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Neufeld A, Malin G. Cultivating physician empathy: a person-centered study based in self-determination theory. Med Educ Online 2024; 29:2335739. [PMID: 38566612 PMCID: PMC10993750 DOI: 10.1080/10872981.2024.2335739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/22/2024] [Indexed: 04/04/2024]
Abstract
While physician empathy is a vital ingredient in both physician wellness and quality of patient care, consensus on its origins, and how to cultivate it, is still lacking. The present study examines this issue in a new and innovative way, through the lens of self-determination theory. Using survey methodology, we collected data from N = 177 (44%) students at a Canadian medical school. We then used a person-centered approach (cluster analysis) to identify medical student profiles of self-determination (based on trait autonomy and perceived competence in learning) and how the learning environment impacted empathy for those in each profile. When the learning environment was more autonomy-supportive, students experienced higher satisfaction and lower frustration of their basic psychological needs in medical school, as well as greater empathy towards patients. The translation into increased empathy, however, was only evident among the students with higher self-determination at baseline. Results from this study suggest that autonomy-supportive learning environments will generally support medical students' psychological needs for optimal motivation and well-being, but whether or not they lead to empathy towards patients will depend on individual differences in self-determination. Findings and their implications are discussed in terms of developing theory-driven approaches to cultivating empathy in medical education.
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Affiliation(s)
- Adam Neufeld
- Cumming School of Medicine, Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Greg Malin
- College of Medicine, Department of Academic Family Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Vicario CM, Mucciardi M, Faraone G, Lucifora C, Schade HM, Falzone A, Salehinejad MA, Craparo G, Nitsche MA. Individual predictors of vaccine hesitancy in the Italian post COVID-19 pandemic era. Hum Vaccin Immunother 2024; 20:2306677. [PMID: 38289323 PMCID: PMC10829816 DOI: 10.1080/21645515.2024.2306677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/13/2024] [Indexed: 02/01/2024] Open
Abstract
A wide range of survey studies have explored vaccination hesitancy/resistance during the COVID-19 pandemic and provided evidence that this can be explained by several individual variables from the ideological, clinical, and socio-affective domain. However, evidence about which individual variables predict vaccine hesitancy in the post-pandemic state of COVID-19 is meager. We administered a battery of questionnaires to a group of 120 Italian participants with high and low scores on the adult vaccine hesitancy scale (aVHS) to investigate the predictive role of ideological (i.e. political orientation), clinical (i.e. anxiety, interoceptive accuracy), and socio-affective (i.e. alexithymia, disgust sensitivity/propensity, empathy) variables on vaccine hesitancy/resistance. This study provides evidence that lower interoceptive awareness and cognitive empathy are predictors of a greater hesitancy to get vaccinated in the post-pandemic COVID-19 state.
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Affiliation(s)
- Carmelo M Vicario
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università di Messina, Messina, Italy
| | - Massimo Mucciardi
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università di Messina, Messina, Italy
| | - Giulia Faraone
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università di Messina, Messina, Italy
| | - Chiara Lucifora
- Dipartimento di Filosofia e Comunicazione, Università di Bologna, Bologna, Italy
| | - Hannah M Schade
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Alessandra Falzone
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università di Messina, Messina, Italy
| | - Mohammad A Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- School of Cognitive Sciences, Institute for Research in Fundamental Sciences, Tehran, Iran
| | - Giuseppe Craparo
- Faculty of Human and Social Sciences, Kore University of Enna, Cittadella Universitaria, Enna, Italy
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- University Clinic of Psychiatry and Psychotherapy and University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital of Bethel Foundation, University Hospital OWL, Bielefeld University, Bielefeld, Germany
- German Center for Mental Health (DZPG), Bochum, Germany
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Yoo HJ, Shin S. Moving forwards to patient-centred care for patients with ventricular assist devices: A mixed methods study of nurses' perspectives. Intensive Crit Care Nurs 2024; 82:103635. [PMID: 38340544 DOI: 10.1016/j.iccn.2024.103635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To identify nurses' caring behaviours toward patients with left ventricular assist devices and deepen their understanding of experiences in nursing care. Patients with left ventricular assist devices require care in many aspects, but there is limited in-depth research about caring behaviours and experiences from the perspective of nurses providing care. RESEARCH METHODOLOGY/DESIGN Mixed methods study with a sequential explanatory design. Data were collected from clinical nurses with experience caring for patients using left ventricular assist devices in South Korea between May-August 2022. MAIN OUTCOME MEASURES Quantitative data (n = 79) were collected through an online survey of the Caring Behaviours Inventory - 24 and analysed using descriptive statistics. For qualitative data (n = 15), nurses' caring experiences were collected through individual interviews and analysed using Colaizzi's phenomenological method. RESULTS The overall average of caring behaviours was 4.80 ± 0.85, specifically, 'knowledge and skill' (5.04 ± 0.78), 'assurance' (5.01 ± 0.79), 'respect' (4.85 ± 0.90), and 'connectedness' (4.04 ± 0.99), respectively. The experience of caring was trapped in the uncomfortable reality of left ventricular assist device nursing, causing device-focused care, and approaching the essence of nursing through care focused on the patient's wholeness. CONCLUSIONS Caring for patients with a left ventricular assist devices was challenging for nurses. However, through the care process, they realised the meaning of patient-centred care, reflected in the essence of nursing, and sublimated it into an opportunity to grow. IMPLICATIONS FOR CLINICAL PRACTICE Nurses must focus on patient-centred care for left ventricular assist devices. To achieve this, it is essential to create a clinical environment and educational system for nurses to provide effective nursing care and enhance patient participation.
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Affiliation(s)
- Hye Jin Yoo
- College of Nursing, Dankook University, Cheonan, South Korea
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Lind M, Koch MK, Bluck S. Nursing students' empathic communication: Role in recognizing and treating chronic pain patients. Patient Educ Couns 2024; 123:108236. [PMID: 38452687 DOI: 10.1016/j.pec.2024.108236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 02/22/2024] [Accepted: 02/28/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE A substantial body of research supports what many nurses know from experience: empathy is at the heart of providing quality care. The major objective of this study was to identify unique mechanisms through which higher empathy translates into greater intentions to treat patients in pain employing novel methodology. METHODS Using an ecologically-valid scenario methodology, student nurses (N = 156) reviewed the narrative of a patient in chronic pain. They completed standard, valid measures of empathy toward the patient, perception of the patient's pain, and intention to provide pain-relieving treatment. Nursing student's personality traits were assessed and perception of patients' age and sex were experimentally manipulated. RESULTS Empathy was associated with higher intention to treat the patient in chronic pain irrespective of patients' age or sex. A moderated-mediation analysis confirmed that nursing students with higher empathy perceived the patient in the scenario as being in greater pain. This was correspondingly associated with higher intention to provide treatment. Nursing students' trait Extraversion was a moderator. CONCLUSION Empathy not only improves rapport between patients and providers but is related to intentions to provide pain-relieving treatment. PRACTICE IMPLICATIONS The clinical and educational importance of empathy in patient-provider relationships are discussed.
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Affiliation(s)
- Majse Lind
- Department of Communication and Psychology, Aalborg University, Aalborg, Denmark.
| | - Mary Kate Koch
- Department of Psychology, University of Florida, Gainesville, USA
| | - Susan Bluck
- Department of Psychology, University of Florida, Gainesville, USA
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Power T, Sheehy L, Lucas C, Bosco A, Wang B, Gavegan FL, Quast C, Patton V. Avoiding controversy: Considerations for point-of-view nursing simulations. Nurse Education Today 2024; 137:106166. [PMID: 38508020 DOI: 10.1016/j.nedt.2024.106166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/09/2024] [Accepted: 03/12/2024] [Indexed: 03/22/2024]
Abstract
Point-of-view simulations involve participants engaging in simulation to experience what it might be like to live with a health condition or disability. These types of simulations have been used frequently in nurse education as a valuable pedagogical tool, as research has shown that student engagement with point-of-view simulations increases student empathy. However, point-of-view simulations have also been problematised by disability community members and scholars researching in the disability space, as ableist and culturally unsafe. This manuscript explores recommendations for, and criticisms of, point-of-view simulations and offers considerations to address these concerns.
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Affiliation(s)
- Tamara Power
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Level 8, D18 - Susan Wakil Health Building, The University of Sydney, Gadigal Country, Camperdown, NSW 2006, Australia.
| | - Louise Sheehy
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Level 8, D18 - Susan Wakil Health Building, The University of Sydney, Gadigal Country, Camperdown, NSW 2006, Australia
| | - Cherie Lucas
- School of Population Health, Faculty of Medicine and Health, Level 3, Samuels Building (F25), University of NSW, Bedegal Country, Sydney, NSW 2052, Australia; School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney (Adjunct Fellow), 15 Broadway, Gadigal Country, Ultimo, NSW 2007, Australia
| | - Anna Bosco
- Curtin School of Nursing, Curtin University, Building 405, Whadjuk Country, Bentley, WA 6102, Australia
| | - Bangyun Wang
- Faculty of Medicine and Health, Central Sydney (Patyegarang) Precinct Clinical Skills and Simulation Education, Level 1, D18, Susan Wakil Health Building, The University of Sydney, Gadigal Country, Camperdown, NSW 2006, Australia
| | - Fiona Lee Gavegan
- Westmead Hospital, G2 Outpatients and Dermatology, Darug Country, NSW 2145, Australia
| | - Carol Quast
- NSW Stoma Ltd, Unit 5, 7-29 Bridge Rd, Gadigal Country, Stanmore, NSW 2048, Australia
| | - Vicki Patton
- Curtin University & Royal Perth Bentley Group, Royal Perth Hospital, Wellington Street, Whadjuk Country, Perth, WA 6000, Australia
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Arumugam K, Nandagopal H, Joseph J, Balaji JN, Surapaneni KM. EMBRACE (Empowering Medical students' skills in BReaking bAd news with Compassion and Empathy) module improves the skills of undergraduate medical students in effectively breaking the bad news: a case-control study. Adv Physiol Educ 2024; 48:356-365. [PMID: 38482563 DOI: 10.1152/advan.00224.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/05/2023] [Accepted: 03/08/2024] [Indexed: 04/17/2024]
Abstract
Effective communication skills are pivotal in health care, particularly when conveying distressing information to patients and their families. However, medical education still lacks the adoption of a universal model that can be incorporated into the curricula to train and assess students in effectively communicating with patients. This study aims to assess the impact of training undergraduate medical students to deliver bad news effectively using the Empowering Medical students' skills in BReaking bAd news with Compassion and Empathy (EMBRACE) module. This randomized case-control study involved medical students from the first, second, and third professional years (study group, n = 75; control group, n = 75). For the study group, the EMBRACE modules were distributed. Then, a 1-hour training session on effectively delivering bad news was followed by a multiple-choice question test and objective structured clinical examination with response, interpretation, and communication skills stations. Participants' feedback was obtained on a five-point Likert scale. There was a highly significant improvement in knowledge and skills among the study group compared to controls with a P value less than 0.0001. Of the participants, 98.76% perceived that the training equipped them with practical skills, and 98.77% felt that the facilitator had demonstrated the steps of delivering bad news clearly and effectively. Only 4.44% of participants were confident in effectively interacting with patients before the session, and an overwhelming 81.11% gained confidence in their communication skills after the training. With demonstrated significant improvement in knowledge and skills, this study supports the adoption of EMBRACE modules in undergraduate medical education, ultimately improving patient experiences, doctor-patient relationships, and health outcomes.NEW & NOTEWORTHY The Empowering Medical students' skills in BReaking bAd news with Compassion and Empathy (EMBRACE) module is noteworthy for its holistic approach to training medical students in the delicate art of delivering distressing news to patients. It not only incorporates the evidence-based setting, perception, invitation, knowledge, emotions, and strategy (SPIKES) method but also distinguishes itself by providing real-life conversation examples and self-assessment cases, which make the training highly relatable and practical for students to actively engage in their learning and personal development.
