Indispensable Ingredient
Creola Reese
HHS 307 Communication Skills for Health & Human Service Personnel
Instructor: Tamikia Lott
December 22, 2013
1
EMPATHY INDISPENSABLE
2
Empathy - An Indispensable Ingredient
Is empathy a productive tool to develop effective patient provider communication? How does empathy influence active listening in therapeutic care settings? What role, if any, does empathy play in the delivery of cultural competent health care? This paper will examine the positive impact of empathy in establishing trusting patient-provider therapeutic relationships and the benefits of "putting oneself into another 's shoes."
While "empathy is commonly used but …show more content…
poorly understood," empathy is critical to establish trusting patient provider therapeutic relationships because it improves communication through active listening, promotes cultural awareness, and play a vital role in the delivery of competent quality health care (Van Servellen, 2009). Empathy is an "amazing phenomenal of caring human nature, the capacity to share and understand the patients ' state of mind or emotions and the ability to place oneself into another 's shoes" (Ioannidou & Konstantikaki, 2008). Early
"theoretical writings of prominent psychoanalytic theorists (Feud, Klein, Winnicott, Heiman,
Bion) circled round the subject of empathy without naming it" (Kitron, D. (2011). "Empathy was referred to as bedside manner, expressed and symbolized in joy, sorrow, misery excitement, pain and confusion, enabling health care professionals and patients to work together" (Ioannidou &
Konstantikaki, 2008).
Years ago, there were no cultural awareness and competency lessons taught on how to be sensitive, caring, and compassionate. The ability be understanding and patience was perceived as fundamental humanistic expectation of the physician and health care profession. "Today empathetic communication is a teachable, learnable skill with tangible benefits for both clinician and patient" (Ioannidou & Konstantikaki, 2008). Cultural awareness and competency courses are considered pre requisites in medical schools and the healthcare profession. Scientific disclosure
EMPATHY INDISPENSABLE
3
of empathy over the years has typically resulted from “theoretical elaborations of raw clinical experiences, not the raw clinical data,” (Kitron, D. (2011). However, significant evidence show listening attentively and responding accordingly improves communication, reduces disparities and improves health care outcomes" (Shannon, 2010). Research reveals patient satisfaction, greater treatment adherence, more accurate diagnoses of patients ' conditions and fewer malpractices are likely to result. Empathy has proven patient-provider benefits including, but not limited, showing compassion, establishing a mutual bond of trust, identifying and addressing cultural linguistic needs and eliminating communication barriers and gaps. The deliverance of cultural competent quality healthcare and the establishment of therapeutic patient-provider relationships hinges on empathy. Empathy is an indispensable ingredient and productive tool with the "ability to put oneself into another 's shoes" (Ioannidou & Konstantikaki, 2008).
First, empathy is critical to establishing and maintaining a patient provider therapeutic relationship because it builds trust and improves communication through active listening. "There are many fears in caring for disadvantaged populations: lack of insurance, inadequate access, fears of the medical system, fears of discrimination against, and fears of hospitalization may influence their trust of health providers and the healthcare system" (Van Servellen, 2009). The need to establish trust becomes reliant on the ability of the provider to empathize with the patient. The provider must illustrate genuine caring and understanding necessary for the patient to begin to trust him. "Professional medical ethics demands health care providers, in addition to specific duties and rules of conduct, embody a responsible and trustworthy personality"
(Gelhaus, 2012).
Trust in providers helps patients deal with the fears and uncertainties surrounding their care and conditions. Patient encounters should be built on trust; and they "must feel secure
EMPATHY INDISPENSABLE
4
enough to open up and share intimate personal information. There is a tendency for patients to trust providers when empathy is displayed. "Enhancing intellectual empathy can decrease personal bias and stereotyping and improve the opportunity for developing a therapeutic relationship with the patient" (Dearing & Steadman, 2009). "Patients are more likely to disclose important details about their condition, thoughts, and feelings" (Van Servellen, 2009).
Empathy creates a dialogue for direct questionings to "obtain, clarify, and specify information about the condition of the patient" and leads to therapeutic communication and relationships" (Van Servellen, 2009). Direct questioning is a forum for the provider to gain more accurate information for proper assessment, diagnoses and treatment of the patient 's condition.
