The development of empathy in the healthcare setting: a qualitative approach

Cultural awareness scale: psychometric properties and applicability in assessing cultural competence among polish nursing students

BACKGROUND

Cultural competence is an essential skill for nursing students to provide effective care in multicultural healthcare settings. Despite the availability of various tools globally, there are limited number of validated instruments for assessing cultural awareness among nursing students in Poland. This study aimed to culturally and linguistically adapt the Cultural Awareness Scale (CAS) to the Polish context and evaluate its psychometric properties.

MATERIALS AND METHODS

A cross-sectional, web-based survey was conducted between May and June 2024 among 1,020 nursing students from nine Polish medical universities. The CAS was translated and adapted following WHO guidelines for cultural and linguistic adaptation. Psychometric evaluation included exploratory and confirmatory factor analyses (EFA, CFA), reliability testing using Cronbach's alpha and McDonald's omega, and assessments of validity, including convergent and known-groups validity.

RESULTS

The Polish version of the CAS (CAS_P) demonstrated high reliability, with a Cronbach's alpha of 0.892 and McDonald's omega of 0.908. EFA confirmed the multidimensional structure of the scale, while CFA indicated moderate model fit (CFI = 0.797, TLI = 0.781, RMSEA = 0.0735). Convergent validity analysis showed significant correlations between CAS domains and personality traits such as altruism and openness to experience (p < 0.001). Known-groups validity analysis revealed that nursing students with prior intercultural education scored significantly higher on all CAS domains (p < 0.05), highlighting the impact of formal training on cultural awareness. The Behaviors/Comfort with Interactions subscale showed lower reliability (Cronbach's alpha = 0.592), suggesting cultural-specific variations in responses.

CONCLUSIONS

The CAS_P is a reliable and valid instrument for assessing cultural awareness among Polish nursing students. Its implementation can guide curriculum development and enhance intercultural competence in nursing education. Further refinements are necessary to improve the scale's sensitivity to local cultural contexts.

CLINICAL TRIAL NUMBER

Not applicable.

Exploring Pain Empathy Among Doctors, Nurses and Patients: A Scoping Review

Purpose

This review aims to systematically assess the existing body of research on pain empathy among healthcare workers and patients, with the goal of enhancing both understanding and clinical application.

Methods

Studies were retrieved from seven databases: PubMed, EBSCO, The Cochrane Library, Embase, CBM, CNKI, and Wanfang, with a search date limit from database inception to September 13, 2024. Inclusion and exclusion criteria were established based on the PCCs (Population, Concept, Context, Study design) principle. The research was independently screened and summarized by two researchers. A pre-designed data extraction form was used for information extraction from the included studies.

Results

A total of 4729 studies were initially identified, with 50 studies included after screening. The participants were categorized into six groups: pain patients, nurses, patients with neurological diseases, cancer patients, patients with psychiatric disorders, doctors, and medical students. The studies employed 75 distinct research tools, including the Empathy for Pain Scale (EPS), the Interpersonal Reactivity Index (IRI), pain empathy paradigms, and the Visual Analogue Scale (VAS), along with various detection technologies, such as functional magnetic resonance imaging (fMRI) and electroencephalography (EEG). Factors influencing pain empathy included psychological factors, individual traits, and social influences. Mechanistic studies explored the neural substrates of emotional empathy (anterior insula, anterior cingulate cortex, amygdala), cognitive empathy (precuneus and parietal-occipital junction), the relationship between emotional regulation and cognitive processing, and the synergistic interactions of multiple brain regions.

Conclusion

This review offers a comprehensive overview of research on pain empathy among healthcare workers and patients, emphasizing its multidisciplinary nature and complexity. It provides theoretical foundations and outlines potential directions for future research, which may include the adoption of unified research standards, interdisciplinary collaboration, the application of advanced technologies, and cross-cultural studies to further advance the field of pain empathy.

Family caregivers' experience of caring for patients undergoing hemodialysis: A qualitative study at Muhimbili National Hospital in Dar es Salaam, Tanzania

BACKGROUND

The number of patients with chronic kidney disease requiring hemodialysis services is growing in Tanzania. Considering patients undergoing hemodialysis are outpatients, family caregivers fill the gap of caring and support during the lifelong treatment process. Limited information exists especially in the context of Tanzania regarding the challenges the family caregivers encounter during their involvement in the caring process. This study aimed to explore family caregivers' experience of caring for patients undergoing hemodialysis at Muhimbili National Hospital, Dar es Salaam, Tanzania.

METHODS

A qualitative study employing phenomenological design was conducted. Fourteen family caregivers of patients receiving hemodialysis services at Muhimbili National Hospital were purposively selected. Semi-structured in-depth interviews were used for data collection. Interviews were audio-recorded and transcribed verbatim. Data were analyzed following Braun and Clarke's six phases of thematic analysis.

RESULTS

The study uncovered four key themes from fourteen interviews. The themes were: 1) Family caregivers and providers' interaction, focusing on interpersonal and professional relationships 2) The status of dialysis treatment, describing access and availability of resources for the provision of hemodialysis services 3) Impact of long-term care, touching issues of emotional, physical and social-economic impact to family members and 4) Coping with caring, describing internal and external mechanisms family members use to adjust to demanding situation of caring their loved ones.

CONCLUSION

Caring for patients receiving hemodialysis treatment burdens family caregivers, impacting their livelihood and resources. Healthcare providers need to build a close working relationship with family caregivers to understand their challenges and needs and help build their coping capacities. Additionally, dialysis service coverage issues such as affordability, accessibility, and availability need to be addressed to reduce the caring burden on family caregivers.

Determining the Relationship Between Surgical Nurses' Empathy Skills and Their Knowledge of and Attitudes to Pain

PURPOSE

This study aimed to determine the relationship between surgical nurses' empathy skills and their knowledge of and attitudes to pain.

DESIGN

A quantitative, correlational research study design, one of the quantitative methods, was employed.

METHODS

The study was conducted between March and August 2024 in the surgical units (surgical clinics, operating rooms, and intensive care units) of a research and practice hospital and a city hospital with 242 nurses in the central county of a province in Türkiye. Data were collected using a Nurse Information Form, the Pain Knowledge and Attitudes Survey, and the Basic Empathy Scale.

RESULTS

The mean scores were 16.38 ± 4.65 (40.01%) for pain knowledge and attitudes, 29.25 ± 6.48 for cognitive empathy, and 32.66 ± 5.78 for emotional empathy. Positive correlations were found between pain knowledge and attitudes scores and cognitive (r = 0.156) and emotional empathy scores (r = 0.271), (P < .05). Negative correlations existed between age, work experience, and empathy scores (P < .001). Age and work experience had a negative correlations with empathy scores (P < .001). Empathy levels varied significantly by education, prior pain and empathy knowledge, surgery, and acute pain experience (P < .05). Regression analysis indicated that pain knowledge and attitude scores explained 56.8% of the variance in cognitive empathy and 59.5% in emotional empathy (P < .01).

CONCLUSIONS

Study results indicated that nurses' pain knowledge and attitudes were inadequate and that there was a positive relationship between pain knowledge and attitudes scores and empathy levels. In this context, in-service training programs should be revised to include pain management and empathy in detail. Effective multimodal education strategies like case studies and simulations are recommended to enhance knowledge and skills in pain management and empathy.