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Affiliation(s)
- Kaviya Arumugam
- First Professional MBBS, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai, Tamil Nadu, India
| | - Harshavardhini Nandagopal
- First Professional MBBS, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai, Tamil Nadu, India
| | - Joseline Joseph
- First Professional MBBS, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai, Tamil Nadu, India
| | - Jyotsna Needamangalam Balaji
- Third Professional MBBS: Part 1, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai, Tamil Nadu, India
| | - Krishna Mohan Surapaneni
- Department of Biochemistry, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai, Tamil Nadu, India
- Department of Medical Education, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai, Tamil Nadu, India
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Soto-Rubio A, Andreu Y, Gil-Juliá B, Picazo C, Murgui S, MacInnis CC, Sinclair S. Adaptation and validation of a patient-reported compassion measure in the Spanish population: The Spanish version of the Sinclair Compassion Questionnaire (SCQesp). Res Nurs Health 2024; 47:344-355. [PMID: 38316536 DOI: 10.1002/nur.22373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 12/27/2023] [Accepted: 01/14/2024] [Indexed: 02/07/2024]
Abstract
International practice guidelines and policies recognize compassion as a fundamental dimension of quality care. A key element in enhancing compassion in healthcare settings is having reliable patient-reported experience measures. In the Spanish context, there is a need for a valid Spanish patient-reported compassion measure for use in both research and clinical practice. The Sinclair Compassion Questionnaire (SCQ) represents the gold standard for patient-reported compassion measures in English-speaking settings. The primary aim of this study is to culturally adapt and validate the SCQ in a Spanish population. A Spanish version of the SCQ (SCQesp) was used to collect data from 303 Spanish patients (in two contexts: hospitalized and medical visit). Confirmatory factor analysis confirmed a one-factor solution in the 15-item (SCQesp) and five-item (SCQesp-SF) short form version. The SCQesp showed excellent values of reliability: Cronbach's α = 0.98; composite variance = 0.98 (0.905-0.854); and stratified variance = 0.78. The SCQesp-SF showed similar values of reliability. The SCQesp has excellent psychometric properties, making it a valid and reliable measure for assessing compassion in healthcare research and clinical care. This scientifically rigorous and psychometrically robust compassion measure in Spanish could allow healthcare providers, researchers, and leaders to routinely assess compassion.
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Affiliation(s)
- Ana Soto-Rubio
- Developmental and Education Psychology Department, Faculty of Psychology and Speech Therapy, University of Valencia, Valencia, Spain
| | - Yolanda Andreu
- Personality, Assessment and Psychological Treatments Department, Faculty of Psychology and Speech Therapy, University of Valencia, Valencia, Spain
| | - Beatriz Gil-Juliá
- Personality, Assessment and Psychological Treatments Department, Faculty of Psychology and Speech Therapy, University of Valencia, Valencia, Spain
| | - Carmen Picazo
- Psychology and Sociology Department, University of Zaragoza, Zaragoza, Spain
| | - Sergio Murgui
- Social Psychology Department, Faculty of Psychology and Speech Therapy, University of Valencia, Valencia, Spain
| | - Cara C MacInnis
- Department of Psychology, Faculty of Pure and Applied Science, Acadia University, Wolfville, Nova Scotia, Canada
| | - Shane Sinclair
- Compassion Research Lab, Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
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Shoshani A. The roots of compassion in early childhood: Relationships between theory of mind and attachment representations with empathic concern and prosocial behavior. J Exp Child Psychol 2024; 242:105880. [PMID: 38368743 DOI: 10.1016/j.jecp.2024.105880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 01/15/2024] [Accepted: 01/20/2024] [Indexed: 02/20/2024]
Abstract
This study focused on attachment representations and theory of mind as potential developmental origins of individual differences in preschoolers' peer- and adult-directed empathic concern and prosocial behavior. In two experiments, 3- to 6-year-olds were exposed to either a high-distressed or low-distressed adult or child using a laboratory setting (Experiment 1; N = 263) or hypothetical vignettes (Experiment 2; N = 202). Self-reported and coded expressions of empathic concern and prosocial behaviors were used as early indicators of compassion. The findings indicated that children expressed more empathic concern and engaged in more prosocial behavior in the high-distress condition than in the low-distress condition. Children's empathic concern and prosocial behavior increased with age. Secure attachment and theory of mind abilities played significant moderating roles in the association between distress conditions and empathic concern. Children with more advanced theory of mind abilities and secure attachment were better at recognizing the concerns of distressed peers or adults and showed significantly more empathic concern. Resistant and disorganized children exhibited more self-distress in response to others' distress. The implications for early interventions directed at increasing empathic concern and prosocial behavior are discussed.
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Affiliation(s)
- Anat Shoshani
- Baruch Ivcher School of Psychology, Reichman University (IDC Herzliya), Herzliya 46150, Israel.
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Luciani M, Ardenghi S, Rampoldi G, Russo S, Bani M, Strepparava MG, Di Mauro S, Ausili D. Caring for nursing students is caring for patients: A multicentre cross-sectional study on the relationship between nursing students' caring and the perception of instructors' caring. Nurse Education Today 2024; 137:106154. [PMID: 38508021 DOI: 10.1016/j.nedt.2024.106154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 02/19/2024] [Accepted: 03/07/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Caring in nursing is a fundamental aspect, yet teaching and fostering caring behaviours in nursing students remain challenging. Clinical instructors play a crucial role in this process. OBJECTIVES The aims of this study were a) to describe nursing students' caring behaviours and perceptions of instructor caring, b) to assess sex-related and year of course differences in students' caring behaviours and perceptions of nursing caring, and c) to investigate the association between nursing students' caring and their perception of instructors' caring. DESIGN A multi-centre, cross-sectional observational study was conducted. SETTING The study involved undergraduate nursing students from four teaching hospitals of a university in Northern Italy. PARTICIPANTS A total of 316 nursing undergraduate students participated in the study (83.9 % female, 16.1 % male, 23.1 % 1st year, 48.1 % 2nd year, 28.8 % 3rd year). METHODS Participants completed online self-reported surveys assessing caring behaviours, empathy, burnout, and perceptions of instructor caring. Caring behaviours, expressive and instrumental caring, were measured using the Caring Behaviour Inventory (CBI), and perceptions of instructor caring were assessed using the Nursing Students' Perceptions of Instructor Caring (NSPIC) questionnaire. RESULTS Students' caring behaviours were positively associated with their perceptions of instructor caring, particularly in relation to a supportive learning climate and instructor flexibility. Female students displayed higher scores in expressive caring, while students in their second and third years demonstrated increased instrumental caring behaviours. Responding to Individual Needs was significantly lower in third-years students, compared to first- and second-year ones. CONCLUSIONS This study emphasizes the crucial role of clinical instructors in shaping nursing students' caring attributes. However, the influence of sex on caring behaviours remains unclear, necessitating further investigation. These findings underscore the significance of nurturing caring behaviours in nursing education and offer insights for selecting, training, and supporting clinical instructors, to foster more compassionate and competent nurses.
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Affiliation(s)
- Michela Luciani
- Department of Medicine and surgery, University of Milano - Bicocca, Monza, Italy
| | - Stefano Ardenghi
- Department of Medicine and surgery, University of Milano - Bicocca, Monza, Italy; Fondazione I.R.C.C.S. San Gerardo dei Tintori, Monza, Italy.
| | - Giulia Rampoldi
- Department of Medicine and surgery, University of Milano - Bicocca, Monza, Italy
| | - Selena Russo
- Department of Medicine and surgery, University of Milano - Bicocca, Monza, Italy
| | - Marco Bani
- Department of Medicine and surgery, University of Milano - Bicocca, Monza, Italy
| | - Maria Grazia Strepparava
- Department of Medicine and surgery, University of Milano - Bicocca, Monza, Italy; Fondazione I.R.C.C.S. San Gerardo dei Tintori, Monza, Italy
| | - Stefania Di Mauro
- Department of Medicine and surgery, University of Milano - Bicocca, Monza, Italy
| | - Davide Ausili
- Department of Medicine and surgery, University of Milano - Bicocca, Monza, Italy
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Carvalho SA, Carvalho F, Fonseca L, Santos G, Castilho P. Beyond the Centrality of Shame: How Self-Concealment and Fear of Receiving Compassion From Others Impact Psychological Suffering in Transgender Adults. J Homosex 2024; 71:1373-1391. [PMID: 36043899 DOI: 10.1080/00918369.2022.2114398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Shame-based social interactions are a minority social stressor commonly experienced by transgender individuals. However, few studies have explored the centrality of shame experiences in transgender identity and mental health. Also, the ability to receive care and soothing support may be influenced by intrapersonal shame- and fear-related factors, which may hinder openness, and support and care seeking, thus contributing to psychological distress. This study aims to examine the relationship between central shame experiences, fear of receiving compassion from others, self-concealment, and psychological distress (depression, anxiety, and stress symptoms) in a sample of Portuguese transgender adults. Following a cross-sectional design, data from a convenience sample of 70 self-identified transgender individuals undergoing gender-affirming medical interventions (GAMIs) were analyzed, using SPSS PROCESS, to determine whether the relationship between central shame experiences and psychological suffering occurred indirectly through fear of receiving compassion from others, and self-concealment. Results suggest that fear of receiving compassion from others, but not self-concealment, was the underlying factor between central shame experiences, and depression and anxiety. Results suggest that the centrality of shame experiences and stress symptomatology associate sequentially through fear of compassion and, in turn, through self-concealment. Clinical implications for mental health interventions with transgender individuals undergoing GAMI are discussed.
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Affiliation(s)
- Sérgio A Carvalho
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
- HEI-Lab: Digital Human-Environment Interaction Lab, School of Psychology and Life Sciences (EPCV), Lusófona University, Lisbon, Portugal
| | - Frederica Carvalho
- Faculty of Medicine, Institute of Psychological Medicine (IPM), University of Coimbra, Coimbra, Portugal
| | - Lígia Fonseca
- CHUC, Centro de Responsabilidade Integrada de Psiquiatria (CRIP), Coimbra University Hospital, Coimbra, Portugal
| | - Graça Santos
- CHUC, Centro de Responsabilidade Integrada de Psiquiatria (CRIP), Coimbra University Hospital, Coimbra, Portugal
| | - Paula Castilho
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
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Gani C, Bickenbach P, Tenev A, Niyazi M, Festl-Wietek T, Herrmann-Werner A. Impact of electronic patient-reported outcome measures on patients' perception of the physician - the randomized ePREFERENCE study. Radiother Oncol 2024; 194:110192. [PMID: 38428640 DOI: 10.1016/j.radonc.2024.110192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/15/2024] [Accepted: 02/25/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Electronic Patient-reported outcome measures (ePROMs) are increasingly used in radiotherapy departments. However, the impact of ePROM integration on patients' perceptions of healthcare providers, particularly in terms of empathy and professionalism, remains unclear. Thus, this study aims to assess the patients' views on healthcare professionals during ePROM-based consultations. METHODS In this randomized trial, radiotherapy patients were enrolled and asked to evaluate video vignettes of consultations between a radiation oncologist and a patient. Two scenarios were shown in random order, one vignette portrayed a paper-chart-based clinic visit, and the other a consultation in which ePROMs were implemented. Established questionnaires such as Physician Compassion Questionnaire (PCQ), Jefferson Patient Perception of Physician Empathy (JPP), Physician Professionalism Questionnaire (PPQ) and Global Consultation Rating Scale (GCRS) were used to rate the healthcare professional. The primary endpoint was physician compassion. RESULTS Between May and August 2022, 152 patients, predominantly with malignancies of the breast, prostate, and brain participated. Patients rated the physician in ePROM-based consultations with higher mean scores for physician compassion compared to paper chart-based ones (36.4 vs. 34.2, p = 0.029). No negative impact of ePROMs was observed in terms of professionalism, global rating or physician empathy. Despite a shorter duration of the visit and reduced eye contact, 63 % of patients ultimately favored ePROM-based consultations. CONCLUSION The ePREFERENCE trial shows that the implementation of ePROMs in clinic visits during radiotherapy treatment positively impacts the patients' perception of the physician's compassion. ePROMs can therefore not only be considered a useful tool to improve workflows but are also broadly accepted by patients.