Feelings of connectedness reinforces trustworthy of the provider moves the dialogue forward.
The patient is more than willing to supply the provider with pertinent past, and present patient data, history, and background. "The relationship of trust between patient and provider is built on the effectiveness of their communications and is essential to quality treatment care outcomes, particularly to adherence and patient satisfaction" (Van Servellen, 2009).
"Trust is the gateway to communication and involves active listening.”Active listeners practice empathy and together they are capable of reading beyond the expressed idea and into the feelings, attitudes, and beliefs of individuals and resolve conflict" (Van Servellen, 2009).
Empathy bridges the gaps of misunderstanding and misperception thorough active listening and allows the provider to “enter more easily into the client 's world" (Dearing & Steadman, 2009).
Active listening may include non-verbal communications. Non-verbal communication and behaviors can detect clues to patient’s feelings and emotions i.e. confusion, frustration, anxiety, fear, hostility, anger, and depression. Non-verbal behaviors can influence physician and patient relations. “Studies have found physician non-verbal behaviors i.e. eye contact, posture,
EMPATHY INDISPENSABLE
5
tone of voice can be related to patient satisfaction, quality of diagnosis and malpractices” and outcomes” (Dowell & Berman, 2013). Silence is "golden" and gives providers an opportunity to hear what patients have to say, enter their world and to gain a more fully understanding, thus setting the wheels in motion to developing a trusting patient provider relationship. Silence could also be conceived as not listening or rude. "The power in silence provides an unhurried atmosphere for patients to reflect on their experiences in the presence of their provider" (Van
Servellen, 2009). Regardless, it can be agreed sensitivity to patient non-verbal behaviors and communication implies the provider is alert, responsive and caring.
Additionally, empathy is a critical element in promoting cultural awareness and competency. Cultural awareness and competency issues are at the forefront of healthcare due to the rapidly changing demographics of a diverse underrepresented minority patient population.
Cultural linguistic needs and services are needed to provide appropriate quality of care. The intellectual capacity of the provider to comprehend patient 's perception, problem, and coping skills to create informative dialogue to appropriately assess, diagnose and treat the patient is pivotal. Many providers lack cultural competency skills. They fail to understand cultural programming and how their own culture shapes their life views, beliefs, and values with clients of different cultures and racial ethnicities or they lack the time to actively listen. Lack of understanding “cultural programming can hinder effective patient provider communication and create patient distrust" (Shannon, 2010). Active listening becomes an essential tool to gain insight to comprehend various norms and cultural patterns of people from different ethnic backgrounds. Patients need to see professionals as competent and caring individuals. "The need for caring health care providers to understand and support cultural competence has never been
EMPATHY INDISPENSABLE
6
greater because physicians across the country provide serve more patients of racial and ethnic diverse backgrounds than in past decades" (Shannon, 2010). A good health care professional is not just about being brilliant in their field of work rather the cultural awareness of the provider to understand the patient 's language, customs, background, experiences, beliefs and feelings.
The provider must be conscious and cognizant to culturally linguistic habits, behaviors and traditions of patients before trusting relationships can be formed. "Cultural related questions can be sensitive and have a negative effect causing the patient to feel inferior, embarrassed, humiliated or shameful, creating communication barriers between healthcare providers and patients" (Van Servellen, 2009). Culturally linguistic barriers may "hinder effective patientprovider communications by creating patient distrust, conflict and increased disparities"
(Shannon, 2010). Language barriers affect the full disclosure of the patient 's medical and socio cultural background and history. It also prevents patient-provider dialogue from moving forward to accurately assess and diagnose the patient 's condition. "Cultural programming affects everyone 's (patients and providers) behaviors and attitudes and when, what, how and to whom we communicate" (Van Servellen, 2009).
The absence of empathy gives rise to the potential of conflict. Issues of diversity i.e. gender, age, status, ethnicity can result in patient dissatisfaction, lack of trust and lack of adherence to treatment and termination of the patient-provider relationship" (Van Servellen,
2009). Associated internalized conflict related symptoms of stress and tension could have detrimental effects of negative medical and behavioral health outcomes. The ability of the provider "to understand, to blench and to disconnect from their personal feelings (sense of objectivity), is particularly important in creating effective trusting relations" (Ioannidou &
Konstantikaki, 2008).