Post-mastectomy wound care - need for an empathetic approach

Mastectomy, a surgical procedure involving the removal of breast tissue, is a common treatment option for breast cancer. Post treatment, survivors often experience both physical and psychological symptoms, which in turn delay the recovery phase. Post-mastectomy wound complications, such as infection, pain, delayed healing, seroma formation, persistent discomfort and limited mobility often lead to prolonged hospital stays and reduced quality of life. Proper wound care, including dressing changes and wound management, is crucial for optimal healing. However, mastectomy also has a significant emotional and psychological impact on patients, leading to depression, anxiety, and poor body image due to significant changes in the body such as loss of hair, unsightly scars and weight changes. Patients also feel uncomfortable when medical professionals concentrate solely on survival, rather than empathizing with them. While these emotional reactions are often expected and considered normal during breast cancer treatment, what comes as a surprise is the additional harm caused by healthcare providers' communication and behaviour when treating breast cancer patients. Despite advances in medical technology, there remains a significant gap in providing psychosocial support for breast cancer survivors. Undergoing a mastectomy is an emotionally challenging experience, and healthcare providers play a vital role in establishing the groundwork for psychological recuperation. By incorporating empathetic practices into daily patient care, healthcare providers can be trained to create an unbiased, informative, and compassionate environment, to improve patient outcomes and satisfaction. The use of compassionate communication when interacting with the patient and their care givers can foster a more nurturing atmosphere for all parties involved. By prioritizing empathy in post-mastectomy wound care, healthcare providers can enhance the overall well-being of breast cancer survivors. This review explores the physical and emotional impact of mastectomy on patients, the healing process, and the importance of integrating empathy into post-mastectomy wound care.

Interpersonal sensitivity and its associated factors among nursing students during the COVID-19 pandemic: a network analysis

BACKGROUND

Interpersonal sensitivity is a crucial individual characteristic, particularly for young nursing students. However, limited research has specifically examined interpersonal sensitivity in nursing students. This study aimed to employ network analysis to investigate the interconnectedness of interpersonal sensitivity and its associated factors among nursing students during the COVID-19 pandemic.

METHODS

Network analysis was employed to explore the network structure. The first network model was developed to evaluate interpersonal sensitivity. The second network model was constructed to investigate the associations between interpersonal sensitivity and variables that were found to be statistically significant in the multivariable linear regression model.

RESULTS

A total of 864 nursing students participated in the study. The strongest nodes in assessing interpersonal sensitivity among nursing students encompass three distinct aspects: compliments, genuine understanding, and criticism. The multivariate linear regression analysis revealed significant associations between interpersonal sensitivity and various factors, including openness (β = 0.67), anxiety symptoms (β = 0.45), well-being (β = -0.63), loneliness (β = 1.55), and perceived social support (β = 0.66).

CONCLUSIONS

This study yields valuable insights into the phenomenon of interpersonal sensitivity among nursing students amid the COVID-19 pandemic. These findings emphasize the significance of incorporating targeted interventions addressing these factors into nursing education curricula.

The neuroscience of compassion: a scoping review of the literature on the neuroscience of compassion and compassion-related therapies

OBJECTIVES

Compassion is the emotion that motivates people to relieve the physical, emotional, or mental pains of others. Engaging in compassionate behaviour has been found to enhance psychological wellness and resilience. However, constant displays of compassionate behaviour can lead to burnout particularly for healthcare workers who inherently practise compassion day to day. This burnout can be relieved by Compassion focused meditation. The aim of this review is to identify neuroplastic changes in the brain associated with meditation, with a focus on compassion and compassion related meditation.

METHODS

Based on PRISMA guidelines, we conducted a scoping review of studies which described neuroplastic effects of meditation, focusing on compassion-based training. Studies were excluded if they (i) included multiple meditation practices or (ii) included participant populations with psychiatric/neuropsychiatric history (except anxiety or depression) or (iii) included exclusively ageing populations.

RESULTS

The results of the reviewed studies showed various neurological changes in regions of the brain as a result of compassion based training. These regions include amygdala, the anterior insula, medial prefrontal cortex, medial orbitofrontal cortex and structures within the dopamine system.

CONCLUSION

This review highlights that compassion-based training could lead to neuroplastic changes which interconnect to enhance overall well-being, resilience and compassionate care among health-care professionals. However, further work is required to establish conclusive evidence of its sustained benefit and cost-effectiveness, as well as its utility in a healthcare setting.

ChatGPT-4o and 4o1 Preview as Dietary Support Tools in a Real-World Medicated Obesity Program: A Prospective Comparative Analysis

BACKGROUND/OBJECTIVES

Clinicians are becoming increasingly interested in the use of large language models (LLMs) in obesity services. While most experts agree that LLM integration would increase access to obesity care and its efficiency, many remain skeptical of their scientific accuracy and capacity to convey human empathy. Recent studies have shown that ChatGPT-3 models are capable of emulating human dietitian responses to a range of basic dietary questions.

METHODS

This study compared responses of two ChatGPT-4o models to those from human dietitians across 10 complex questions (5 broad; 5 narrow) derived from patient-clinician interactions within a real-world medicated digital weight loss service.

RESULTS

Investigators found that neither ChatGPT-4o nor Chat GPT-4o1 preview were statistically outperformed (p < 0.05) by human dietitians on any of the study's 10 questions. The same finding was made when scores were aggregated from the ten questions across the following four individual study criteria: scientific correctness, comprehensibility, empathy/relatability, and actionability.

CONCLUSIONS

These results provide preliminary evidence that advanced LLMs may be able to play a significant supporting role in medicated obesity services. Research in other obesity contexts is needed before any stronger conclusions are made about LLM lifestyle coaching and whether such initiatives increase care access.

The impact of affective and cognitive empathy on stress in medical students

OBJECTIVE

To analyze the relationship between empathy and its domains (i.e., affective and cognitive) and stress in medical students.

METHODS

An online cross-sectional study with 543 medical students as respondents divided in three groups: pre-clinical cycle (n = 173), clinical cycle (n = 197), and internship (n = 173). The participants completed the sociodemographic questionnaire, the Interpersonal Reactivity Index, and the Perceived stress scale.

RESULTS

The participants were mostly female (71.5%) with an average age of 23.54 (± 4.54) years old. Medical students in the clinical cycle, when compared to the ones in their pre-clinical cycle and internship, showed higher stress levels. Pre-clinical students presented higher levels of total empathy and its affective domain. The highest levels of empathy, especially affective empathy, were associated with higher stress levels in all three groups. Regarding cognitive empathy, there was no observed association with stress among the groups.

CONCLUSIONS

The levels of empathy and its affective domain correlated significantly with the stress indicators among students of different cycles (i.e., pre-clinical, clinical cycle, and internship).