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Affiliation(s)
- C Gani
- Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany; German Cancer Consortium (DKTK), partner site Tübingen, a partnership between DKFZ and University Hospital, Tübingen, Germany.
| | - P Bickenbach
- Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany; German Cancer Consortium (DKTK), partner site Tübingen, a partnership between DKFZ and University Hospital, Tübingen, Germany
| | - A Tenev
- Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany; German Cancer Consortium (DKTK), partner site Tübingen, a partnership between DKFZ and University Hospital, Tübingen, Germany
| | - M Niyazi
- Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany; German Cancer Consortium (DKTK), partner site Tübingen, a partnership between DKFZ and University Hospital, Tübingen, Germany
| | - T Festl-Wietek
- Tuebingen Institute for Medical Education, University of Tuebingen, Tuebingen, Germany
| | - A Herrmann-Werner
- Tuebingen Institute for Medical Education, University of Tuebingen, Tuebingen, Germany
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12
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Gordon-Hecker T, Shalvi S, Uzefovsky F, Bereby-Meyer Y. Cognitive empathy boosts honesty in children and young adolescents. J Exp Child Psychol 2024; 241:105869. [PMID: 38350253 DOI: 10.1016/j.jecp.2024.105869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 09/11/2023] [Accepted: 01/12/2024] [Indexed: 02/15/2024]
Abstract
Children and young adolescents often tend to behave dishonestly in order to serve their self-interests. This study focused on how empathic abilities affect children's tendency to deceive others. Deception is the act of causing others to form a false belief to get them to act in a way that serves the deceiver's interests. As such, it requires the ability to predict how others might use the provided information. In two experiments, 274 participants (aged 10-16 years) played a game in which they could send a deceptive message to another participant to boost their own payoff at the other player's expense. We measured participants' cognitive and emotional empathy using different measures. We found that a measure of cognitive empathy, namely the fantasy scale, was associated with less deception of another player when that other player was not identified and was presented only as "Player B." However, when Player B was identified by name, empathy did not predict deception. In such cases, the only factors affecting deception rates were the gain for the participant (higher possible gains lead to more deception) and loss to the other player (higher possible losses lead to less deception). Overall, the findings suggest that even by 11 years of age, children can understand the impact of their unethical behavior on another child and adjust their actions accordingly. However, when the other child is not identified, children need to possess high levels of cognitive empathy toward imagined individuals to resist the temptation to deceive the other child.
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Affiliation(s)
| | - Shaul Shalvi
- University of Amsterdam, 1018 WB Amsterdam, The Netherlands
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13
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Lotze M. Emotional processing impairments in patients with insula lesions following stroke. Neuroimage 2024; 291:120591. [PMID: 38552812 DOI: 10.1016/j.neuroimage.2024.120591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024] Open
Abstract
Functional imaging has helped to understand the role of the human insula as a major processing network for integrating input with the current state of the body. However, these studies remain at a correlative level. Studies that have examined insula damage show lesion-specific performance deficits. Case reports have provided anecdotal evidence for deficits following insula damage, but group lesion studies offer a number of advances in providing evidence for functional representation of the insula. We conducted a systematic literature search to review group studies of patients with insula damage after stroke and identified 23 studies that tested emotional processing performance in these patients. Eight of these studies assessed emotional processing of visual (most commonly IAPS), auditory (e.g., prosody), somatosensory (emotional touch) and autonomic function (heart rate variability). Fifteen other studies looked at social processing, including emotional face recognition, gaming tasks and tests of empathy. Overall, there was a bias towards testing only patients with right-hemispheric lesions, making it difficult to consider hemisphere specificity. Although many studies included an overlay of lesion maps to characterise their patients, most did not differentiate lesion statistics between insula subunits and/or applied voxel-based associations between lesion location and impairment. This is probably due to small group sizes, which limit statistical comparisons. We conclude that multicentre analyses of lesion studies with comparable patients and performance tests are needed to definitively test the specific function of parts of the insula in emotional processing and social interaction.
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Affiliation(s)
- Martin Lotze
- Functional Imaging Unit, Center for Diagnostic Radiology, University of Greifswald, Germany.
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14
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Fox S, McAllum K, Ginoux L. Team Care for the Care Team: A Scoping Review of the Relational Dimensions of Collaboration in Healthcare Contexts. Health Commun 2024; 39:960-971. [PMID: 37081769 DOI: 10.1080/10410236.2023.2198673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Examining team care for the care team, this scoping literature review highlights the relational and compassionate dimensions of collaboration and teamwork that can alleviate healthcare worker suffering and promote well-being in challenging contexts of care. Its goal is to provide greater conceptual clarity about team care and examine the contextual dimensions regarding the needs and facilitators of team care. Analysis of the 48 retained texts identified three broad types of communicative practice that constitute team care: sharing; supporting; and leading with compassion. The environmental conditions facilitating team care included a caring team culture and specific and accessible organizational supports. These results are crystallized into a conceptual model of team care that situates team care within a system of team and organizational needs and anticipated outcomes. Gaps in the literature are noted and avenues for future research are suggested.
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Affiliation(s)
| | | | - Laura Ginoux
- Department of Communication, Université de Montréal
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15
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Kasaye H, Scarf V, Sheehy A, Baird K. Health care providers' perspectives on the mistreatment towards women during maternity care: Do perceptions of the working environment and empathy level matter? Women Birth 2024; 37:101601. [PMID: 38518578 DOI: 10.1016/j.wombi.2024.101601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 03/09/2024] [Accepted: 03/09/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Mistreatment of women in maternity care violates human rights, erodes trust and disrupts the continuity of maternal healthcare services. Investigating Health Care Providers' (HCPs) perspectives is indispensable in uncovering drivers and designing targeted interventions. AIM To identify the roles of HCPs' perceptions of the working environment and levels of empathy on the mistreatment of women during maternity care. METHODS We conducted a self-administered survey among 148 maternal HCPs practising in ten health centres and four hospitals in the East Wollega Zone, Western Ethiopia, from June to September 2022. FINDINGS Most providers reported seeing other HCPs mistreating women (93.2%), while three-fourths (75.7%) admitted it as their actions. Violation of privacy and confidentiality was the most frequently reported category of mistreatment (44.6%), followed by physical abuse (37.1%) and verbal abuse (35.8%). The likelihood of mistreating women was reduced by 65% (AOR=0.35, 95% CI: [0.14, 0.86]) among individuals with positive perceptions of their working environment compared to those with negative perceptions. A unit increase in providers' empathy also led to a five per cent decrease in mistreatment (AOR=0.95, 95% CI: [0.91, 0.98]. CONCLUSIONS HCPs' perceptions of their working environment and enhanced empathy levels were associated with the reduction of the odds of mistreatment of women. While empathic care should be cultivated as a component of HCPs' competencies, efforts should be made to improve the conditions of the demanding health system to realise a resilient, motivated, competent, and compassionate workforce. The interplay between gender, profession, and mistreatment level requires further investigation.
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Affiliation(s)
- Habtamu Kasaye
- Collective for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, New South Wales, Australia; Department of Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
| | - Vanessa Scarf
- Collective for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, New South Wales, Australia
| | - Annabel Sheehy
- Collective for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, New South Wales, Australia
| | - Kathleen Baird
- Collective for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, New South Wales, Australia
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16
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Gupta K, Zhang Y, Gunasekaran TS, Krishna N, Pai YS, Billinghurst M. CAEVR: Biosignals-Driven Context-Aware Empathy in Virtual Reality. IEEE Trans Vis Comput Graph 2024; 30:2671-2681. [PMID: 38437090 DOI: 10.1109/tvcg.2024.3372130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
There is little research on how Virtual Reality (VR) applications can identify and respond meaningfully to users' emotional changes. In this paper, we investigate the impact of Context-Aware Empathic VR (CAEVR) on the emotional and cognitive aspects of user experience in VR. We developed a real-time emotion prediction model using electroencephalography (EEG), electrodermal activity (EDA), and heart rate variability (HRV) and used this in personalized and generalized models for emotion recognition. We then explored the application of this model in a context-aware empathic (CAE) virtual agent and an emotion-adaptive (EA) VR environment. We found a significant increase in positive emotions, cognitive load, and empathy toward the CAE agent, suggesting the potential of CAEVR environments to refine user-agent interactions. We identify lessons learned from this study and directions for future work.
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17
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The Lancet Child Adolescent Health. Evidence-based kindness and empathy for autistic children. Lancet Child Adolesc Health 2024; 8:311. [PMID: 38574749 DOI: 10.1016/s2352-4642(24)00080-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
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18
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Zhang L, Wager TD, Koban L. Social cues influence perception of others' pain. Eur J Pain 2024; 28:845-854. [PMID: 38146898 DOI: 10.1002/ejp.2225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/30/2023] [Accepted: 12/08/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Accurately perceiving other people's pain is important in both daily life and healthcare settings. However, judging other's pain is inherently difficult and can be biased by various social and cultural factors. Here, we examined whether perception of others' pain and pain management recommendations are socially influenced by seeing the opinions of other raters. METHODS In Experiment 1 (N = 50), participants rated pictures depicting injured hands or feet of pre-selected high, medium and low intensities. Each picture was preceded by cues indicating ratings of 10 previous participants. Cues were randomized to indicate low (SocialLOW) or high (SocialHIGH) pain judgements and were not predictive of actual normative pain intensity. In Experiment 2 (N = 209), participants viewed facial video clips of patients with chronic shoulder pain making painful movements. They estimated patients' pain intensity and provided pain management recommendations. RESULTS Experiment 1 revealed that perceivers' pain estimates were significantly and substantially higher for stimuli following SocialHIGH than SocialLOW cues (Cohen's d = 1.26, p < 0.001) and paralleled by increased skin conductance responses. Experiment 2 replicated the effect of social cues on pain judgements (d = 0.58, p < 0.001). However, social cues did not influence post-study pain management recommendations, potentially due to memory limitations. CONCLUSIONS Together, these studies reveal that judgements of others' pain are robustly modulated by information about others' opinions. Future research could test the prevalence and strength of such effects in clinical settings. SIGNIFICANCE The present study shows that even arbitrary opinions of other raters influence the perception of others' pain. This finding adds new insight into the growing evidence of social and cultural biases in pain estimation.
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Affiliation(s)
- Lanlan Zhang
- Department of Public Teaching, Guangzhou Sport University, Guangzhou, China
| | - Tor D Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - Leonie Koban
- Lyon Neuroscience Research Center, CNRS, Inserm, Université Claude Bernard Lyon 1, Bron, France
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19
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Lee Y, Shin H, Gil YH. Measurement of Empathy in Virtual Reality with Head-Mounted Displays: A Systematic Review. IEEE Trans Vis Comput Graph 2024; 30:2485-2495. [PMID: 38437085 DOI: 10.1109/tvcg.2024.3372076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
We present a systematic review of 111 papers that measure the impact of virtual experiences created through head-mounted displays (HMDs) on empathy. Our goal was to analyze the conditions and the extent to which virtual reality (VR) enhances empathy. To achieve this, we categorized the relevant literature according to measurement methods, correlated human factors, viewing experiences, topics, and participants. Meta-analysis was performed based on categorized themes, and under specified conditions, we found that VR can improve empathy. Emotional empathy increased temporarily after the VR experience and returned to its original level over time, whereas cognitive empathy remained enhanced. Furthermore, while VR did not surpass 2D video in improving emotional empathy, it did enhance cognitive empathy, which is associated with embodiment. Our results are consistent with existing research suggesting differentiation between cognitive empathy (influenced by environmental factors and learnable) and emotional empathy (highly heritable and less variable). Interactivity, target of empathy, and point of view were not found to significantly affect empathy, but participants' age and nationality were found to influence empathy levels. It can be concluded that VR enhances cognitive empathy by immersing individuals in the perspective of others and that storytelling and personal characteristics are more important than the composition of the VR scene. Our findings provide guiding information for creating empathy content in VR and designing experiments to measure empathy.
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20
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Zhang X, Li L, Zhang Q, Le LH, Wu Y. Physician Empathy in Doctor-Patient Communication: A Systematic Review. Health Commun 2024; 39:1027-1037. [PMID: 37062918 DOI: 10.1080/10410236.2023.2201735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Physician empathy is at the heart of doctor-patient communication and significantly influences patient outcomes. However, the research on how physicians express their empathy and how physician empathy affects patient outcomes and doctor-patient communication has not been well summarized in the latest literature. Thus, we conducted a systematic review to synthesize existing studies on physician empathy and its value to patient outcomes and doctor-patient communication. The systematic review consisted of studies published in English peer-reviewed journals between January 2017 and October 2021. Following the PRISMA procedure, a total of 3055 articles were retrieved, and 11 articles were retained. The thematic analysis revealed three emergent themes: physicians' empathic expressions; patient outcomes (patient functional status, patient safety, and patient satisfaction); and empathy enhancing doctor-patient communication. This study highlighted the different ways empathy may be expressed by physicians and its positive effects on patient outcomes and doctor- patient communication. This study also suggested the under-researched areas that can be expanded in the future.