EMPATHY INDISPENSABLE
7
It is crucial for patients to view providers as non-judgmental and avoid stereotyping patterns based on appearance, cultural and/or social background. Empathy enables cultural competent providers to have a full understanding of cultural programming and equip them with the tools needed to bridge communication barriers and gaps. Patient(s) will respond, trust and communicate more favorably when empathy is displayed and enable providers ' ability to empathetically assess, manage and adapt to the cultural and diversity dynamics of patients.
Patients are more likely to sense a caring heart and disclose pertinent background and history information when empathy is displayed and their culture identity is acknowledged. A series of studies "found a high degree of correlation between patient satisfaction scores and perception of physician empathy; observation of doctors showed more interest in social and psychological aspects of patients" (Bland, 2013). Patients offered more information about their socio-psychological background and issues and were more satisfied with their care. Another study "found patients reported lower levels of anxiety and perceived their general practitioner to have been more empathetic" (Bland, 2013).
Empathy is paramount to the patients feeling human and valued and the ability of the provider to understand the culturally and linguistic needs of patients. Empathy is the linking component needed to build trust, actively listen, understand and appropriately address cultural and linguistic needs, barriers and gaps of patients. Cultural competence is an integral part of patient health care and considered inseparable to effective communication and delivering quality care" (Shannon, 2010).
Finally, empathy plays a vital role in the delivery of competent quality health care. There is "preponderance of evidence regarding the impact empathy has on the delivery of quality health care and important contributions to treatment outcomes such as: patients ' view of the provider
EMPATHY INDISPENSABLE
8
really cares, patient satisfaction, and trust; greater treatment adherence and compliance; and more accurate diagnoses of patients ' conditions, patients ' abilities to process negative information about their diagnoses and treatment, and ability of the provider to shift patients ' negative responses to some level of therapeutic value" (Van Servellen, 2009).
There is no denying "empathy is commonly used but poorly understood concept often confused with related concepts of sympathy and pity" (Van Servellen, 2009). This is significance because the patient 's emotional status is closely associated with physical health outcomes and quality of care. "The actions of sympathy include the inclination to think or feel like another, but the crucial difference is sympathy also includes the display of pity or sadness" (Van Servellen,
2009). Sympathetic people are unable to separate their own feelings from those of the other.
"Sympathy tends to be a reactive response, turning attention to the provider and away from the patient" (Brown, et al., 2009). The distinct difference is "empathy is a preferred skill and sympathy can be considered risk" (Van Servellen, 2009). The benefits of empathy can stand alone. Empathy may not always be easily established and "could be viewed as a …show more content…
double-edged sword, facilitating caring and compassion but at the same time trigger distress in the provider"
(Decety et al. 1680). An otherwise empathetic provider may not be consistently empathic in all patient–provider encounters or they lack the time to actively listen. There are instances the provider can experience feelings of simple burn out and distress from displaying caring emotions
(compassion, sympathy, and/or pity) for patient. Oncologists, hospice and palliative care providers are prime examples because of the traumatic stress and emotions of patients ' eminent demise. It should be noted professional virtues of compassion, sympathy and pity have different functions and can be mistakenly masked as empathy.
EMPATHY INDISPENSABLE
9
Nevertheless, "empathy is a primarily cognitive skill and powerful tool to understand the needs of the patient and a constructive and well-meaning tuning in with the patient without getting lost in the emotions of pity and sympathy" (Gelhaus, 2012).
Showing empathy by listening attentively and responding accordingly improves communication, reduces disparities and improve treatment outcomes" (Shannon, 2010). Patient satisfactions, greater treatment adherence, more accurate diagnoses of patients ' conditions, and fewer malpractices are positively attributions of empathy, indicators of healthy outcomes and the delivery of competent quality health care.