Balancing the Scalpel and the Heart: A Neurosurgeon's Guide to Empathy

Empathy is a basic core human characteristic, the foundation for social relationships and interpersonal attachment. In medicine, particularly in neurosurgery, empathy goes beyond the concept of clinical neutrality and emerges as a guiding philosophy to form patient-centered care. Neurosurgical patients, who are often handling complex, life-changing pathologies, benefit greatly from empathetic reassurances that diminish their anxiety and establish a more robust patient-clinician connection. However, constructs of modern healthcare that undermine empathy include the very high value placed on time, oppressive workloads, inadequate staffing, and performance-driven cultures that can reduce compassion to nothing more than a secondary concern. The evidence underscores that empathy helps to improve patient satisfaction, treatment adherence, and development of strong therapeutic alliances. An empathic practice also helps the clinician in being protective against burnout, building emotional resilience, and the induction of reflection in self-assessment-all beneficial for his or her mental health. Indeed, another obvious and serious decrease in empathy has been detected with the increasing years of training in trainees and practitioners, as well as in clinical environments. The institutions need to have adequate staffing, the best flow processes, and empathetic leadership from the front, really prioritizing emotional well-being. Teaching empathy in medical school and during residency is critical, so our future physicians understand its importance. Empathy is further consolidated by ongoing professional training in communication skills and emotional intelligence and self-care strategies. Neurosurgery, as a high-demand and tough surgical discipline, can benefit the most from a culture of empathy.

Exploring Nursing Students' Experiences of Empathy and User Experiences in an Immersive Virtual Reality Simulation Game: Cross-Sectional Study

BACKGROUND

Empathy is associated with better clinical outcomes and patient-care experiences, and it has been demonstrated that training can improve nursing students' empathy. The use of virtual reality (VR) as an experiential learning strategy may increase the empathetic behavior of caregivers. Although much research exists on the use of VR in education, there is still little research on learning empathy in nursing education through immersive VR games that include a head-mounted display and hand controllers. In addition, it is important to study both learning and user experiences in nursing education that utilizes VR technology.

OBJECTIVE

This study aims to explore nursing students' experiences of empathy and user experiences in an immersive VR simulation game.

METHODS

A cross-sectional design was used. A total of 52 graduating nursing students from 3 universities of applied sciences in Finland participated in the study. The immersive VR simulation game employed in the study was played with a head-mounted display and hand controllers. The instruments used were the Basic Empathy Scale in Adults (BES-A) before the VR simulation gaming session and the Comprehensive State Empathy Scale (CSES) and AttrakDiff 2.0 Scale after the session.

RESULTS

The students' overall level of empathy experienced in the immersive VR simulation game was favorable (CSES; mean 2.9, SD 0.57). Participants who had a higher level of empathy (BES-A) before playing the immersive VR simulation game also experienced slightly more feelings of empathy after playing (CSES). However, the association between the measures was not statistically significant (r=0.187, P=.18). The overall empathy (CSES) experienced in the immersive VR simulation game was positively correlated with its subscales. The use of the VR simulation provided a positive user experience in all 4 factors of the AttrakDiff 2.0 Scale. Overall User Experience and Emotion Sharing correlated negatively (r=-0.248, P=.042), as did Attractiveness and Emotion Sharing (r=-0.327, P=.018). Hedonic Quality Stimulation correlated negatively with Cognitive Empathy (r=-0.279, P=.045).

CONCLUSIONS

The results of this study indicate that the use of an immersive VR simulation game in nursing education as a means of increasing empathy seems promising and justified. The immersive VR simulation game offered positive user experiences, which further supported the idea of implementing it in education. However, more research is needed on what kinds of VR environments are the most effective in promoting empathy among nursing students. Furthermore, when using VR technology in learning, one should consider that the VR setting must not be too technical but rather simple, straightforward, and predictable.

Improving GPs' Emotional Intelligence and Resilience to Better Manage Chronic Respiratory Diseases Through an Experiential Online Training Intervention: A Mixed Methods Study

BACKGROUND/OBJECTIVES

High levels of emotional intelligence (EI) and resilience in primary care physicians (PCPs) can help them communicate better with patients, build stronger relationships with colleagues, and foster a positive and collaborative workplace. However, studies have indicated that primary care physicians (PCPs) often do not focus enough on developing these skills. Consequently, the purpose of this mixed methods study was to evaluate the effectiveness of an experiential online training (EOT) intervention in enhancing the EI and resilience of PCPs who treat patients with chronic respiratory diseases (CRDs).

METHODS

A total of 46 PCPs from Greece participated in a 25-hour EOT program, which focused on counseling skills for lifestyle change and breathing techniques for self-regulation. Quantitative data were collected using the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF) and the Connor-Davidson Resilience Scale (CD-RISC-25) before, immediately after, and three months post-intervention. Additionally, qualitative data were obtained through written reflections from participants regarding their clinical practice.

RESULTS

The results revealed significant improvements in EI and resilience scores immediately after the intervention (ΕΙ: 5.13, SD: 0.65 vs. 5.3, SD: 0.57, p = 0.007; resilience: 76.6, SD: 11.75 vs. 79.83, SD: 10.24, p = 0.029), as well as at the three-month follow-up (ΕΙ: 5.3, SD: 0.57 vs. 5.36, SD: 0.48, p = 0.007; resilience: 79.83, SD: 10.24 vs. 81.03, SD: 7.86, p = 0.029). The thematic analysis of qualitative data identified improvements in five key themes: communication skills, stress management, emotional awareness, resilience, and patient care. Participants reported feeling more confident, empathetic, and effective when interacting with patients, particularly those from diverse backgrounds. The convergence of the quantitative and qualitative findings showed the efficacy of the EOT intervention in enhancing PCPs' EI, resilience, well-being, and, ultimately, their practice.

The effects of bullying behaviours among nursing students in Sierra Leone: a qualitative exploratory study

BACKGROUND

Bullying can have profound negative effects on nursing students who often contend with psychological trauma because of repeated acts of mistreatment. This study was done to explore the effects of bullying behaviours among nursing students with above average and below average academic performance in two nursing schools in Sierra Leone.

METHODS

A qualitative exploratory study involved six rounds of data collection and analysis over a one month period. 48 nursing students recruited from Njala University School of Nursing and Mattru School of Nursing participated in semi structured interviews. Recruitment was done using a purposive sampling method and students with higher than average and lower than average Grade point average (GPA) were selected to participate in the interviews. Interviews were audiotaped recorded and transcribed verbatim for analysis. An inductive approach with line-by-line coding to identify themes and subthemes was done for the first set of interviews, following this the researchers took a deductive approach to analysis to evaluate if subsequent themes were consistent with initial analysis.

RESULTS

Sensitization and apathy were the two broad themes regarding the effects of bullying behaviour demonstrated by students with higher than average and lower than average GPA respectively. Both groups of students had come to accept the inevitability of bullying as nursing students despite the distress it caused them. However, students with lower-than-average GPA also demonstrated resentment and a loss of interest in their studies because of the bullying they had encountered.

CONCLUSION

The findings of this study demonstrate that bullying negative affects nursing students regardless of their academic performance. There is an urgent need for policy makers to prioritise the deterrence of bullying of nursing students through implementation of strategies that protect students and punish perpetrators of abuse in nursing schools nationwide.

The impact of community engaged healthcare education on undergraduate students' empathy and their views towards social accountability; a mixed methods systematic review

BACKGROUND

Many non-communicable diseases are rooted in social factors that determine health outcomes. Complex topics such as the social determinants of health are difficult to teach through traditional didactic methods. Since the introduction of the social accountability of medical schools' framework in 1995 by the World Health Organisation, healthcare education institutions are encouraged to shift their traditional education models towards a socially accountable approach. Community engagement can facilitate a deeper understanding of health inequity, barriers to health care, and the social determinants of health whilst enabling institutions to meet their obligation to the communities they serve. This systematic review aimed to answer the following question: ''What is the impact of community engaged healthcare education on undergraduate healthcare students' empathy and their views towards social accountability?''.