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Affiliation(s)
- Xin Zhang
- Center for Medical Humanities in the Developing World, Qufu Normal University
| | - Linzi Li
- Department of Gynaecology, Rizhao Maternal and Child Health
| | - Quan Zhang
- School of International Affairs and Public Administration, Ocean University of China
| | | | - Yijin Wu
- Center for Medical Humanities in the Developing World, Qufu Normal University
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21
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Schreier HMC, Feinberg ME, Jones DE, Ganguli A, Givens C, Graham-Engeland J. Children's empathy moderates the association between perceived interparental conflict and child health. Brain Behav Immun 2024; 118:128-135. [PMID: 38408496 PMCID: PMC11008563 DOI: 10.1016/j.bbi.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 02/07/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024] Open
Abstract
Interparental conflict is known to negatively impact child well-being, including behavioral and physiological well-being. Children's empathy - that is, vicariously experiencing others' emotions - may increase children's sensitivity to and the biological repercussions of interparental conflict. Although empathy represents a valued trait and is an important part of socioemotional development, its influence on children's physical health is unknown. This study examined whether empathy moderates the association between perceived interparental conflict and both child systemic inflammation and parent-rated overall child health in a sample of children between the ages of seven to nine. Children and their parents participating in the long-term evaluation of the Family Foundations program, a randomized trial of a perinatal preventative intervention, provided data approximately eight years following enrollment into the program. We collected peripheral blood samples via dried blood spots, anthropometric measurements, and child and parent psychosocial questionnaires. Results indicated significant positive main effects of child empathy on both C-reactive protein (CRP; B = 0.26, SE = 0.11, p =.026) and Interleukin-6 (IL-6; B = 0.20, SE = 0.10, p =.045) levels. Further, child affective empathy moderated the associations between perceived interparental conflict and both CRP (B = 0.39, SE = 0.19, p =.050) and parent-reported child health (B = 0.30, SE = 0.13, p =.021), such that greater empathy strengthened the negative associations between interparental conflict and child health. Overall, findings suggests that there may be a biological cost of being more empathic in high-conflict environments and highlight the need for tools to help more empathic children appropriately manage vicarious emotions.
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Affiliation(s)
- Hannah M C Schreier
- Department of Biobehavioral Health, The Pennsylvania State University, United States; Social Science Research Institute, The Pennsylvania State University, United States.
| | - Mark E Feinberg
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, United States
| | - Damon E Jones
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, United States
| | - Aishwarya Ganguli
- Department of Biobehavioral Health, The Pennsylvania State University, United States
| | - Caitlin Givens
- Department of Biobehavioral Health, The Pennsylvania State University, United States
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22
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Hinz LD. Filling the form: Expressive Therapies Continuum-guided treatment of narcissistic personality disorder. J Clin Psychol 2024; 80:1192-1206. [PMID: 38178697 DOI: 10.1002/jclp.23635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 11/08/2023] [Accepted: 12/08/2023] [Indexed: 01/06/2024]
Abstract
Sara was a 65-year-old Caucasian woman who requested art therapy after the death of her partner. She had experienced incest by her father and verbal abuse by her mother until she left home at 21. Her life was characterized by broken relationships due to alienating anger outbursts and an interrupted work history; she met three criteria for narcissistic personality disorder. Sara initially was socially isolated and intellectualizing. She desired recognition but was fearful of exposure. The Expressive Therapies Continuum (ETC) theoretical framework, which consisted of a gradual progression from cognitively-dominated sessions to more emotionally focused processing, guided the therapeutic work. The ETC theory encourages transparency and collaboration between therapist and client regarding therapeutic tasks and goals, and provides a framework for addressing and repairing ruptures in the therapeutic alliance. Art therapy began with the cognitive tasks which Sara completed relatively comfortably, then encouraged integration of emotion via expressive writing, diagrams, and body mapping. Through careful attention to repair of ruptures by directly discussing and adapting the direction and tasks of therapy, Sara slowly was able to experience emotions other than anger. She integrated cognitive and emotional insights about her life and developed empathy for her childhood self. At termination Sara had cultivated two friendships and met only one criterion of NPD. Limitations of this case study include a lack of research evidence for ETC-guided art therapy with NPD clients and by the retrospective approach. Future research efforts could provide this support by encouraging clinicians to conduct prospective case study research.
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Affiliation(s)
- Lisa D Hinz
- Department of Art Therapy Psychology, Dominiacan University of California, San Rafael, California, USA
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23
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Marshman C, Allen J, Ling D, Brand G. 'It's very values driven': A qualitative systematic review of the meaning of compassion according to healthcare professionals. J Clin Nurs 2024; 33:1647-1665. [PMID: 38240044 DOI: 10.1111/jocn.16998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/19/2023] [Accepted: 01/07/2024] [Indexed: 04/04/2024]
Abstract
AIMS AND OBJECTIVES To explore the meaning ascribed to the concept of compassion by healthcare professionals. BACKGROUND Compassion is universally regarded as the foundation of healthcare, a core value of healthcare organisations, and essential to the provision of quality care. Despite increasing research on compassion in healthcare, how healthcare professionals understand compassion remains unclear. DESIGN A systematic review of qualitative studies was conducted and is reported following PRISMA guidelines. METHOD Medline, Emcare, PsychINFO and CINAHL were searched to November 2021 for qualitative studies in English that explored healthcare professionals' understandings of compassion. Included studies were appraised for quality before data were extracted and thematically analysed. FINDINGS Seventeen papers met the inclusion criteria. An overarching theme, 'It's very values driven' underpins the four main themes identified: (1) 'It's about people and working with them': Compassion as being human, (2) 'There is this feeling': Compassion as being present, (3) 'If I don't understand them, I won't be able to help': Compassion as understanding, (4) 'Wanting to help in some way': Compassion as action. CONCLUSIONS Healthcare professional participants reported compassion as motivated by values and inherent to humanistic healthcare practice. The meanings healthcare professions described were varied and contextual. Qualitative research should further explore healthcare practitioners' experiences of compassion as part of their practice to inform health professions education, policy, and practice. RELEVANCE TO CLINICAL PRACTICE To practice with compassion, healthcare professionals require supportive and humanistic organisations that honour each person's humanity and encourage people to be human and compassionate to each other as well as to patients, their families and/or carers. Healthcare professionals need to reflect on what compassion means to them, how it is situated within their unique practice context, and how compassion can enhance clinical practice. NO PATIENT OR PUBLIC CONTRIBUTION This systematic review had no patient or public contribution.
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Affiliation(s)
- Cameron Marshman
- Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
- Peninsula Health, Frankston, Victoria, Australia
- The Australian College of Mental Health Nurses, Deakin, Australian Capital Territory, Australia
| | - Jacqui Allen
- Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Debbie Ling
- Department of Social Work, Monash University, Melbourne, Victoria, Australia
- Epworth HealthCare, Melbourne, Victoria, Australia
| | - Gabrielle Brand
- Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
- Monash Centre for Scholarship in Health Education (MCSHE), Monash University, Clayton, Victoria, Australia
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24
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Dandy S, Wittkowski A, Murray CD. Parents' experiences of receiving their child's diagnosis of congenital heart disease: A systematic review and meta-synthesis of the qualitative literature. Br J Health Psychol 2024; 29:351-378. [PMID: 37968248 DOI: 10.1111/bjhp.12703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/31/2023] [Accepted: 10/18/2023] [Indexed: 11/17/2023]
Abstract
PURPOSE This systematic review aimed to synthesize qualitative research on parents' psychological experiences following their child's diagnosis of congenital heart disease (CHD). METHODS A systematic search of six electronic databases (CINAHL, Embase, MEDLINE, PsycINFO, PubMed and Web of Science) was completed, inclusive of all years up to May 2022. Any included articles were synthesized using thematic synthesis and appraised using the Critical Appraisal Skills Programme Qualitative Checklist. RESULTS Twenty-six articles were included. Four main themes, and 11 subthemes, emerged from the synthesis. Theme 1 (unpreparedness for the diagnosis) concerned parents' shock, guilt and anger regarding the diagnosis. Theme 2 (the overwhelming reality of CHD) described parental fear about decision-making and the child's prognosis, and the influence of professionals on parents' well-being. Theme 3 (mourning multiple losses) detailed parents' sadness at losing their envisioned pregnancy, birth and parenthood experiences. Theme 4 (redefining hopes to reach an acceptance of CHD) described parents' adjustment to the diagnosis. CONCLUSIONS Receiving a child's CHD diagnosis was a uniquely challenging situation for parents. The findings provided insight into the emotions parents experienced and how they adjusted to the diagnosis psychologically. As parents' experiences were significantly influenced by their interactions with professionals, clinicians should offer compassion, validation and clear information throughout the diagnosis process.
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25
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Bedert M, Moody K, Nieuwkerk P, van Holten N, de Wit J, van der Valk M. Between delivering chronic care and answering patients' burdens: Understanding HIV specialist nurses' experiences in the age of treatment. J Adv Nurs 2024; 80:1943-1954. [PMID: 37983876 DOI: 10.1111/jan.15941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/14/2023] [Accepted: 10/25/2023] [Indexed: 11/22/2023]
Abstract
AIM(S) To understand the experiences of HIV nurses in the context of ambivalence between biomedical treatment advancements and the continuing burden for people living with HIV and negative representations of HIV. DESIGN An interpretative phenomenological study was conducted using in-depth interviews. METHODS Twenty-one interviews with nurses were conducted between November 2021 and March 2022. A thematic analysis was performed. RESULTS Six themes related to the nurses' experiences emerged. Despite effective treatment for most people with HIV, nurses identify patient populations that require additional care. Nurses are flexible in making extra appointments to accommodate complex issues in these patients. Nurses develop a unique relationship with their patients based on trust and empathy, linked to patient's experiences with stigma and discrimination for people with HIV. Nurses perceive their tasks as becoming increasingly complex. There is explicit awareness about the changes in HIV care from acute to chronic care and how this affects nurses' tasks. Nurses continue to differentiate HIV from other chronic conditions. CONCLUSION Biomedical advancements change the organization of HIV care while public health concerns remain and patient population has particular needs due to negative social representations of HIV. Nurses navigate these issues in their everyday care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE A potential re-evaluation of the role of nurses in providing chronic HIV care. IMPACT Our study addresses the roles of HIV nurses as care is shifting towards chronic care models. The unique relationship between nurses and patients is key in understanding the importance of nurses in the care trajectory. These findings impact the institutional role of nurses in HIV treatment centres and the institutional organization of HIV care. REPORT METHOD The COREQ guideline was used. PATIENT OR PUBLIC CONTRIBUTION Amsterdam UMC (AMC) staff, the national organization of HIV Nurses and patient organizations contributed to the study design.
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Affiliation(s)
- Maarten Bedert
- Division of Infectious Diseases, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Kevin Moody
- Division of Infectious Diseases, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Pythia Nieuwkerk
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Natasja van Holten
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - John de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Marc van der Valk
- Division of Infectious Diseases, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- HIV Monitoring Foundation, Amsterdam, The Netherlands
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Fidan Ö, Çunkuş Köktaş N, Şanlialp Zeyrek A. The relationship between moral courage and lovingkindness-compassion levels in critical care nurses: A cross-sectional study. Aust Crit Care 2024; 37:468-474. [PMID: 37263903 DOI: 10.1016/j.aucc.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/13/2023] [Accepted: 04/15/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Ethical dilemmas and ethical problems are very common in intensive care units. Nurses need moral courage to deal with these problems. Nurses' high empathy, humility, lovingkindness, and compassion support them to act with moral courage. OBJECTIVES The aim of this study was to determine the moral courage, lovingkindness, and compassion levels of critical care nurses and to reveal whether there is a relationship between them. METHODS One hundred sixty-eight nurses working in the intensive care unit of a university hospital in Turkey were included in this correlational descriptive cross-sectional study. The data were collected with the Nurses' Moral Courage Scale (NMCS) and the Loving-kindness Compassion Scale (LCS). RESULTS There was a positive and significant relationship between the NMCS and the LCS lovingkindness (r = .377, p < .05) and compassion (r = .405, p < .05) subdimensions; on the other hand, a negative and significant relationship was observed with the LCS self-centredness subdimension (r = -.215, p = .025). In addition, the mean scores of the LCS subdimensions of compassion, self-centredness, and lovingkindness were predictors of the NMCS total score (R = .475, R2 = .286, p < .05). CONCLUSIONS In this study, it was determined that critical care nurses with high moral courage levels had high levels of compassion and lovingkindness and low levels of self-centredness. A high level of moral courage and compassion in nurses may contribute to quality and safe patient care. In-service trainings may be planned to increase nurses' awareness of moral courage, loving-kindness, and compassion.
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Affiliation(s)
- Özlem Fidan
- Faculty of Health Sciences, Nursing Department, Pamukkale University, Denizli, Turkey.
| | - Nesrin Çunkuş Köktaş
- Faculty of Health Sciences, Nursing Department, Pamukkale University, Denizli, Turkey.
| | - Arife Şanlialp Zeyrek
- Faculty of Health Sciences, Nursing Department, Pamukkale University, Denizli, Turkey.