In conclusion empathy is a critical element in the delivery of cultural competent quality health care because it establishes trust need for a therapeutic patient-provider relationship, strengthens communication through active listening, and promotes culture awareness. “Empathy is an important human capability and the ability to understand, to blench and to disconnect from one’s personal feelings” (Ioannidou & Konstantikaki, 2008). Studies demonstrate patients experience "higher levels of trust and greater improvements in social skills in
empathic relationships" (Sale, et al., 2008). Patients will respond, trust and more likely disclose imperative information about their condition, thoughts and feelings when providers are perceived to be caring and empathetic. “Providers are viewed more empathic and treatment more trustworthy when they engage in active listening communication and non-verbal behaviors can influence physician and patient relations” (Dowell & Berman, 2013). Empathy and "cultural awareness is essential to understand cultural programming, establish mutual trusting patient-provide therapeutic relationships, reduce disparities and deliver high quality care" (Shannon, 2010).
Cultural and linguistic patient needs, barriers and gaps are more competently understood and addressed by caring and providers. Empathy have direct therapeutic benefits when patients feel
10
EMPATHY INDISPENSABLE
understood and valued; they offer more information about their past medical and sociopsychological history and background. A reported number of important treatment outcomes are attributed to empathy i.e. patient satisfaction, kept doctor appointments, greater treatment adherence, more accurate diagnoses of patients ' conditions, and fewer malpractices. Empathy comprehensively impacts
trusting
patient-provider
therapeutic
relationships,
improves
communication through active listening, promotes culturally awareness and competency and treatment outcomes. Final word, the delivery of quality healthcare, hinges on empathy, an indispensable ingredient and productive tool, with the “ability to put oneself into another 's shoes"
(Ioannidou & Konstantikaki, 2008).
11
EMPATHY INDISPENSABLE
References:
Bland, P. (2013). Patients of Empathetic GPs Have Better Outcomes. Practitioner, 257(1761), 5.
Retrieved from http://search.proquest.com/docview/1427460494?accountid=32521.
Brown, P., Calnan, M., Scrivener, A., & Szmukler, G. (2009). Trust in Mental Health: A
Neglected Concept. Journal of Mental Health, 18(5), 449-458. Retrieved from the
EBSCOhost database.
Dearing, Karen S, PhD., A.P.R.N., & Steadman, Sheryl, PhD., A.P.R.N. (2009). Enhancing
Intellectual Empathy: The lived Experience of Voice Stimulation. Perspectives in
Psychiatric Care, 45(3), 173-82. Retrieved from http://search.proquest.com/docview/200769554?accountid=32521. Dowell, N. M., & Berman, J. S. (2013). Therapist Nonverbal Behavior and Perceptions of
Empathy, Alliance, and Treatment Credibility. Journal of Psychotherapy Integration,
23(2), 158-165. doi:10.1037/a0031421.
Gelhaus, P. (2012). The Desired Moral Attitude of the Physician: (II) compassion. Medicine,
Health Care, and Philosophy, 15(4), 397-410. doi:http://dx.doi.org/10.1007/s11019-0119368-2.
Ioannidou, F., & Konstantikaki, V. (2008). Empathy and Emotional Intelligence: What is it
Really About? International Journal of Caring Sciences, 1(3), 118-123. Retrieved from http://search.proquest.com/docview/1112231766?accountid=32521. Kitron, D. (2011). Empathy - The Indispensable Ingredient in the Impossible Profession.
Psychoanalytic Inquiry, 31(1), 17-27. doi:10.1080/07351690.2010.512845.
Sale, E., Bellamy, N., Springer, J. F., & Wang, M. Q. (2008). Quality of Provider-Participant
Relationships and Enhancement of Adolescent Social Skills. Journal of Primary
EMPATHY INDISPENSABLE
12
Prevention, 29(3), 263-78. doi:http://dx.doi.org/10.1007/s10935-008-0138-8.
Shannon, D., M.D. (2010). Cultural competency in health care organizations: Why and How?
Physician Executive, 36(5), 18-22. Retrieved from http://search.proquest.com/docview/755266653?accountid=32521. Van Servellen, Gwen (2009). Communication Skills for the Health Care Professional: Concept,
Practice, and Evidence (2nd ed). Sudbury, Massachusetts: Jones and Bartlett.