METHODS

This is a mixed-methods systematic review. The protocol was registered with PROSPERO (CRD42022306181). The following databases were searched: Scopus, MEDLINE, Embase, CINAHL, ERIC, BEI for primary research studies published from 1995 to September 2024. Grey literature was also searched via EThOS and Google. Studies recruiting undergraduate students of regulated healthcare professions in countries of very high development were included. A convergent integrated approach to synthesis was followed.

RESULTS

Out of the 19,590 papers yielded from the literature search, 76 met the inclusion criteria and were included in the review. The following subthemes were generated under three overarching themes: Social accountability (advocacy for action; giving back to the community; bigger picture-identifying social determinants of health and barriers to healthcare; barriers to social accountability), Empathy (humanise community members-everybody has a story; overcome bias and challenge attitudes, assumptions and stereotypes; cultural competence and sensitivity; empathetic communication and interpersonal skills; feeling sympathy and sadness), and Shaping the future workforce (future professional demeanour; professional interests; interprofessional education and collaboration).

CONCLUSIONS

Community engaged education can help students better understand community needs, social determinants of health, improve empathy and cultural sensitivity, and build advocacy for social justice and change.

Feedback in nursing practice: exploring barriers to and strategies for effective delivery

Feedback is essential for promoting nurses' professional development and enhancing the quality of patient care. Effective feedback, in terms of delivery, content and receipt, can support nurses to identify their strengths and areas for improvement, enhance patient care and strengthen teamwork and communication. Despite its importance, however, delivering feedback can be challenging, notably due to concerns about how it will be received. Creating a supportive environment, using a structured framework and fostering self-reflection among staff can support nurse managers to deliver feedback effectively. This article explores the importance of feedback in nursing practice, examines some of the barriers to providing feedback and suggests strategies for delivering effective feedback.

Impact of interprofessional education on empathy of pre-licensure healthcare students: A mixed-studies systematic review

BACKGROUND

In the age of automation and technology, incorporating empathy in pre-licensure healthcare education is essential in providing empathic care to patients and co-workers. This can be achieved through interprofessional education (IPE).

OBJECTIVE

To consolidate evidence to evaluate interprofessional education's impact on pre-licensure healthcare students' empathy levels.

DESIGN

A mixed-studies systematic review following a convergent segregated approach.

METHODS

Ten electronic databases were searched from their inception until 30 November 2023. Quantitative, qualitative, and mixed-method studies that explored the impact of IPE on the change in empathy level in pre-licensure healthcare students were reviewed. The methodological quality of the included studies was assessed using the Mixed-Method Appraisal Tool. Findings from the qualitative and quantitative aspects were analysed and synthesized separately using thematic and narrative synthesis. The findings were integrated by convergent synthesis.

RESULTS

A total of 36 studies involving 3887 participants were included in this review, consisting of five quantitative, 14 qualitative and 17 mixed-methods studies. This review found that IPE enhanced the empathy level of students by improving their understanding of empathy and various empathic responses. Through IPE activities, students demonstrated empathy towards both patients and interprofessional peers. Three themes were generated through the synthesis of qualitative and quantitative results: (1) Empathy Awareness, (2) Internal Empathic Processes, and (3) Intentional Actions. The results showed that healthcare students exhibited empathic care behaviours towards patients and their interprofessional peers.

CONCLUSION

The findings of this review suggested that IPE was effective in improving awareness and knowledge of empathy and in providing empathy care to patients and interprofessional peers. This review encourages educators to implement IPE to pre-licensure healthcare students to increase their knowledge of the importance of providing empathic patient care and interprofessional empathy. Future research could explore more on the processes of interprofessional empathy in students.

Co-production of a novel intervention targeting obesity-related barriers to mammographic screening participation

INTRODUCTION

Women with obesity are less likely to participate in mammographic screening and more likely to develop post-menopausal breast cancer. We describe the co-production of a novel training intervention for breast screening staff, targeting obesity-related barriers to participating in a population-based mammographic screening.

METHODS

A Stakeholder Consultant Group (SCG) was established to guide the co-production process. A narrative review of the literature was conducted, as well as first person interviews of women with lived experience of obesity, to identify/inform themes for service delivery staff training.

RESULTS

Three themes from the narrative review emerged: (i) enhanced staff-client communication, (ii) promoting compassionate connections during client interactions (iii) tailored mammography positioning for women with obesity. Iterative co-design and consultation with the SCG resulted in six key sessions delivered within an in-service training day: determinants of obesity, weight stigma and healthcare, screening challenges for women living with obesity, empathy 'mapping', front-line training for reception staff, and screening challenges for radiographers when screening women with obesity. Subsequent practical workshops for radiographers provided hands-on positioning training using a real-life model and a 'mammo vest'. Feedback showed that 74 % of staff rated the training as "very good" or "excellent".

CONCLUSION

Training to improve staff interactions with women with obesity appears to be acceptable.

IMPLICATIONS FOR PRACTICE

The intervention has been successfully implemented in a population-based breast screening program to improve the mammography experience for both clients and staff. Improving the mammogram experience will improve the likelihood of clients returning to screening when next due. Given the prevalence of obesity and body image issues, targeted interventions that optimize client interactions could significantly reduce breast cancer mortality through early detection.

Relationship Between Heart Rate and Perceived Stress in Intensive Care Unit Residents: Exploratory Analysis Using Fitbit Data

BACKGROUND

Intensive care unit (ICU) residents are exposed to high stress levels due to the intense nature of their work, which can impact their mental health and job performance. Heart rate measured through wearable devices has the potential to provide insights into residents' self-reported stress and aid in developing targeted interventions.

OBJECTIVE

This exploratory study aims to analyze continuous heart rate data and self-reported stress levels and stressors in ICU residents to examine correlations between physiological responses, stress levels, and daily stressors reported.

METHODS

A secondary data analysis was conducted on heart rate measurements and stress assessments collected from 57 ICU residents over a 3-week period using Fitbit Charge 3 devices. These devices captured continuous physiological data alongside daily surveys that assessed stress levels and identified stressors. The study used Spearman rank correlation, point-biserial correlation analysis, 2-tailed paired t tests, and mixed-effect models to analyze the relationship between heart rate features and stress indicators.

RESULTS

The findings reveal complex interactions between stress levels and heart rate patterns. The correlation analysis between stress levels and median heart rate values across different percentile ranges showed that lower percentile heart rates (bottom 5%, 10%, 25%, and 50%) had modest correlations with stress, whereas higher percentiles (top 50%, 25%, 10%, and 5%) did not correlate significantly (all P>.05). The 2-tailed paired t test indicated significant differences in stress levels reported in midday versus end-of-day surveys (P<.001), although these changes in stress levels were not consistently reflected in heart rate patterns. Additionally, we explored and found that stressors related to "other health" issues had the highest positive correlation with stress level changes from midday to end-of-day surveys. However, the weak effect of these stressors on peak heart rate suggests that their impact on physiological measures like heart rate is not yet clear. According to our mixed-effects model, stress levels significantly influenced heart rate variations when hierarchical data were taken into account (P=.03), meaning that as the stress level increased, there was a significant increase in mean heart rate.

CONCLUSIONS

This study highlights the complexity of using heart rate as an indicator of stress, particularly in high-stress environments like the ICU. Our findings suggest that while heart rate is found to correlate with self-reported stress in the mixed-effect model, its impact is modest, and it should be combined with other physiological and psychological measures to obtain a more accurate and comprehensive assessment of residents' stress levels.