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Gerger H, Munder T, Kreuzer N, Locher C, Blease C. Lay Perspectives on Empathy in Patient-Physician Communication: An Online Experimental Study. Health Commun 2024; 39:1246-1255. [PMID: 37219394 DOI: 10.1080/10410236.2023.2210380] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Research indicates that patients consider empathy as a key factor contributing to the quality-of-care. However, ambiguities in the definition of this multidimensional construct complicate definite conclusions to-date. Addressing the challenges in the literature, and using a hypothetical physician-patient interaction which explored patient-perceived differences between expressions of affective empathy, cognitive empathy, compassion and no empathy, this study aimed to test whether lay participants' evaluations of the quality-of-care depend on the type of empathic physician behavior, and on the physician's gender. We conducted a randomized web-based experiment using a 4 (type of empathy) by 2 (physician gender) between-subjects design. Empathy was subdivided into three concepts: first, affective empathy (i.e. feeling with someone); second, cognitive empathy (i.e. understanding); and third, compassion (i.e. feeling for someone and offering support). Perceived quality-of-care was the primary outcome. Compared with non-empathic interactions, quality-of-care was rated higher when physicians reacted cognitively empathic or compassionate (d = 0.71; 0.43 to 1.00 and d = 0.68; 0.38 to 0.98). No significant difference was found between affective empathy and no empathy (d = 0.13; -0.14 to 0.42). The physician's gender was not related with quality-of-care. Aspects of participants' personality but not their age, gender or the number of physician visits were associated with quality-of-care. No interactions were observed. In showing that patients rated quality-of-care higher when physician reactions were described as cognitively empathic and compassionate, as compared with affectively empathic or non-empathic, our findings refine views about the kinds of empathy that are important in patient care with implications for clinical practice, education and communication trainings.
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Affiliation(s)
- Heike Gerger
- Department of Family Medicine, Care and Public Health Research Institute, Maastricht University
- Department of General Practice, Erasmus University Medical Center
- Department of Clinical Psychology and Psychotherapy, University of Basel
| | - Thomas Munder
- Department of Psychology, University of Zurich
- Department of Psychology, University of Kassel
| | - Nicole Kreuzer
- Department of Clinical Psychology and Psychotherapy, University of Basel
| | - Cosima Locher
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich
| | - Charlotte Blease
- Department of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School
- Department of Women's and Children's Health, Uppsala University
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Jin K, Wu J, Zhang R, Zhang S, Wu X, Wu T, Gu R, Liu C. Observing heroic behavior and its influencing factors in immersive virtual environments. Proc Natl Acad Sci U S A 2024; 121:e2314590121. [PMID: 38625938 DOI: 10.1073/pnas.2314590121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/02/2024] [Indexed: 04/18/2024] Open
Abstract
Studying heroism in controlled settings presents challenges and ethical controversies due to its association with physical risk. Leveraging virtual reality (VR) technology, we conducted a three-study series with 397 participants from China to investigate heroic actions. Participants unexpectedly witnessed a criminal event in a simulated scenario, allowing observation of their tendency to physically intercept a thief. We examined situational factors (voluntariness, authority, and risk) and personal variables [gender, impulsivity, empathy, and social value orientation (SVO)] that may influence heroism. Also, the potential association between heroism and social conformity was explored. In terms of situational variables, voluntariness modulated participants' tendency to intercept the escaping thief, while perceived risk demonstrated its impact by interacting with gender. That is, in study 3 where the perceived risk was expected to be higher (as supported by an online study 5), males exhibited a greater inclination toward heroic behavior compared to females. Regarding other personal variables, the tendency to engage in heroic behavior decreased as empathy levels rose among males, whereas the opposite trend was observed for females. SVO influenced heroic behavior but without a gender interaction. Finally, an inverse relationship between heroism and social conformity was observed. The robustness of these findings was partly supported by the Chinese sample (but not the international sample) of an online study 4 that provided written descriptions of VR scenarios, indicating cultural variations. These results advance insights into motivational factors influencing heroism in the context of restoring order and highlight the power of VR technology in examining social psychological hypotheses beyond ethical constraints.
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Affiliation(s)
- Kelou Jin
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
- International Data Group McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Jie Wu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
- International Data Group McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Ran Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
- International Data Group McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Shen Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
- International Data Group McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Xiaoyan Wu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
- International Data Group McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Tingting Wu
- Beijing Key Lab of Learning and Cognition, School of Psychology, Capital Normal University, Beijing 100048, China
| | - Ruolei Gu
- Key Laboratory of Behavioral Science, Institute of Psychology Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Chao Liu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
- International Data Group McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
- Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing 100875, China
- Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing 100875, China
- National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing 100875, China
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Ng IKS, Tan LF, Kumarakulasinghe NB, Goh WGW, Ngiam N, Teo DB. Providing family updates: a primer for the medical trainee. Postgrad Med J 2024; 100:344-349. [PMID: 38272463 DOI: 10.1093/postmj/qgad143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 12/12/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024]
Abstract
Providing family updates is a common clinical task for medical trainees and practitioners working in hospital settings. Good clinical communication skills are essential in clinical care as it is associated with improved patient satisfaction, understanding of condition, treatment adherence, and better overall clinical outcomes. Moreover, poor communications are often the source of medical complaints. However, while patient-centred communication skills training has generally been incorporated into clinical education, there hitherto remains inadequate training on clinical communications with patients' families, which carry different nuances. In recent years, it is increasingly recognized that familial involvement in the care of hospitalized patients leads to better clinical and psychological outcomes. In fact, in Asian populations with more collectivistic cultures, families are generally highly involved in patient care and decision-making. Therefore, effective clinical communications and regular provision of family updates are essential to build therapeutic rapport, facilitate familial involvement in patient care, and also provide a more holistic understanding of the patient's background and psychosocial set-up. In this article, we herein describe a seven-step understand the clinical context, gather perspectives, deliver medical information, address questions, concerns and expectations, provide tentative plans, demonstrate empathy, postcommunication reflections model as a practical guide for medical trainees and practitioners in provision of structured and effective family updates in their clinical practice.
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Affiliation(s)
- Isaac K S Ng
- Department of Medicine, National University Hospital, Singapore 119228, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Li Feng Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- Healthy Ageing Programme, Alexandra Hospital, Singapore 159964, Singapore
| | - Nesaretnam Barr Kumarakulasinghe
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- Department of Haematology-Oncology, National University Cancer Institute of Singapore, Singapore 119228, Singapore
| | - Wilson G W Goh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore 119228, Singapore
| | - Nicola Ngiam
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore 119074, Singapore
| | - Desmond B Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- Fast and Chronic Programmes, Alexandra Hospital, Singapore 159964, Singapore
- Division of Advanced Internal Medicine, Department of Medicine, National University Hospital, Singapore 119228, Singapore
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Young L, Ferrara F, Kelly L, Martin T, Thompson-Iritani S, LaFollette MR. Professional quality of life in animal research personnel is linked to retention & job satisfaction: A mixed-methods cross-sectional survey on compassion fatigue in the USA. PLoS One 2024; 19:e0298744. [PMID: 38626016 PMCID: PMC11020707 DOI: 10.1371/journal.pone.0298744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 01/29/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND Working with research animals can be both rewarding and challenging. The rewarding part of the work is associated with understanding the necessity for animal research to improve the health of humans and animals and the knowledge that one can provide care and compassion for the animals. Challenges with animal research include witnessing stress/pain in animals necessitated by scientific requirements, end of study euthanasia, and societal stigmatization about animal research. These challenges could be compounded with more general workplace stresses, in turn, impacting job retention and satisfaction. However, these factors have yet to be formally evaluated. Therefore, the purpose of this survey was to comprehensively evaluate professional quality of life's correlation with key workplace metrics. METHODS Six institutions were recruited to participate in a longitudinal intervention trial on compassion fatigue resiliency. This manuscript reports key baseline metrics from this survey. A cross-sectional mixed methods survey was developed to evaluate professional quality of life, job satisfaction, retention, and factors influencing compassion fatigue resiliency. Quantitative data were analyzed via general linear models and qualitative data were analyzed by theme. RESULTS Baseline data was collected from 198 participants. Personnel who reported higher compassion satisfaction also reported higher retention and job satisfaction. Conversely, personnel who reported higher burnout also reported lower job satisfaction. In response to open-ended questions, participants said their compassion fatigue was impacted by institutional culture (70% of participants), animal research (58%), general mental health (41%), and specific compassion fatigue support (24%). CONCLUSIONS In conclusion, these results show that professional quality of life is related to important operational metrics of job satisfaction and retention. Furthermore, compassion fatigue is impacted by factors beyond working with research animals, including institutional culture and general mental health support. Overall, this project provides rationale and insight for institutional support of compassion fatigue resiliency.
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Affiliation(s)
- Lauren Young
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
- The 3Rs Collaborative, Denver, Colorado, United States of America
| | | | - Lisa Kelly
- University of Georgia, Athens, Georgia, United States of America
| | - Tara Martin
- Refinement and Enrichment Advancements Laboratory, Unit for Laboratory Animal Medicine, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Sally Thompson-Iritani
- Department of Environmental and Occupational Health Sciences, Office of Research, University of Washington, Seattle, WA, United States of America
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Roach P, Ruzycki SM, Lithgow KC, McFadden CR, Chikwanha A, Holroyd-Leduc J, Barnabe C. A logic framework for addressing medical racism in academic medicine: an analysis of qualitative data. BMC Med Ethics 2024; 25:45. [PMID: 38616267 PMCID: PMC11017534 DOI: 10.1186/s12910-024-01045-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 04/02/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Despite decades of anti-racism and equity, diversity, and inclusion (EDI) interventions in academic medicine, medical racism continues to harm patients and healthcare providers. We sought to deeply explore experiences and beliefs about medical racism among academic clinicians to understand the drivers of persistent medical racism and to inform intervention design. METHODS We interviewed academically-affiliated clinicians with any racial identity from the Departments of Family Medicine, Cardiac Sciences, Emergency Medicine, and Medicine to understand their experiences and perceptions of medical racism. We performed thematic content analysis of semi-structured interview data to understand the barriers and facilitators of ongoing medical racism. Based on participant narratives, we developed a logic framework that demonstrates the necessary steps in the process of addressing racism using if/then logic. This framework was then applied to all narratives and the barriers to addressing medical racism were aligned with each step in the logic framework. Proposed interventions, as suggested by participants or study team members and/or identified in the literature, were matched to these identified barriers to addressing racism. RESULTS Participant narratives of their experiences of medical racism demonstrated multiple barriers to addressing racism, such as a perceived lack of empathy from white colleagues. Few potential facilitators to addressing racism were also identified, including shared language to understand racism. The logic framework suggested that addressing racism requires individuals to understand, recognize, name, and confront medical racism. CONCLUSIONS Organizations can use this logic framework to understand their local context and select targeted anti-racism or EDI interventions. Theory-informed approaches to medical racism may be more effective than interventions that do not address local barriers or facilitators for persistent medical racism.
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Affiliation(s)
- Pamela Roach
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Shannon M Ruzycki
- Department of Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, 1422, T2N 2T9, Canada.