Empathy - An Indispensable Ingredient
Creola Reese
HHS 307 Communication Skills for Health & Human Service Personnel
Instructor: Tamikia Lott
December 22, 2013
1
EMPATHY INDISPENSABLE
2
Empathy - An Indispensable Ingredient
Is empathy a productive tool to develop effective patient provider communication? How does empathy influence active listening in therapeutic care settings? What role, if any, does empathy play in the delivery of cultural competent health care? This paper will examine the positive impact of empathy in establishing trusting patient-provider therapeutic relationships and the benefits of "putting oneself into another 's shoes."
While "empathy is commonly used but …show more content…
poorly understood," empathy is critical to establish trusting patient provider therapeutic relationships because it improves communication through active listening, promotes cultural awareness, and play a vital role in the delivery of competent quality health care (Van Servellen, 2009). Empathy is an "amazing phenomenal of caring human nature, the capacity to share and understand the patients ' state of mind or emotions and the ability to place oneself into another 's shoes" (Ioannidou & Konstantikaki, 2008). Early
"theoretical writings of prominent psychoanalytic theorists (Feud, Klein, Winnicott, Heiman,
Bion) circled round the subject of empathy without naming it" (Kitron, D. (2011). "Empathy was referred to as bedside manner, expressed and symbolized in joy, sorrow, misery excitement, pain and confusion, enabling health care professionals and patients to work together" (Ioannidou &
Konstantikaki, 2008).
Years ago, there were no cultural awareness and competency lessons taught on how to be sensitive, caring, and compassionate. The ability be understanding and patience was perceived as fundamental humanistic expectation of the physician and health care profession. "Today empathetic communication is a teachable, learnable skill with tangible benefits for both clinician and patient" (Ioannidou & Konstantikaki, 2008). Cultural awareness and competency courses are considered pre requisites in medical schools and the healthcare profession. Scientific disclosure
EMPATHY INDISPENSABLE
3
of empathy over the years has typically resulted from “theoretical elaborations of raw clinical experiences, not the raw clinical data,” (Kitron, D. (2011). However, significant evidence show listening attentively and responding accordingly improves communication, reduces disparities and improves health care outcomes" (Shannon, 2010). Research reveals patient satisfaction, greater treatment adherence, more accurate diagnoses of patients ' conditions and fewer malpractices are likely to result. Empathy has proven patient-provider benefits including, but not limited, showing compassion, establishing a mutual bond of trust, identifying and addressing cultural linguistic needs and eliminating communication barriers and gaps. The deliverance of cultural competent quality healthcare and the establishment of therapeutic patient-provider relationships hinges on empathy. Empathy is an indispensable ingredient and productive tool with the "ability to put oneself into another 's shoes" (Ioannidou & Konstantikaki, 2008).
First, empathy is critical to establishing and maintaining a patient provider therapeutic relationship because it builds trust and improves communication through active listening. "There are many fears in caring for disadvantaged populations: lack of insurance, inadequate access, fears of the medical system, fears of discrimination against, and fears of hospitalization may influence their trust of health providers and the healthcare system" (Van Servellen, 2009). The need to establish trust becomes reliant on the ability of the provider to empathize with the patient. The provider must illustrate genuine caring and understanding necessary for the patient to begin to trust him. "Professional medical ethics demands health care providers, in addition to specific duties and rules of conduct, embody a responsible and trustworthy personality"
(Gelhaus, 2012).
Trust in providers helps patients deal with the fears and uncertainties surrounding their care and conditions. Patient encounters should be built on trust; and they "must feel secure
EMPATHY INDISPENSABLE
4
enough to open up and share intimate personal information. There is a tendency for patients to trust providers when empathy is displayed. "Enhancing intellectual empathy can decrease personal bias and stereotyping and improve the opportunity for developing a therapeutic relationship with the patient" (Dearing & Steadman, 2009). "Patients are more likely to disclose important details about their condition, thoughts, and feelings" (Van Servellen, 2009).
Empathy creates a dialogue for direct questionings to "obtain, clarify, and specify information about the condition of the patient" and leads to therapeutic communication and relationships" (Van Servellen, 2009). Direct questioning is a forum for the provider to gain more accurate information for proper assessment, diagnoses and treatment of the patient 's condition.