Perceptions of Empathy Among Nursing Assistants in Long-Term Care Facilities: A Qualitative Study

Background: Empathy is a fundamental component of the therapeutic relationship between healthcare providers and patients and has the potential to yield significant benefits, including heightened care satisfaction, enhanced care quality, and improved mental well-being for patients. As nursing assistants (NAs) are primary direct care providers in long-term care facilities (LTCFs), it is necessary to understand NAs' views on empathy in their care provision for residents, but a gap exists in the literature regarding NAs' perspectives on empathy in this context. Aim: In this study, we aimed to explore perceptions of empathy among NAs in LTCFs. Research Design: A qualitative approach was applied in this study. Participants and Research Context: Through purposive and snowball sampling, 18 NAs who provided care for residents in six LTCFs in Taiwan were recruited. Face-to-face in-depth interviews were conducted using a semistructured interview guide, and data were analyzed using a content analysis. Ethical Considerations: Ethical approval was obtained from the Institutional Review Board. All participants signed a written informed consent form prior to the interview. Results: Four themes encompassing 11 categories were generated including "being fundamental to caregiving to establish trust and enhance quality care," "practicing altruistic behavior in the pursuit of ethical caregiving," "cycling empathic flow in care," and "facing challenges in delivering empathetic care." Conclusions: NAs in LTCFs viewed empathy as an essential element of the caregiving process. They saw empathy as selfless care, assistance to others, and alleviation of residents' suffering. Understanding residents' emotions, thoughts, and needs, active listening and compassionate engagement were vital to expressing empathy. However, NAs faced challenges in expressing empathy due to demanding tasks, time limitations, and insufficient knowledge and communication skills. In addition, emotional desensitization further complicated the provision of empathic care. The findings of this study can provide information for nurse managers and directors to understand NAs' perspectives on empathy and difficulties when providing empathic care in the long-term care context.

Introducing the ELPIS scale: a novel tool for measuring emotional empathy toward cancer patients

Empathy, defined as the ability to understand and share another person's feelings, is crucial in the healthcare setting, particularly for patients with cancer who face significant psychosocial challenges. We aimed to develop a novel tool, the Empathy, Life with Cancer, and Psychosocial Skills (ELPIS) Scale that prioritizes emotional and cognitive components in order to determine the reflection of the negative stigmatization of cancer in societies on individuals, excluding the behavioral and ethical dimensions of empathy. The study was conducted using a quantitative research design with a sample of first- and second-year medical students in Türkiye. An initial pool of 48 items was developed based on an extensive review of the literature and existing empathy scales. Following expert review and pilot testing, the scale was refined to 24 items. Exploratory factor analysis and confirmatory factor analysis were conducted to establish the scale's factor structure and validate its reliability and validity. The exploratory factor analysis revealed a three-factor structure comprising "emotional empathy," "sympathetic responses," and "realistic approaches," with a total of 20 items after refinement. Confirmatory factor analysis confirmed the model fit, with the scale demonstrating high internal consistency across all three dimensions. The scale's reliability was further supported by high Cronbach's alpha values. The results suggest that the ELPIS Scale is a reliable and valid instrument for measuring emotional empathy toward cancer patients. It offers a nuanced approach by separately assessing emotional, sympathetic, and realistic components of empathy, making it a valuable tool for both educational and clinical applications. Future research should explore the scale's application in diverse populations and settings, as well as its utility in tracking empathy development over time. In conclusion, the ELPIS Scale, which focuses on the emotional and cognitive components of empathy, a multifaceted construct, fills a critical gap in the measurement of empathy in the context of cancer care and provides a comprehensive tool that can improve both patient care and the education of healthcare providers.

The Impact of Mindfulness-Based Stress Reduction on Workplace Well-Being and Empathy Levels Among Nurses Working in Psychiatric Wards in Iran: A Controlled Trial

Workplace stressors can negatively impact the well-being and nurse-patient empathy among nurses working in psychiatric wards. This controlled trial investigated the impact of mindfulness-based stress reduction (MBSR) on workplace well-being and empathy levels among these nurses. In this study, 80 clinical nurses from the psychiatric wards of Ibn-e-Sina psychiatric hospital, affiliated with Mashhad University of Medical Sciences, Mashhad, Iran, completed a demographics form, the Eudaimonic Workplace Well-being Scale, and the Clinical Interpersonal Reactivity Index. Subsequently, participants were allocated to either the MBSR group (n = 40) or the control group (n = 40). The MBSR group received an eight-week program consisting of weekly two-hour sessions based on the MBSR principles developed by Kabat-Zinn. The participants in both the MBSR and control groups completed the data collection tools immediately after the intervention and one month later. The mean scores of workplace well-being and its intrapersonal dimension increased significantly more in the MBSR group than in the control group over time. Similarly, empathy and its perspective-taking subscale improved significantly more in the MBSR group than in the control group over time. The MBSR intervention can be a beneficial tool to improve workplace well-being and nurse-patient empathy levels among nurses working in psychiatric wards.

Empathy ability and influencing factors among pediatric residents in China: a mixed-methods study

BACKGROUND

Empathy is one of the fundamental factors enhancing the therapeutic effects of physician-patient relationships, but there has been no relevant research in China on the pediatric resident physicians' capacity for empathy or the influencing factors.

METHODS

A mixed-methods study was undertaken. The student version of the Jefferson Scale of Empathy was used to assess 181 postgraduate residents at Shanghai Children's Medical Center and Shanghai Children's Hospital. Differences in empathy ability among pediatric resident physicians of different genders and specialties were analyzed using independent sample t-tests and Mann-Whitney U tests. A one-way analysis of variance was used to analyze the differences in empathy ability at different educational levels and years of medical residency training. Seven third-year postgraduate pediatric residents from Shanghai Children's Medical Center participated in semi-structured interviews exploring the influencing factors. We analyzed the interview transcripts using thematic analysis.

RESULTS

The scale was completed by 154 pediatric residents. No statistically significant differences in empathy were found between educational level, postgraduate year, gender, or specialty. The factors influencing empathy in doctor-patient communication included the person who accompanied the child to see the doctor, how the children cooperated with doctors for medical treatment, the volume of pediatric outpatient and emergency visits, and the physician's ability to withstand pressure. All interviewed resident physicians regarded learning empathy as important but rarely spent extra time learning it.

CONCLUSIONS

The evaluation results of resident physicians on changes in empathy after improving clinical abilities vary according to their understanding of empathy, and the work environment has an important impact on pediatricians' empathy ability. Their empathy score is relatively low, and this requires exploration and intervention.

Using Immersive Environments in E-Mental Health Rehabilitation Programs Directed to Future Health Professionals to Promote Empathy and Health Literacy about Schizophrenia

Rehabilitation involves all types of patients, including people with schizophrenia. Schizophrenia is considered a complex syndrome characterized in general by fundamental and characteristic distortions of thinking and perception. The quality of life of a person with schizophrenia can be compromised by difficulty in carrying out their daily tasks and by the social stigma of their condition. The importance of training and sensitizing students in rehabilitation areas to this type of problem to improve the rehabilitation processes in which they will participate as future professionals involves empathy and the ability to communicate with these populations. It is possible through virtual reality to create immersive environments to simulate some psychotic symptoms characteristic of people with schizophrenia, such as visual hallucinations and hearing voices. The aim of this study was to test the effect of exposure to experiences characteristic of schizophrenia through two different types of immersive environments, graphical computational virtual reality and 360° video, on students from areas of social rehabilitation regarding empathy, social distance, and attitudes towards people with schizophrenia. Although the results were positive for the three parameters under study, no significant differences were found for each of them between the environments to which the participants were exposed. This study concluded that the choice between the two types of immersive environments should be based on the project's objectives, the target audience's needs, and available resources, rather than the type of environment itself, as their impact was similar.