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.
| | - Kirstie C Lithgow
- Department of Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, 1422, T2N 2T9, Canada
| | - Chanda R McFadden
- Department of Allied Health, Alberta Health Services, Calgary, Canada
| | - Adrian Chikwanha
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Jayna Holroyd-Leduc
- Department of Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, 1422, T2N 2T9, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Cheryl Barnabe
- Department of Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, 1422, T2N 2T9, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Yao H, Gomes de Siqueira A, Rogers ML, Bloch-Elkouby S, Lawrence O, Sarli G, Foster A, Mitelman SA, Galynker I, Lok B. The impact of scaffolded and non-scaffolded suicidal virtual human interaction training on clinician emotional self-awareness, empathic communication, and clinical efficacy. BMC Med Educ 2024; 24:413. [PMID: 38622653 PMCID: PMC11017492 DOI: 10.1186/s12909-024-05371-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 03/29/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Clinicians working with patients at risk of suicide often experience high stress, which can result in negative emotional responses (NERs). Such negative emotional responses may lead to less empathic communication (EC) and unintentional rejection of the patient, potentially damaging the therapeutic alliance and adversely impacting suicidal outcomes. Therefore, clinicians need training to effectively manage negative emotions toward suicidal patients to improve suicidal outcomes. METHODS This study investigated the impact of virtual human interaction (VHI) training on clinicians' self-awareness of their negative emotional responses, assessed by the Therapist Response Questionnaire Suicide Form, clinicians' verbal empathic communication assessed by the Empathic Communication and Coding System, and clinical efficacy (CE). Clinical efficacy was assessed by the likelihood of subsequent appointments, perceived helpfulness, and overall interaction satisfaction as rated by individuals with lived experience of suicide attempts. Two conditions of virtual human interactions were used: one with instructions on verbal empathic communication and reminders to report negative emotional responses during the interaction (scaffolded); and the other with no such instructions or reminders (non-scaffolded). Both conditions provided pre-interaction instructions and post-interaction feedback aimed at improving clinicians' empathic communication and management of negative emotions. Sixty-two clinicians participated in three virtual human interaction sessions under one of the two conditions. Linear mixed models were utilized to evaluate the impact on clinicians' negative emotional responses, verbal empathic communication, and clinical efficacy; and to determine changes in these outcomes over time, as moderated by the training conditions. RESULTS Clinician participants' negative emotional responses decreased after two training sessions with virtual human interactions in both conditions. Participants in the scaffolded condition exhibited enhanced empathic communication after one training session, while two sessions were required for participants in the non-scaffolded condition. Surprisingly, after two training sessions, clinical efficacy was improved in the non-scaffolded group, while no similar improvements were observed in the scaffolded group. CONCLUSION Lower clinical efficacy after virtual human interaction training in clinicians with higher verbal empathic communication suggests that nonverbal expressions of empathy are critical when interacting with suicidal patients. Future work should explore virtual human interaction training in both nonverbal and verbal empathic communication.
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Affiliation(s)
- Heng Yao
- Department of Computer and Information Science and Engineering, University of Florida, Gainesville, 32611, FL, USA.
| | - Alexandre Gomes de Siqueira
- Department of Computer and Information Science and Engineering, University of Florida, Gainesville, 32611, FL, USA
| | - Megan L Rogers
- Department of Psychology, Texas State University, San Marcos, 78666, TX, USA
| | - Sarah Bloch-Elkouby
- Department of Psychiatry and Behavioral Sciences, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, 10033, NY, USA
| | - Olivia Lawrence
- Department of Psychiatry and Behavioral Sciences, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
| | - Giuseppe Sarli
- Department of Psychiatry and Behavioral Sciences, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
- Department of Mental Health and Addiction, ASST Brianza, Vimercate, Italy
| | - Adriana Foster
- Healthcare Corporation of America (HCA) Florida, Woodmont Hospital, Tamarac, 33321, FL, USA
| | - Serge A Mitelman
- Department of Psychiatry and Behavioral Sciences, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
| | - Igor Galynker
- Department of Psychiatry and Behavioral Sciences, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
| | - Benjamin Lok
- Department of Computer and Information Science and Engineering, University of Florida, Gainesville, 32611, FL, USA.
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Lou H, Cai H, Huang X, Li G, Wang L, Liu F, Qin W, Liu T, Liu W, Wang ZM, Li B, Xia Y, Wang J. Cadonilimab Combined with Chemotherapy with or without Bevacizumab as First-Line Treatment in Recurrent or Metastatic Cervical Cancer (COMPASSION-13): A Phase 2 Study. Clin Cancer Res 2024; 30:1501-1508. [PMID: 38372727 PMCID: PMC11016896 DOI: 10.1158/1078-0432.ccr-23-3162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/04/2023] [Accepted: 02/15/2024] [Indexed: 02/20/2024]
Abstract
PURPOSE Immune checkpoint inhibitors (ICI) have been a potential treatment option for patients with cervical cancer in several clinical studies. We investigated the safety and efficacy of cadonilimab, a bispecific antibody targeting PD-1 and CTLA-4, plus standard therapy for the first-line treatment of R/M CC (recurrent and/or metastatic cervical cancer). PATIENTS AND METHODS Eligible patients were assigned to 3 cohorts: cohort A-15 (cadonilimab 15 mg/kg every 3 weeks (Q3W) plus chemotherapy), cohort A-10 (cadonilimb 10 mg/kg Q3W plus chemotherapy), and cohort B-10 (cadonilimab 10 mg/kg Q3W plus chemotherapy and bevacizumab). They received the corresponding treatments until disease progression, unacceptable toxicity, withdrawal of consent, or investigator decision. The primary objective was safety; the secondary endpoints included objective overall response (ORR), duration of response, disease control rate, progression-free survival, and overall survival. This study is registered with ClinicalTrials.gov (NCT04868708). RESULTS As of February 13, 2023, treatment-related adverse events (TRAE) occurred in 45 (100.0%) patients. Grade ≥3 TRAEs were reported in 33 (73.3%) patients. Immune-related adverse events (irAE) occurred in 29 (64.4%) patients and grade ≥3 irAEs were observed in 9 (20.0%) patients. Seven (15.6%) of 45 patients permanently discontinued cadonilimab treatment due to TRAEs. One death due to hemorrhagic shock occurred in cohort B-10. Among 44 patients who underwent at least one post-baseline tumor assessment, the ORR was 66.7% in cohort A-15, 68.8% in cohort A-10, 92.3% in cohort B-10, and 79.3% in cohorts A-10 and B-10 combined. CONCLUSIONS Cadonilimab combined with standard therapy was acceptable, with encouraging antitumor activity in patients with R/M CC.
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Affiliation(s)
- Hanmei Lou
- Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
| | - Hongbing Cai
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xin Huang
- Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Guiling Li
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Wang
- Henan Cancer Hospital, Zhengzhou, China
| | - Fei Liu
- Akeso Biopharma Inc., Zhongshan, China
| | | | - Ting Liu
- Akeso Biopharma Inc., Zhongshan, China
| | - Wei Liu
- Akeso Biopharma Inc., Zhongshan, China
| | | | | | - Yu Xia
- Akeso Biopharma Inc., Zhongshan, China
| | - Jing Wang
- Hunan Cancer Hospital, Changsha, China
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Zhu Y, Zhu T, Wang H, Zhu JM, Zheng DD, Yin P, Li BK. Implications of perceived empathy from spouses during pregnancy for health-related quality of life among pregnant women: a cross-sectional study in Anhui, China. BMC Pregnancy Childbirth 2024; 24:269. [PMID: 38609869 PMCID: PMC11010408 DOI: 10.1186/s12884-024-06419-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/13/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Empathy is a critical component of nursing care, impacting both nurses' and patients' outcomes. However, perceived empathy from spouses during pregnancy and its impact on health-related quality of life (HRQoL) are unclear. This study aimed to examine pregnant women's perceived empathy from their spouses and assess the relation of perceived empathy on HRQoL. METHODS This cross-sectional study, performed in the obstetric clinics or wards of four well-known hospitals in Anhui Province, China, included 349 pregnant women in the second or third trimester; participants were recruited by convenience sampling and enrolled from October to December 2021. A general information questionnaire, the Interpersonal Reactivity Index (IRI), a purpose-designed empathy questionnaire and the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) were used to evaluate the pregnant women's general information, perceptions of empathy and HRQoL. Data were analysed using SPSS 22 at a threshold of P < 0.05. Descriptive analysis, Pearson correlation analysis, Student's t test, ANOVA, and multiple regression analysis were used for analysis. RESULTS The pregnant women's total empathy, physical component summary (PCS) and mental component summary (MCS) scores were 41.6 ± 9.0, 41.6 ± 7.6, and 47.7 ± 9.1, respectively. Correlation analysis revealed that the purpose-designed empathy questionnaire items were significantly positively correlated with perspective taking and empathic concern but were not correlated with the personal distress dimension and were only partially correlated with the fantasy dimension. Maternal physical condition during pregnancy, planned pregnancy, and occupational stress were predictors of the PCS score (β = 0.281, P < 0.01; β = 0.132, P = 0.02; β = -0.128, P = 0.02). The behavioural empathy item of our purpose-designed empathy questionnaire and empathic concern were important predictors of the MCS score (β = 0.127, P = 0.02; β = 0.158, P < 0.01), as well as other demographic and obstetric information, explaining 22.0% of the variance in MCS scores totally (F = 12.228, P < 0.01). CONCLUSIONS Pregnant women perceived lower empathy from their spouses and reported lower HRQoL. Perceived empathy, particularly behavioural empathy, may significantly impact pregnant women's MCS scores but has no effect on their PCS scores. Strategies that foster perceived empathy from spouses among pregnant women are essential for facilitating healthy pregnancies and potentially improving maternal and child health.
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Affiliation(s)
- Yu Zhu
- School of Nursing, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Ting Zhu
- Pharmacy Department, Suzhou Municipal Hospital, Suzhou, 234099, China
| | - Hui Wang
- School of Chinese Medicine, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Ji-Min Zhu
- School of Life Sciences, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Dan-Dan Zheng
- Obstetrical Department, First Affiliated Hospital of Anhui, University of Chinese Medical, Hefei, 230022, China
| | - Ping Yin
- Nursing Department, Anhui No. 2 Provincial People's Hospital, Hefei, 230041, China.
| | - Bai-Kun Li
- School of Chinese Medicine, Anhui University of Chinese Medicine, Hefei, 230012, China.
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Kınık K, Kuday AD, Çalışkan C. Psychological Hardiness and Compassion Satisfaction Among the Turkish Red Crescent: The Case of 2023 Kahramanmaras Earthquake. Disaster Med Public Health Prep 2024; 18:e58. [PMID: 38600760 DOI: 10.1017/dmp.2024.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
OBJECTIVES This study assessed psychological hardiness and compassion satisfaction among the Türk Kızılay (Turkish Red Crescent) personnel and volunteers involved in the 2023 Kahramanmaraş earthquake. Additionally, the relationship between compassion satisfaction and psychological hardiness was also investigated. METHODS This cross-sectional study was conducted between March and July 2023. Participants completed an online survey, which included the Sociodemographic Information Form, Psychological Hardiness Scale, and Compassion Satisfaction Scale. The data was analyzed with SPSS version 25 (IBM Corp., Armonk, New York, USA), using a significance level of 95% and p < 0.05. RESULTS The study involved 400 participants, comprising 84 (21%) personnel and 316 (79%) volunteers. Participants exhibited an average psychological hardiness level of 24.56 ± 7.25 and a compassion satisfaction level of 47.40 ± 17.28. A significant positive correlation was observed between compassion satisfaction and psychological hardiness (r = 0.571; p < 0.001). The results of logistics regression have revealed that the level of psychological hardiness is higher in males compared to females (OR = 1.930, CI = 1.115 - 3.340; P < 0.05) and is also higher in those with high compassion satisfaction compared to those with low compassion satisfaction (OR = 1.386, CI = 1.256 - 1.529; p < 0.001). CONCLUSIONS The findings of this study indicate that individuals involved in disaster response should consider compassion satisfaction as an important tool for enhancing psychological hardiness.
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Affiliation(s)
- Kerem Kınık
- Department of Disaster Medicine, Hamidiye Institute of Health Sciences, University of Health Sciences, Istanbul, Türkiye
- Department of Emergency Aid and Disaster Management, Hamidiye Faculty of Health Sciences, University of Health Sciences, Istanbul, Türkiye
| | - Ahmet Doğan Kuday
- Department of Disaster Medicine, Hamidiye Institute of Health Sciences, University of Health Sciences, Istanbul, Türkiye
| | - Cüneyt Çalışkan
- Department of Disaster Medicine, Hamidiye Institute of Health Sciences, University of Health Sciences, Istanbul, Türkiye
- Department of Emergency Aid and Disaster Management, Hamidiye Faculty of Health Sciences, University of Health Sciences, Istanbul, Türkiye
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Li M, Racey C, Rae CL, Strawson W, Critchley HD, Ward J. Can the neural representation of physical pain predict empathy for pain in others? Soc Cogn Affect Neurosci 2024; 19:nsae023. [PMID: 38481007 PMCID: PMC11008503 DOI: 10.1093/scan/nsae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 01/16/2024] [Accepted: 03/19/2024] [Indexed: 04/12/2024] Open
Abstract
The question of whether physical pain and vicarious pain have some shared neural substrates is unresolved. Recent research has argued that physical and vicarious pain are represented by dissociable multivariate brain patterns by creating biomarkers for physical pain (Neurologic Pain Signature, NPS) and vicarious pain (Vicarious Pain Signature, VPS), respectively. In the current research, the NPS and two versions of the VPS were applied to three fMRI datasets (one new, two published) relating to vicarious pain which focused on between-subject differences in vicarious pain (Datasets 1 and 3) and within-subject manipulations of perspective taking (Dataset 2). Results show that (i) NPS can distinguish brain responses to images of pain vs no-pain and to a greater extent in vicarious pain responders who report experiencing pain when observing pain and (ii) neither version of the VPS mapped on to individual differences in vicarious pain and the two versions differed in their success in predicting vicarious pain overall. This study suggests that the NPS (created to detect physical pain) is, under some circumstances, sensitive to vicarious pain and there is significant variability in VPS measures (created to detect vicarious pain) to act as generalizable biomarkers of vicarious pain.