Feelings of connectedness reinforces trustworthy of the provider moves the dialogue forward.
The patient is more than willing to supply the provider with pertinent past, and present patient data, history, and background. "The relationship of trust between patient and provider is built on the effectiveness of their communications and is essential to quality treatment care outcomes, particularly to adherence and patient satisfaction" (Van Servellen, 2009).
"Trust is the gateway to communication and involves active listening.”Active listeners practice empathy and together they are capable of reading beyond the expressed idea and into the feelings, attitudes, and beliefs of individuals and resolve conflict" (Van Servellen, 2009).
Empathy bridges the gaps of misunderstanding and misperception thorough active listening and allows the provider to “enter more easily into the client 's world" (Dearing & Steadman, 2009).
Active listening may include non-verbal communications. Non-verbal communication and behaviors can detect clues to patient’s feelings and emotions i.e. confusion, frustration, anxiety, fear, hostility, anger, and depression. Non-verbal behaviors can influence physician and patient relations. “Studies have found physician non-verbal behaviors i.e. eye contact, posture,
EMPATHY INDISPENSABLE
5
tone of voice can be related to patient satisfaction, quality of diagnosis and malpractices” and outcomes” (Dowell & Berman, 2013). Silence is "golden" and gives providers an opportunity to hear what patients have to say, enter their world and to gain a more fully understanding, thus setting the wheels in motion to developing a trusting patient provider relationship. Silence could also be conceived as not listening or rude. "The power in silence provides an unhurried atmosphere for patients to reflect on their experiences in the presence of their provider" (Van
Servellen, 2009). Regardless, it can be agreed sensitivity to patient non-verbal behaviors and communication implies the provider is alert, responsive and caring.
Additionally, empathy is a critical element in promoting cultural awareness and competency. Cultural awareness and competency issues are at the forefront of healthcare due to the rapidly changing demographics of a diverse underrepresented minority patient population.
Cultural linguistic needs and services are needed to provide appropriate quality of care. The intellectual capacity of the provider to comprehend patient 's perception, problem, and coping skills to create informative dialogue to appropriately assess, diagnose and treat the patient is pivotal. Many providers lack cultural competency skills. They fail to understand cultural programming and how their own culture shapes their life views, beliefs, and values with clients of different cultures and racial ethnicities or they lack the time to actively listen. Lack of understanding “cultural programming can hinder effective patient provider communication and create patient distrust" (Shannon, 2010). Active listening becomes an essential tool to gain insight to comprehend various norms and cultural patterns of people from different ethnic backgrounds. Patients need to see professionals as competent and caring individuals. "The need for caring health care providers to understand and support cultural competence has never been
EMPATHY INDISPENSABLE
6
greater because physicians across the country provide serve more patients of racial and ethnic diverse backgrounds than in past decades" (Shannon, 2010). A good health care professional is not just about being brilliant in their field of work rather the cultural awareness of the provider to understand the patient 's language, customs, background, experiences, beliefs and feelings.
The provider must be conscious and cognizant to culturally linguistic habits, behaviors and traditions of patients before trusting relationships can be formed. "Cultural related questions can be sensitive and have a negative effect causing the patient to feel inferior, embarrassed, humiliated or shameful, creating communication barriers between healthcare providers and patients" (Van Servellen, 2009). Culturally linguistic barriers may "hinder effective patientprovider communications by creating patient distrust, conflict and increased disparities"
(Shannon, 2010). Language barriers affect the full disclosure of the patient 's medical and socio cultural background and history. It also prevents patient-provider dialogue from moving forward to accurately assess and diagnose the patient 's condition. "Cultural programming affects everyone 's (patients and providers) behaviors and attitudes and when, what, how and to whom we communicate" (Van Servellen, 2009).
The absence of empathy gives rise to the potential of conflict. Issues of diversity i.e. gender, age, status, ethnicity can result in patient dissatisfaction, lack of trust and lack of adherence to treatment and termination of the patient-provider relationship" (Van Servellen,
2009). Associated internalized conflict related symptoms of stress and tension could have detrimental effects of negative medical and behavioral health outcomes. The ability of the provider "to understand, to blench and to disconnect from their personal feelings (sense of objectivity), is particularly important in creating effective trusting relations" (Ioannidou &
Konstantikaki, 2008).