Perceived access to social support during and after TB treatment in Mbeya and Songwe regions, Tanzania: perspectives from TB patients and survivors set against health care providers

Introduction

Pulmonary tuberculosis (PTB) remains a life-threatening disease in Tanzania, with negative physical, financial, economic and psychosocial consequences to individuals and the society. It mainly lowers the quality of life of patients, survivors and their families, especially those in the poorest and socially deprived categories.

Objectives

To report and discuss a qualitative study that assessed the nature of social support desired and received by PTB patients and survivors. Participants were given a chance to share their experiences and their perceptions on whether the social support they desired had an impact on their treatment-seeking behaviour and treatment adherence.

Methods

Face-to-face interviews were conducted with the three aforementioned groups, purposively selected at a TB clinic between October 2020 and March 2021. The questions covered topics related to the types of social support desired and the sources of support during and after treatment, if any. Interviews were concluded until no new information was obtained. Data analysis was facilitated using NVivo 12 software.

Results

Participants pointed out a need for psychosocial, financial, and material support during and after treatment. However, they sometimes miss support from family/household members or the rest of the community. Because of this experience, they lived with difficulties, facing hardships when required to pay out of pocket for transport during the care-seeking. Survivors testified experience of a denial of support by even their close relatives who regarded them as no longer needing it after recovering. Patients and survivors also reported experience of social isolation as they were believed able to transmit PTB infections. Limited psychological support at the contacted TB clinics was another experience reported. TB clinic staff's experiences confirmed almost all the experiences shared by their clients. With limited support, resilience and self-care were identified as key mechanisms for coping.

Conclusion

Complete recovery from PTB is possible, but reverting to a normal life is difficult without social support. Policies and programs need to increase opportunities for social support for TB patients and survivors. Doing so is likely to improve TB-related treatment, care-seeking practices, and adherence.

Patients' perspectives on planned interventions tested in the Otago MASTER feasibility trial: an implementation-based process evaluation study

BACKGROUND

Patients are key stakeholders of clinical research, and their perspectives are relevant for researchers when planning and conducting clinical trials. Numerous aspects of trial process can influence participants' experiences. Their experiences within a trial can impact retention rates. Poor treatment adherence may bias treatment effect estimates. One way to improve recruitment and adherence is to design trials that are aligned with patients' needs and preferences. This study reports a process evaluation of the Otago MASTER feasibility trial.

OBJECTIVES

Our aims were to investigate the patients' perceptions of the trial interventions through individual interviews.

METHODS

Twenty-five participants were recruited for the feasibility trial and were allocated to two groups: tailored or standardised exercise. Sixteen participants agreed to take part in individual semi-structured interviews. Interviews were transcribed verbatim, and all interviews were analysed thematically using an iterative approach.

RESULTS

Our key findings suggest participants: (1) took part in the study to access healthcare services and contribute to research; (2) valued interventions received; (3) reported certain barriers and facilitators to participate in the trial; and (4) highlighted areas for improvement when designing the full trial.

CONCLUSION

Participants volunteered to access healthcare and to contribute to research. Participants valued the personalised care, perceived that their engagement within the trial improved their self-management and self-efficacy behaviour, valued the time spent with clinicians, and the empathetic environment and education received. Facilitators and barriers will require careful consideration in the future as the barriers may impact reliability and validity of future trial results.

Inseparability between public health, planetary health and the nursing process: premise for sustainable development

The aim is to conduct theoretical reflection on the inseparability among public health, planetary health and the nursing process in light of complexity thinking, with the aim of contributing to healthy and sustainable development. Study with a theoretical-reflexive approach that accessed bibliographical sources from contemporary authors who defend the inseparability between public health and planetary health and, at the same time, provide theoretical-systemic support to the nursing process, under an inductive critical bias. The nursing process is conceived as a complex phenomenon, which comprises interdependent dynamics, dialogical approaches, critical-reflective perception and prospective leadership. Theoretical reflection on the nursing process and sustainable development raises an expanded, contextualized and interdependent look at the role of nursing professionals in different health contexts, in order not to compromise well-being and environmental health.

Facilitators and barriers of empathetic behaviour in physiotherapy clinical practice: A qualitative focus group study

BACKGROUND

Empathy is an essential competence of a person-centered approach, and a recognisable ability for providing physiotherapy quality healthcare. Empathetic communication enhances the improvement of patient outcomes and their experience of treatment.

OBJECTIVE

The aim of the study was to present further insights considering facilitators and barriers of an empathetic communication between patients and physiotherapists.

METHODS

A qualitative focus group study was designed according to COREQ guidance for qualitative studies. Two focus groups were conducted. The first group included six patients and two individuals from non-governmental organizations, whereas three physiotherapists, two academic physiotherapist personnel and two undergraduate physiotherapy students participated in the second group. Both groups were audio recorded, and all data was verbatim transcribed for coding thematic analysis.

RESULTS

9 themes were revealed regarding empathetic facilitators (qualities of good communication, relationship building, interprofessional collaborative practice, positive environment, love for the healthcare profession and professionalism), while 8 themes were revealed regarding barriers (challenging situations, working conditions, burn out, depreciation of empathetic communication, lack of training, lack of professionalism, lack of personal development and health professionals' own personal problems).

CONCLUSION(S)

The enhancement of empathy can be accomplished in a trustworthy relationship between patient and clinicians where the development of proficient communication skills are prioritized. However, hindering factors associated with health professionals, patients and the health system should be surmounted.

ETHICAL APPROVAL NUMBER

339-ΣΕ8/10-1-2020.

Youth is Prized in Medicine, Old Age is Valued in Law: Analysis of Media Narratives Over 200 Years

BACKGROUND

This is the first study to explore how age has influenced depictions of doctors and lawyers in the media over the course of 210 years, from 1810 to 2019. The media represents a significant platform for examining age stereotypes and possesses tremendous power to shape public opinion. Insights could be used to improve depictions of older professionals in the media.

OBJECTIVE

This study aims to understand how age shapes the portrayals of doctors and lawyers. Specifically, it compares the difference in sentiments toward younger and older doctors as well as younger and older lawyers in the media over 210 years.

METHODS

Leveraging a 600-million-word corpus of American media publications spanning 210 years, we compiled top descriptors (N=478,452) of nouns related to youth × occupation (eg, younger doctor or physician) and old age × occupation (eg, older lawyer or attorney). These descriptors were selected using well-established criteria including co-occurrence frequency and context relevance, and were rated on a Likert scale from 1 (very negative) to 5 (very positive). Sentiment scores were generated for "doctor/physician," "young(er) doctor/physician," "old(er) doctor/physician," "lawyer/attorney," "young(er) lawyer/attorney," and "old(er) lawyer/attorney." The scores were calculated per decade for 21 decades from 1810 to 2019. Topic modeling was conducted on the descriptors of each occupation in both the 1800s and 1900s using latent Dirichlet allocation.