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Affiliation(s)
- M Li
- School of Psychology, University of Sussex, Brighton BN1 9QH, UK
| | - C Racey
- School of Psychology, University of Sussex, Brighton BN1 9QH, UK
| | - C L Rae
- School of Psychology, University of Sussex, Brighton BN1 9QH, UK
| | - W Strawson
- Brighton and Sussex Medical School, University of Sussex, Brighton BN1 9PX, UK
| | - H D Critchley
- Brighton and Sussex Medical School, University of Sussex, Brighton BN1 9PX, UK
| | - J Ward
- School of Psychology, University of Sussex, Brighton BN1 9QH, UK
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Zakerkish M, Shakurnia A, Hafezi A, Maniati M. Association between burnout and empathy in medical residents. PLoS One 2024; 19:e0301636. [PMID: 38593142 PMCID: PMC11003688 DOI: 10.1371/journal.pone.0301636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 03/19/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Burnout is a work-related syndrome that can affect physicians' performance. Empathy is one of the clinical competencies in whose formation many factors play a role. Empathy and burnout are important topics of research in medical sciences, and both are related to the communication between the patient and the physician. This study investigated the relationship between occupational burnout and empathy among medical residents. METHOD This cross-sectional study was conducted on 297 medical residents in Ahvaz Jundishapur University of Medical Sciences from January to March 2021. The data collection tools were the Jefferson Scale of Empathy (JSE) and the Maslach Burnout Inventory (MBI). The reliability of the instruments was measured by calculating Cronbach's alpha. Data were analyzed by SPSS-18, using the Pearson correlation test and linear regression models. RESULTS The average age of the study population was 33.06 ±4.7 years, with more than half being females (57.6%) and married (51.9%). The residents' mean scores of empathy and overall burnout were 102.87 out of 140 and 55.90 out of 132, respectively. The burnout scores showed an inverse correlation with the overall empathy scores (r = -0.123, P = 0.035), and the score of standing in the patient's shoes (r = -0.165, P = 0.004). Linear regression test was used to detect which dimension of empathy was a better predictor for the reduction of burnout scores. Results showed that the best predictor was standing in the patient's shoes (P = 0.014). CONCLUSION The findings showed a negative association between empathy and burnout among medical residents, which suggests the need for adjustment of the existing burnout management at the institutional level. Therefore, residents should be supported by managers to reduce burnout and improve their empathic behavior.
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Affiliation(s)
- Mehrnoosh Zakerkish
- Departments of Internal Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Abdolhussein Shakurnia
- Departments of Immunology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Hafezi
- General Physician, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahmood Maniati
- Department of General Courses, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Bientzle M, Eggeling M, Kimmerle J. Good reasons for bad behavior: a randomized controlled experiment on the impact of narrative reading and writing on empathic concern, perspective-taking, and attitude. Front Public Health 2024; 12:1343225. [PMID: 38645444 PMCID: PMC11026716 DOI: 10.3389/fpubh.2024.1343225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/26/2024] [Indexed: 04/23/2024] Open
Abstract
Background Empathic concern and perspective-taking may contribute to avoiding stigmatization of adverse health behavior. Narrative writing has been shown to be effective in promoting perspective-taking and empathy. But since narrative writing is time consuming, we tested in the present study narrative reading as an alternative, more parsimonious approach. Methods In a randomized controlled experiment, we compared writing a narrative text about a fictitious person who displays disapproved of health behavior to reading such a text and to a control condition in which participants wrote about an unrelated topic. With a sample of n = 194 participants, we investigated the impact of writing and reading a narrative text on promoting empathic concern and perspective-taking as well as on attitude change. Results We found that both writing and reading a narrative text about the fictitious character increased empathic concern, F(1, 191) = 32.85, p < 0.001, part. η2 = 0.15, and perspective-taking, F(1, 191) = 24.76, p < 0.001, part. η2 = 0.12, more strongly than writing about an unrelated topic. Writing and reading a narrative text also resulted in a more positive attitude toward this person, F(1, 191) = 17.63, p < 0.001, part. η2 = 0.08. Simply reading a narrative text was equally efficient as narrative writing with respect to empathic concern, p = 0.581, perspective-taking, p = 0.629, and attitude, p = 0.197. Conclusion The finding that narrative reading is as effective as narrative writing suggests that the readers appear to be able to comprehend and engage with the story being told. When narrative reading is as effective as narrative writing, it can succeed with reduced effort in increasing empathic concern, perspective-taking, and attitude. We discuss the benefits of this approach for reducing stigmatization of adverse health behavior.
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Affiliation(s)
- Martina Bientzle
- Knowledge Construction Lab, Leibniz-Institut für Wissensmedien, Tuebingen, Germany
| | - Marie Eggeling
- Knowledge Construction Lab, Leibniz-Institut für Wissensmedien, Tuebingen, Germany
| | - Joachim Kimmerle
- Knowledge Construction Lab, Leibniz-Institut für Wissensmedien, Tuebingen, Germany
- Department of Psychology, Eberhard Karls University Tuebingen, Tuebingen, Germany
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Ferguson PC. QIM24-177: Effects of a Music-Based Intervention on Reducing Compassion Fatigue in Oncology Advanced Practice Providers. J Natl Compr Canc Netw 2024; 22:QIM24-177. [PMID: 38579859 DOI: 10.6004/jnccn.2023.7296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
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Powell M, Sexton B, Adair KC. Self-compassion letter tool for healthcare worker well-being: a qualitative descriptive analysis. BMJ Open 2024; 14:e078784. [PMID: 38580364 PMCID: PMC11002434 DOI: 10.1136/bmjopen-2023-078784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 03/10/2024] [Indexed: 04/07/2024] Open
Abstract
OBJECTIVE This qualitative study aimed to identify categories within therapeutic self-compassion letters written by healthcare workers. Resulting categories were assessed for their relevance to the construct of self-compassion. DESIGN This was a qualitative descriptive study that used summative content analysis and inductive coding. SETTING A US-based academic healthcare system. PARTICIPANTS Healthcare workers who attended a self-compassion webinar were recruited. INTERVENTION The online self-compassion tool asked participants to write a letter to themselves from the perspective of a friend providing support and encouragement. RESULTS 116 letters were analysed. Five major categories emerged: Looking Forward, Reaffirming Self, Reaffirming Reminders, Hardships and Self-Disparagement. Respondents' letters were mostly positively framed and forward thinking, including their hopes of improving themselves and their lives in the future. Negative content generally described hardships and often served to provide self-validation or perspective on obstacles that had been overcome. CONCLUSION The writing prompt elicited content from the writers that reflected the core elements of self-compassion (ie, self-kindness, common humanity, mindfulness). Continued research to further understand, refine and improve the impact of therapeutic letter writing to enhance well-being is warranted to reduce burnout and promote quality patient care.
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Affiliation(s)
- Melissa Powell
- School of Nursing, Duke University, Durham, North Carolina, USA
| | - Bryan Sexton
- Duke Center for the Advancement of Well-Being Science, Duke University, Durham, North Carolina, USA
| | - Kathryn C Adair
- Duke Center for the Advancement of Well-Being Science, Duke University, Durham, North Carolina, USA
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De Brochowski V, Rubin GJ, Webster RK. The effect of nocebo explanation and empathy on side-effect expectations of medication use following a fictional GP consultation. PSYCHOL HEALTH MED 2024; 29:809-821. [PMID: 37491019 DOI: 10.1080/13548506.2023.2240072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 07/18/2023] [Indexed: 07/27/2023]
Abstract
The simple act of informing patients about side-effects increases the likelihood they will experience them (i.e. the nocebo effect). Explaining this psychological phenomenon could help to reduce side-effect experience, however, it is yet to be explored if this can be applied to clinical settings where new medication is prescribed. In addition, the degree to which a health-care provider empathetically communicates this to patients may have an impact. To investigate this, we carried out 2 × 2 factorial trial to assess the effect of nocebo explanation and empathy (plus their interaction) on side-effect expectations following a fictional GP consultation prescribing a new medication. Overall, 208 participants were randomised to watch one of the four fictive GP consultations and play the role of the patient. In all videos, participants received information about the reason for the consultation, the recommendation of a new fictive medicine, how to take it, benefits and side-effects. The videos differed in whether the GP provided an explanation of the nocebo effect (yes/no) and whether they communicated in an empathetic style (yes/no). After watching the video, participants were asked about their side-effect expectations and rated the quality of the GP's communication. Two-way ANOVAs revealed no main effect of nocebo explanation on expectation of side-effects warned or not warned about in the consultation. However, there was a main effect of empathy, with participants watching the empathetic consultations having significantly lower expectations of non-warned-about side-effects. There was no significant interaction. Findings suggest that explaining the nocebo effect and GP empathy did little to allay expectations of side-effects that were specifically mentioned in the consultation. However, GP empathy had an effect by helping to reduce additional side-effect expectations participants still had. Future work should extend these findings to real GP consultations where the full dimensions of empathy can be explored.
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Affiliation(s)
- Valentine De Brochowski
- Health Psychology Section, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - G James Rubin
- Health Protection Research Unit in Emergency Preparedness and Response at, King's College London, London, United Kingdom
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Dallagi-Belkilani M, Olivier M, Besche-Richard C. Validation of the Basic Empathy Scale in an Arabic-speaking population: The BES-Ar. Encephale 2024; 50:149-153. [PMID: 37088580 DOI: 10.1016/j.encep.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/26/2023] [Accepted: 04/04/2023] [Indexed: 04/25/2023]
Abstract
PURPOSE The aim of this work was to test the psychometric properties of the Arabic version of the BES (Basic Empathy Scale) by establishing its factor structure, its internal consistency and construct validity in the general population. DESIGN AND METHODS The BES was tested among 526 Tunisian adults. FINDINGS The two-factor structure of the BES-20 was confirmed. Internal consistency and concurrent validity were very satisfactory. DISCUSSION This scale will be useful for clinicians in various fields (mental health, psychiatry) in Arabic countries.
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Affiliation(s)
- Manel Dallagi-Belkilani
- Université de Reims Champagne-Ardenne, Cognition Santé Société, C2S UR6291, 57, rue Pierre Taittinger, 51571 Reims, France
| | - Marie Olivier
- Université de Reims Champagne-Ardenne, Cognition Santé Société, C2S UR6291, 57, rue Pierre Taittinger, 51571 Reims, France
| | - Chrystel Besche-Richard
- Université de Reims Champagne-Ardenne, Cognition Santé Société, C2S UR6291, 57, rue Pierre Taittinger, 51571 Reims, France.
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Johnson J, Lecci L, Dovidio JF. White Americans' blame attributions and empathy towards Black victims of police violence: How pejorative stereotypes 'engulf the field'. Br J Soc Psychol 2024; 63:936-955. [PMID: 38131304 DOI: 10.1111/bjso.12712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023]
Abstract
We examined the dynamics of minority-directed police violence by considering how our White participants' empathy for Black victims may be influenced by critical intragroup differences related to racial stereotyping. Although the role of stereotyping in reactions to Black Americans accused of crime is well-established, we explore the influence of pejorative Black stereotypes on reactions to Black victims of police violence. Specifically, we investigated the roles of individual differences in the endorsement of the Black criminal stereotype among White observers and manipulated the crime-unrelated stereotypicality (i.e. stereotypical, counterstereotypical) of Black victims of police violence. White US MTurk participants read about a White policeman shooting a Black man (Study 1, n = 140) or sexually assaulting a Black woman (Study 2, n = 166). Across both studies, strong stereotype endorsers reported relatively low empathy for stereotypical victims, mediated by greater blame towards those victims. This finding demonstrates the relevance of heretofore untested motivated reasoning processes in the outgroup empathy deficits literature. Weak stereotype endorsers showed relatively high empathy and low victim blame regardless of Black victim stereotypicality, indicating limited sensitivity to outgroup member suffering is not inevitable. We consider the practical implications of the findings for policing and for citizenship education.