EMPATHY INDISPENSABLE
7
It is crucial for patients to view providers as non-judgmental and avoid stereotyping patterns based on appearance, cultural and/or social background. Empathy enables cultural competent providers to have a full understanding of cultural programming and equip them with the tools needed to bridge communication barriers and gaps. Patient(s) will respond, trust and communicate more favorably when empathy is displayed and enable providers ' ability to empathetically assess, manage and adapt to the cultural and diversity dynamics of patients.
Patients are more likely to sense a caring heart and disclose pertinent background and history information when empathy is displayed and their culture identity is acknowledged. A series of studies "found a high degree of correlation between patient satisfaction scores and perception of physician empathy; observation of doctors showed more interest in social and psychological aspects of patients" (Bland, 2013). Patients offered more information about their socio-psychological background and issues and were more satisfied with their care. Another study "found patients reported lower levels of anxiety and perceived their general practitioner to have been more empathetic" (Bland, 2013).
Empathy is paramount to the patients feeling human and valued and the ability of the provider to understand the culturally and linguistic needs of patients. Empathy is the linking component needed to build trust, actively listen, understand and appropriately address cultural and linguistic needs, barriers and gaps of patients. Cultural competence is an integral part of patient health care and considered inseparable to effective communication and delivering quality care" (Shannon, 2010).
Finally, empathy plays a vital role in the delivery of competent quality health care. There is "preponderance of evidence regarding the impact empathy has on the delivery of quality health care and important contributions to treatment outcomes such as: patients ' view of the provider
EMPATHY INDISPENSABLE
8
really cares, patient satisfaction, and trust; greater treatment adherence and compliance; and more accurate diagnoses of patients ' conditions, patients ' abilities to process negative information about their diagnoses and treatment, and ability of the provider to shift patients ' negative responses to some level of therapeutic value" (Van Servellen, 2009).
There is no denying "empathy is commonly used but poorly understood concept often confused with related concepts of sympathy and pity" (Van Servellen, 2009). This is significance because the patient 's emotional status is closely associated with physical health outcomes and quality of care. "The actions of sympathy include the inclination to think or feel like another, but the crucial difference is sympathy also includes the display of pity or sadness" (Van Servellen,
2009). Sympathetic people are unable to separate their own feelings from those of the other.
"Sympathy tends to be a reactive response, turning attention to the provider and away from the patient" (Brown, et al., 2009). The distinct difference is "empathy is a preferred skill and sympathy can be considered risk" (Van Servellen, 2009). The benefits of empathy can stand alone. Empathy may not always be easily established and "could be viewed as a …show more content…
double-edged sword, facilitating caring and compassion but at the same time trigger distress in the provider"
(Decety et al. 1680). An otherwise empathetic provider may not be consistently empathic in all patient–provider encounters or they lack the time to actively listen. There are instances the provider can experience feelings of simple burn out and distress from displaying caring emotions
(compassion, sympathy, and/or pity) for patient. Oncologists, hospice and palliative care providers are prime examples because of the traumatic stress and emotions of patients ' eminent demise. It should be noted professional virtues of compassion, sympathy and pity have different functions and can be mistakenly masked as empathy.
EMPATHY INDISPENSABLE
9
Nevertheless, "empathy is a primarily cognitive skill and powerful tool to understand the needs of the patient and a constructive and well-meaning tuning in with the patient without getting lost in the emotions of pity and sympathy" (Gelhaus, 2012).
Showing empathy by listening attentively and responding accordingly improves communication, reduces disparities and improve treatment outcomes" (Shannon, 2010). Patient satisfactions, greater treatment adherence, more accurate diagnoses of patients ' conditions, and fewer malpractices are positively attributions of empathy, indicators of healthy outcomes and the delivery of competent quality health care.