RESULTS

As hypothesized, the media placed a premium on youth in the medical profession, with portrayals of younger doctors becoming 10% more positive over 210 years, and those of older doctors becoming 1.4% more negative. Meanwhile, a premium was placed on old age in law. Positive portrayals of older lawyers increased by 22.6% over time, while those of younger lawyers experienced a 4.3% decrease. In the 1800s, narratives on younger doctors revolved around their participation in rural health care. In the 1900s, the focus shifted to their mastery of new medical technologies. There was no marked change in narratives surrounding older doctors from the 1800s to the 1900s, though less attention was paid to their skills in the 1900s. Narratives on younger lawyers in the 1800s referenced their limited experience. In the 1900s, there was more focus on courtroom affairs. In both the 1800s and 1900s, narratives on older lawyers emphasized their prestige, especially in the 1900s.

CONCLUSIONS

Depending on the occupation, one's age may either be seen as an asset or a liability. Efforts must be expended to ensure that older professionals are recognized for their wealth of knowledge and skills. Failing to capitalize on the merits of an older workforce could ultimately be a grave disservice not only to older adults but to society in general.

The mediating role of work-related perceptions in the relationship between empathy and self-perceived clinical performance of residents in China: A multi-center cross-sectional study

OBJECTIVE

This study aimed to describe the association between empathy and residents' clinical performance and investigate whether work-related perception mediates this relationship.

METHODS

A multi-center cross-sectional study was conducted, including 1160 residents from 10 cities in Liaoning Province between March and October 2020. The participants completed various self-reported questionnaires regarding demographic characteristics, work-related perceptions, self-perceived clinical performance, and empathy. The relationships among empathy, work-related perception, and self-perceived clinical performance were examined using a structural equation model (SEM).

RESULTS

Of the 1160 residents, 961 (82.8 %) completed the questionnaires. The SEM path analysis showed that the direct effect of empathy on self-perceived clinical performance was significant and positive (β = 0.34, P < 0.001). There existed significant effects of empathy on work-related perception (β = 0.26, P < 0.001) and work-related perception on performance (β = 0.31, P < 0.001). The path coefficients of empathy concerning self-perceived clinical performance decreased significantly (β = 0.26, P < 0.001) when work-related perception was modeled as a mediator. The bias-corrected and accelerated bootstrap test revealed that work-related perception significantly mediated the relationship between empathy and self-perceived clinical performance (a*b = 0.08, BCa 95 % CI: 0.05-0.13). However, the correlation between the sub-scales of empathy and the items of self-perceived clinical performance was not substantial, even if most of them were statistically significant. The final SEM produced a good fit to the sample data, with CMIN/DF = 2.07 (P < 0.001), CFI = 0.99, GFI = 0.99, AGFI = 0.98, TLI = 0.98, NFI = 0.97, RMSEA (90 % CI) = 0.033 (0.017, 0.049), and SRMR = 0.024.

CONCLUSION

Empathy might significantly affect self-perceived clinical performance both directly and indirectly through the mediating role of work-related perception.

PRACTICE IMPLICATIONS

Efforts to improve clinical performance among residents might benefit from interventions for cultivating empathy and practices for improving work-related perceptions of residents.

Empathy Levels Among Healthcare Professionals: An Asian Multi-professional Cross-Sectional Study

BACKGROUND

The aim of the study was to measure empathy in healthcare professionals in Singapore and to compare the scores between the different professions: doctors, nurses, and allied health professionals.

METHODS

An online survey questionnaire was conducted using the Jefferson Scale of Empathy (JSE) from July 2019 to January 2020. The total JSE score was calculated and compared among the different groups. Multiple linear regression was performed to assess predictors of total empathy scores for groups with statistically lower scores.

RESULTS

The survey was completed by 4,188 healthcare professionals (doctors (n=569, 13.6%), nurses (n=3032, 72.4%), and allied health professionals (n=587, 14.0%)) out of the 9,348-strong survey population, with a response rate of 44.8%. The study revealed a mean empathy score (SD) of 103.6 (15.6) for the cohort. The mean empathy score (SD) was 112.3 (14.7), 101.3 (15.2), and 107.0 (15.0), respectively for doctors, nurses, and allied health professionals. These were statistically significantly different among the groups (p< 0.0001), with nurses scoring significantly lower than either doctors (p< 0.0001) or allied health professionals (p< 0.0001). Multiple linear regression showed that age < 30 years old, male gender, Malay ethnicity, and working in a hospital setting were associated with significantly lower empathy scores in the nursing group.

CONCLUSION

Nurses in Singapore had significantly lower empathy scores compared to doctors and allied health professionals. Further research on the underlying causes should be undertaken and measures to improve empathy among Singapore nursing staff should be explored and implemented.

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

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

Primary Care Professionals' Empathy and Its Relationship to Approaching Patients with Risky Alcohol Consumption

The aim of this study was to estimate the level of empathy among primary care (PC) health professionals and its relationship with their approach to patients at risk due to alcohol consumption. This is an observational, descriptive, and multicenter study that included 80 PHC professionals. The professionals completed a questionnaire comprising socio-occupational questions and inquiries regarding their actions when dealing with patients suspected of risky alcohol consumption. The Jefferson Scale of Empathy was used to measure their level of empathy and was completed by 80 professionals, of whom 57.5% were family physicians, 10% were nurses, and 32.5% were family- and community-medicine residents. The mean age was 39.5 ± 13.1 (SD) (range of 24-65 years) and 71.3% were females. The mean empathy level score was 112.9 ± 11.1 (95% CI: 110.4-115.4; range: 81-132 points). Actions that stood out for their frequency were providing health advice in the general population, offering advice to pregnant women, and recommending abstinence to users of hazardous machinery or motor vehicles. The level of empathy was associated with age (p = 0.029), the health center's scope (p = 0.044), systematic alcohol exploration (p = 0.034), and follow-ups for patients diagnosed with risky consumption (p = 0.037). The mean score obtained indicated a high level of empathy among professionals. Professionals with greater empathy more frequently conducted systematic screening for risky alcohol consumption.

Positive contact and empathy as predictors of primary care providers' willingness to prescribe medications for opioid use disorder

Introduction

Patients with opioid use disorder (OUD) have a heightened need for quality health care, including access to evidence-based medications to reduce cravings and prevent overdose. However, primary care providers (PCPs) are reluctant to work with patients with OUD and implement medication prescribing into primary care practice. Previous studies have sought to identify potential ways to overcome these barriers, but often utilize interventions that facilitate both positive contact with as well as empathy for patients with OUD. In this study, we jointly assess positive contact and empathy to determine their unique impact on treatment attitudes and behaviors among PCPs, after controlling for other known predictors.

Methods

We surveyed 409 PCPs currently practicing in Ohio in 2022. Our primary dependent variables were willingness to work with patients with OUD, receipt of an X-waiver to prescribe buprenorphine, and interest in receiving an X-waiver. Our primary independent variables were positive contact and empathy toward patients with OUD. We computed bivariate correlations and multivariable linear regression (for continuous dependent variables) and logistic regression (for binary dependent variables) to understand the relationship between positive contact, empathy, and our outcome variables while accounting for other known predictors and relevant participant demographics.

Results

Positive contact was positively correlated with willingness to work with patients with OUD, receipt of the X-waiver, an interest in receiving the X-waiver, more frequent checking with patients about the need for naloxone, and higher odds of naloxone prescribing. These relationships held after accounting for PCP demographics, explicit bias toward patients with OUD, and overall levels of contact with patients with OUD. Empathy, conversely, was not a significant predictor of any treatment outcomes in the fully adjusted models.

Conclusion

Interventions and medical education programs aimed at improving treatment outcomes for patients with OUD should facilitate positive contact between PCPs and patients with OUD.

Patient's views of empathic and compassionate healthcare interactions: A scoping review

BACKGROUND

Compassion and empathy are integral to safe and effective patient care. However, to date, most studies have focused on exploring, defining, measuring and analysing empathy and compassion from the perspective of researchers or clinicians. There has been limited attention to the perspectives of patients.

OBJECTIVE

The objective of this scoping review was to map the literature to identify patients' views of healthcare provider behaviours that exemplify empathic and compassionate interactions.

METHOD

This review used the Joanna Briggs Institute scoping review methodology. A comprehensive search of eight electronic databases was conducted with English language studies published in the last 10 years considered for inclusion.

RESULTS

Database searching resulted in 459 records for initial screening. After de-duplication and conducting a title and abstract review, 32 full-text articles were screened for eligibility. A total of 14 studies met the inclusion criteria and were critically reviewed using the Mixed Methods Appraisal Tool. The included papers profiled studies that had been conducted in clinical settings across seven countries. The healthcare encounters described in the papers were with a range of healthcare providers. Two overarching and interconnected categories of behaviours were identified as indicative of empathic/compassionate encounters: (1) communication skills such as listening, touch, body language, eye contact and positive demeanour; and (2) helping behaviours demonstrated by small acts of kindness that go beyond routine healthcare.

CONCLUSION

Given the breadth of studies describing the positive impact of empathy/compassion on people's physical and psychosocial wellbeing, the results from this review are valuable and shed new light on patients' views and experiences. The results provide a deeper understanding of healthcare provider behaviours that exemplify empathic and compassionate healthcare interactions and can be used to inform the education and training of healthcare providers from all disciplines.

Exploring the Needs and Requirements of Informal Caregivers of Older Adults With Cognitive Impairment From Sensor-Based Care Solutions: Multimethod Study

BACKGROUND

With the increase in the older adult population, sensor-based care solutions that can monitor the deviations in physical, emotional, and physiological activities in real-time from a distance are demanded for prolonging the stay of community-dwelling older adults with cognitive impairment. To effectively develop and implement these care solutions, it is important to understand the current experiences, future expectations, perceived usefulness (PU), and communication needs of the informal caregivers of older adults with cognitive impairment regarding such solutions.

OBJECTIVE

This comprehensive study with informal caregivers of older adults with cognitive impairment aims to (1) highlight current experiences with (if any) and future expectations from general sensor-based care solutions, (2) explore PU specifically toward unobtrusive sensing solutions (USSs), (3) determine the information communication (IC) needs and requirements for communicating the information obtained through USSs in different care scenarios (fall, nocturnal unrest, agitation, and normal daily life), and (4) elicit the design features for designing the interaction platform in accordance with the persuasive system design (PSD) model.

METHODS

A multimethod research approach encompassing a survey (N=464) and in-depth interviews (10/464, 2.2%) with informal caregivers of older adults with cognitive impairment was used. The insights into past experiences with and future expectations from the sensor-based care solutions were obtained through inductive thematic analysis of the interviews. A convergent mixed methods approach was used to explore PU and gather the IC needs from USSs by using scenario-specific questions in both survey and interviews. Finally, the design features were elicited by using the PSD model on the obtained IC needs and requirements.

RESULTS

Informal caregivers expect care infrastructure to consider centralized and empathetic care approaches. Specifically, sensor-based care solutions should be adaptable to care needs, demonstrate trust and reliability, and ensure privacy and safety. Most informal caregivers found USSs to be useful for emergencies (mean 4.09, SD 0.04) rather than for monitoring normal daily life activities (mean 3.50, SD 0.04). Moreover, they display variations in information needs including mode, content, time, and stakeholders involved based on the care scenario at hand. Finally, PSD features, namely, reduction, tailoring, personalization, reminders, suggestions, trustworthiness, and social learning, were identified for various care scenarios.

CONCLUSIONS

From the obtained results, it can be concluded that the care scenario at hand drives PU and IC design needs and requirements toward USSs. Therefore, future technology developers are recommended to develop technology that can be easily adapted to diverse care scenarios, whereas designers of such sensor-driven platforms are encouraged to go beyond tailoring and strive for strong personalization while maintaining the privacy of the users.

People's experiences living with peripheral neuropathy: a qualitative study

Introduction

Peripheral neuropathy is a neurological disorder characterised by pain, numbness, or tingling due to nerve damage. Peripheral neuropathy is one of the main health issues in Kuwait and is a rising concern which affects a large proportion of the population, therefore the lived experience needs to be explored to identify areas for improvement in care. This qualitative study explored the experiences of people living with peripheral neuropathy in Kuwait.

Methods

Semi-structured interviews were conducted with 25 participants recruited from the Neurology Outpatient Clinic of the Ibn Sina Hospital in Kuwait. The interview questions explored their experiences and understanding of pain along with the impact on their daily life. The interviews were audio recorded, transcribed and translated into English then coded using NVivo 12. Thematic analysis was conducted to identify patterns and themes in the data.

Results

Three major themes were identified including treatment beliefs (perceived effectiveness of treatment and seeking alternative treatments), the barriers to pain management (medication side effects, relationships with healthcare professionals and lack of information and access to healthcare), and the impact on quality of life (impact on work and social, physical, and psychological consequences). Self-efficacy was a key construct and over-arching theme that was discussed in all aspects, which finds reflection in the protection motivation theory.

Discussion

This paper presents the experiences of people living with peripheral neuropathy and highlights there is scope for improvement of current treatments in Kuwait. Self-management strategies are recommended alongside prescribed medication and healthcare professionals are encouraged to use a patient-centered approach. More importantly, information and support on the condition to promote coping strategies and self-efficacy should be adopted to improve quality of life. These findings can be implemented locally and globally to improve the quality of care provided to people living with peripheral neuropathy.

Ability of Emotional Regulation and Control as a Stress Predictor in Healthcare Professionals

Emotional Regulation and Control implies a person’s ability to respond to stressful demands and emotional experiences in a socially acceptable and adaptive way. The aim of this cross-sectional study was to examine the contribution of the ability of emotional regulation and control in the prediction of workplace stress in healthcare professionals. The study included 203 healthcare professionals employed at a hospital in the Republic of Croatia. Data were collected using two validated questionnaires: Questionnaire on Workplace Stressors for Hospital Professionals and Emotional Regulation and Control Questionnaire (ERC). Most respondents (64%) experienced stress in Workplace Organization and Financial Issues factor, while 52.7% experienced stress in Public Criticism factor. The respondents assessed their ability of emotional regulation and control to be low (mean = 55; range = 20−100). The level of experienced stress was significantly higher if the ability of emotional regulation and control was low (Spearman’s Rho = 0.308; p < 0.001). The multivariate regression model (11.2% explained variances; p = 0.001) indicated a greater possibility of severe stress in respondents who have stronger Memory of Emotionally Saturated Content (odds ratio = 1.18; 95% CI = 1.07−1.30). The results of this study signify the need to establish effective institutional support aimed at objectifying stress and strengthening emotional intelligence and empathy in healthcare professionals.