In conclusion empathy is a critical element in the delivery of cultural competent quality health care because it establishes trust need for a therapeutic patient-provider relationship, strengthens communication through active listening, and promotes culture awareness. “Empathy is an important human capability and the ability to understand, to blench and to disconnect from one’s personal feelings” (Ioannidou & Konstantikaki, 2008). Studies demonstrate patients experience "higher levels of trust and greater improvements in social skills in
empathic relationships" (Sale, et al., 2008). Patients will respond, trust and more likely disclose imperative information about their condition, thoughts and feelings when providers are perceived to be caring and empathetic. “Providers are viewed more empathic and treatment more trustworthy when they engage in active listening communication and non-verbal behaviors can influence physician and patient relations” (Dowell & Berman, 2013). Empathy and "cultural awareness is essential to understand cultural programming, establish mutual trusting patient-provide therapeutic relationships, reduce disparities and deliver high quality care" (Shannon, 2010).
Cultural and linguistic patient needs, barriers and gaps are more competently understood and addressed by caring and providers. Empathy have direct therapeutic benefits when patients feel
10
EMPATHY INDISPENSABLE
understood and valued; they offer more information about their past medical and sociopsychological history and background. A reported number of important treatment outcomes are attributed to empathy i.e. patient satisfaction, kept doctor appointments, greater treatment adherence, more accurate diagnoses of patients ' conditions, and fewer malpractices. Empathy comprehensively impacts
trusting
patient-provider
therapeutic
relationships,
improves
communication through active listening, promotes culturally awareness and competency and treatment outcomes. Final word, the delivery of quality healthcare, hinges on empathy, an indispensable ingredient and productive tool, with the “ability to put oneself into another 's shoes"
(Ioannidou & Konstantikaki, 2008).
11
EMPATHY INDISPENSABLE
References:
Bland, P. (2013). Patients of Empathetic GPs Have Better Outcomes. Practitioner, 257(1761), 5.
Retrieved from http://search.proquest.com/docview/1427460494?accountid=32521.
Brown, P., Calnan, M., Scrivener, A., & Szmukler, G. (2009). Trust in Mental Health: A
Neglected Concept. Journal of Mental Health, 18(5), 449-458. Retrieved from the
EBSCOhost database.
Dearing, Karen S, PhD., A.P.R.N., & Steadman, Sheryl, PhD., A.P.R.N. (2009). Enhancing
Intellectual Empathy: The lived Experience of Voice Stimulation. Perspectives in
Psychiatric Care, 45(3), 173-82. Retrieved from http://search.proquest.com/docview/200769554?accountid=32521. Dowell, N. M., & Berman, J. S. (2013). Therapist Nonverbal Behavior and Perceptions of
Empathy, Alliance, and Treatment Credibility. Journal of Psychotherapy Integration,
23(2), 158-165. doi:10.1037/a0031421.
Gelhaus, P. (2012). The Desired Moral Attitude of the Physician: (II) compassion. Medicine,
Health Care, and Philosophy, 15(4), 397-410. doi:http://dx.doi.org/10.1007/s11019-0119368-2.
Ioannidou, F., & Konstantikaki, V. (2008). Empathy and Emotional Intelligence: What is it
Really About? International Journal of Caring Sciences, 1(3), 118-123. Retrieved from http://search.proquest.com/docview/1112231766?accountid=32521. Kitron, D. (2011). Empathy - The Indispensable Ingredient in the Impossible Profession.
Psychoanalytic Inquiry, 31(1), 17-27. doi:10.1080/07351690.2010.512845.
Sale, E., Bellamy, N., Springer, J. F., & Wang, M. Q. (2008). Quality of Provider-Participant
Relationships and Enhancement of Adolescent Social Skills. Journal of Primary
EMPATHY INDISPENSABLE
12
Prevention, 29(3), 263-78. doi:http://dx.doi.org/10.1007/s10935-008-0138-8.
Shannon, D., M.D. (2010). Cultural competency in health care organizations: Why and How?
Physician Executive, 36(5), 18-22. Retrieved from http://search.proquest.com/docview/755266653?accountid=32521. Van Servellen, Gwen (2009). Communication Skills for the Health Care Professional: Concept,
Practice, and Evidence (2nd ed). Sudbury, Massachusetts: Jones and Bartlett.