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Affiliation(s)
- James Johnson
- The Weber Group of Australia, Gold Coast, Queensland, Australia
| | - Len Lecci
- University of North Carolina Wilmington, Wilmington, North Carolina, USA
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Zhenzhu L, Jingfeng Z, Wei Z, Jianjun Z, Yinshui X. GPT-agents based on medical guidelines can improve the responsiveness and explainability of outcomes for traumatic brain injury rehabilitation. Sci Rep 2024; 14:7626. [PMID: 38561445 PMCID: PMC10985066 DOI: 10.1038/s41598-024-58514-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/30/2024] [Indexed: 04/04/2024] Open
Abstract
This study explored the application of generative pre-trained transformer (GPT) agents based on medical guidelines using large language model (LLM) technology for traumatic brain injury (TBI) rehabilitation-related questions. To assess the effectiveness of multiple agents (GPT-agents) created using GPT-4, a comparison was conducted using direct GPT-4 as the control group (GPT-4). The GPT-agents comprised multiple agents with distinct functions, including "Medical Guideline Classification", "Question Retrieval", "Matching Evaluation", "Intelligent Question Answering (QA)", and "Results Evaluation and Source Citation". Brain rehabilitation questions were selected from the doctor-patient Q&A database for assessment. The primary endpoint was a better answer. The secondary endpoints were accuracy, completeness, explainability, and empathy. Thirty questions were answered; overall GPT-agents took substantially longer and more words to respond than GPT-4 (time: 54.05 vs. 9.66 s, words: 371 vs. 57). However, GPT-agents provided superior answers in more cases compared to GPT-4 (66.7 vs. 33.3%). GPT-Agents surpassed GPT-4 in accuracy evaluation (3.8 ± 1.02 vs. 3.2 ± 0.96, p = 0.0234). No difference in incomplete answers was found (2 ± 0.87 vs. 1.7 ± 0.79, p = 0.213). However, in terms of explainability (2.79 ± 0.45 vs. 07 ± 0.52, p < 0.001) and empathy (2.63 ± 0.57 vs. 1.08 ± 0.51, p < 0.001) evaluation, the GPT-agents performed notably better. Based on medical guidelines, GPT-agents enhanced the accuracy and empathy of responses to TBI rehabilitation questions. This study provides guideline references and demonstrates improved clinical explainability. However, further validation through multicenter trials in a clinical setting is necessary. This study offers practical insights and establishes groundwork for the potential theoretical integration of LLM-agents medicine.
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Affiliation(s)
- Li Zhenzhu
- Radiology Department, Ningbo NO.2 Hospital, Ningbo, 315211, China
- Department of Neurosurgery, Ningbo NO.2 Hospital, Ningbo, 315211, China
- Faculty of Electrical Engineering and Computer Science, Ningbo University, Ningbo, 315211, China
| | - Zhang Jingfeng
- Radiology Department, Ningbo NO.2 Hospital, Ningbo, 315211, China
| | - Zhou Wei
- Department of Neurosurgery, Ningbo NO.2 Hospital, Ningbo, 315211, China
| | - Zheng Jianjun
- Radiology Department, Ningbo NO.2 Hospital, Ningbo, 315211, China.
| | - Xia Yinshui
- Faculty of Electrical Engineering and Computer Science, Ningbo University, Ningbo, 315211, China.
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Frankel J. Treating the sequelae of chronic childhood emotional abandonment. J Clin Psychol 2024; 80:809-823. [PMID: 36724326 DOI: 10.1002/jclp.23490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/30/2022] [Accepted: 01/16/2023] [Indexed: 02/03/2023]
Abstract
Chronic emotional abandonment is traumatic for children, and often leads them to identify with the aggressor (IWA)-in order to hold onto their needed attachment to their parents, they feel, think, and do what their parents require, blame themselves for being abused and for their family's unhappiness, and feel ashamed. IWA often persists as a general tendency. Treatment requires therapists' dependability, attunement, empathy, interest, humility, and perhaps playfulness. Patients' history of abandonment should be explored in detail, though patients may be protective of their parents. Therapists should explore their own behavior if necessary, and acknowledge lapses; normalize and explore patients' shame; and avoid trying to "rescue" patients. Patients must be helped to re-find authority and agency over their own lives, and mourn their early loss of feeling "the right to a life." The treatment of "Claire," a 40-something child of two depressed parents, illustrates some of these points.
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Affiliation(s)
- Jay Frankel
- Postdoctoral Program in Psychotherapy and Psychoanalysis, New York University, New York, New York, USA
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Hughes RVV, Hudson KW, Wright E, Swoboda SM, Frangieh J, D'Aoust RF. Cultivating Self-Compassion to Protect Nurses From Burnout and Secondary Traumatic Stress. Nurs Womens Health 2024; 28:159-167. [PMID: 38462229 DOI: 10.1016/j.nwh.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 03/12/2024]
Abstract
Nursing burnout, a result of prolonged occupational stress, has always been a challenge in health care, but recently the COVID-19 pandemic made this issue into a national priority. In fact, burnout among health care workers is one of the four priorities of the U.S. Surgeon General. Health care leaders and organizations are eager to implement strategies to improve nurses' well-being and, thus, enhance their mental health. Much of the literature has focused on the antecedents and consequences of nursing burnout, but there is limited information on strategies that protect perinatal nurses from burnout. Self-compassion is emerging as one strategy that has a positive correlation with nurse well-being and a negative association with burnout, depression, and anxiety. In this article, we identify and translate strategies to promote self-compassion in perinatal nurses.
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Chen QY, Guo SS, Luo Y, Qu S, Wu DH, Chen XZ, Chen DP, Qin XT, Lin Q, Jin F, Lin SJ, Yao ZF, Liu W, Maxwell Wang Z, Li BY, Xia M, Xu RH, Tang LQ, Mai HQ. Efficacy and safety of cadonilimab in previously treated recurrent or metastatic nasopharyngeal carcinoma(COMPASSION-06): A phase II multicenter study. Oral Oncol 2024; 151:106723. [PMID: 38387261 DOI: 10.1016/j.oraloncology.2024.106723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE This study was designed to assess the efficacy and safety of cadonilimab monotherapy, a first-in-class, bi-specific PD-1/CTLA-4 antibody, in patients with previously treated recurrent or metastatic nasopharyngeal carcinoma (R/M-NPC). PATIENTS AND METHODS This multicenter, open-label, single-arm, phase II clinical trial enrolled patients with R/M-NPC who had failed first-line platinum-based chemotherapy and second-line single agent or combined chemotherapy, and immunotherapy-naive. Patients received cadonilimab for 6 mg/kg once every 2 weeks (Q2W). The primary endpoint was objective response rate (ORR) in full analysis set (FAS) assessed by investigators according to RECIST v.1.1. The secondary endpoint included progression-free survival (PFS), overall survival (OS), duration of response (DoR), time to response (TTR) and safety. RESULTS A total of 23 patients were assessed. The median time from first dose to data cutoff was 16.56 (range, 0.8-25.2) months. ORR was 26.1 % (95 %CI:10.2-48.4). The ORR were 44.4 % (95 %CI: 13.7-78.8) and 14.3 % (95 %CI:1.8-42.8) in patients with tumor PD-L1 expression ≥50 % and <50 %, respectively. ORR was achieved in 40.0 % (95 %CI:12.2-73.8) of patients with EBV-DNA level <4000 IU/ml (n = 10) and 15.4 % (95 %CI:1.9-45.4) of those with ≥4000 IU/ml. The median PFS was 3.71 months (95 %CI: 1.84-9.30). respectively. Median OS was not reached, and the 12-month OS rate was 79.7 % (95 % CI:54.5-91.9). Only two patients (8.3 %) experienced Grade ≥3 treatment-related adverse events (TRAEs) with hypothyroidism (30.4 %), rash (21.7 %) and pruritus (21.7 %) being the most prevalent TRAEs. CONCLUSION Cadonilimab monotherapy demonstrated a promising efficacy and manageable toxicity in patients with previously treated R-M/NPC and provide an efficacious salvage treatment option.
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Affiliation(s)
- Qiu-Yan Chen
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China
| | - Shan-Shan Guo
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China
| | - Ying Luo
- Department of Thoracic Radiotherapy, Hunan Cancer Hospital, Changsha, China
| | - Song Qu
- Department of Radiotherapy, Guangxi Medical University Affiliated Tumor Hospital, Nanning, China
| | - De-Hua Wu
- Department of Radiotherapy, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiao-Zhong Chen
- Department of Oncology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Don-Ping Chen
- Department of Radiotherapy, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, China
| | - Xin-Tian Qin
- Department of Oncology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Qin Lin
- Department of Oncology Radiotherapy, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Feng Jin
- Department of Oncology, The Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, China
| | - Shao-Jun Lin
- Department of Head and Neck Neoplasm Radiotherapy, Fujian Cancer Hospital, Fuzhou, China
| | | | - Wei Liu
- Akeso Biopharma, Inc., Zhongshan, China
| | | | | | | | - Rui-Hua Xu
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Lin-Quan Tang
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China.
| | - Hai-Qiang Mai
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China.
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Dos Santos GN, Lima-Costa AR, Otoni F, Veiga HMDS, Peres RS, Azevedo AV, Antunes MC, Bonfá-Araujo B, Cortez PA. Unveiling empathy: Transforming child neurodisability in the Brazilian context of poverty and violence. Dev Med Child Neurol 2024; 66:541-542. [PMID: 37846042 DOI: 10.1111/dmcn.15784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023]
Abstract
This letter to the editor is on the original article by Dorris et al. The article is available at https://doi.org/10.1111/dmcn.15263Portuguese translation of this letter to the editor is available in the online issue.
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49
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Stahlmann AG, Hopwood CJ, Bleidorn W. Big Five personality traits predict small but robust differences in civic engagement. J Pers 2024; 92:480-494. [PMID: 37066516 DOI: 10.1111/jopy.12838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/09/2023] [Accepted: 03/28/2023] [Indexed: 04/18/2023]
Abstract
OBJECTIVE This preregistered study provides robust estimates of the links between Big Five personality traits and civic engagement across different samples and life stages. METHODS We recruited two samples from the United States and United Kingdom (total N = 1593) and measured Big Five domains, Big Five aspects, and six civic engagement indicators: volunteerism, charitable giving, donating blood, posthumous organ donation, political voting, and vaccination. We compared the links between these measures across samples and tested moderation across life stages and several sociodemographic variables. We explored whether these links replicate between self- and peer-reports. RESULTS We found small but robust effects. Agreeable, extraverted, and open/intellectual participants reported more civic engagement, especially volunteerism and charitable giving. Neurotic and conscientious participants mainly reported less civic engagement, especially blood and organ donations. One of the two Big Five aspects often drove these links, such as Compassion in the link between Agreeableness and volunteerism. We found some differences between younger and middle-aged adults. CONCLUSIONS Big Five personality traits predict civic engagement modestly but consistently, with adequate study power being critical to detecting these links. Lower-order traits, such as Big Five aspects, clarify the relationships between traits and engagement. Life stages and sociodemographic variables have limited effects.
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Affiliation(s)
- Alexander G Stahlmann
- Department of Psychology, University of Zurich, Binzmühlestrasse 14, Box 7, Zurich, CH-8050, Switzerland
| | - Christopher J Hopwood
- Department of Psychology, University of Zurich, Binzmühlestrasse 14, Box 7, Zurich, CH-8050, Switzerland
| | - Wiebke Bleidorn
- Department of Psychology, University of Zurich, Binzmühlestrasse 14, Box 7, Zurich, CH-8050, Switzerland
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50
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Franklin M, Lewis S, Townsend J, Warren M, Boyle F, Smith AL. Making the unbearable, bearable: Qualitative examination of patient, family and nurses' perspectives on the role and value of specialist metastatic breast care nurses. Eur J Oncol Nurs 2024; 69:102523. [PMID: 38342058 DOI: 10.1016/j.ejon.2024.102523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 02/13/2024]
Abstract
PURPOSE To examine the role and value of specialist metastatic breast care nurses in Australia from the perspective of metastatic breast care nurses, patients, and family members. Metastatic breast cancer (mBC) is treatable yet incurable, with distinct supportive care needs, yet many of these needs are unmet. METHOD Diverse sampling methods were used to recruit 10 people with mBC, 5 family members and 10 metastatic breast care nurses. Semi-structured interviews were conducted online or by telephone during August-December 2020, and analysed thematically. RESULTS The role of the specialist nurse was strongly valued within and across participant groups, with close alignment regarding what was highly valued. Three themes were identified. First, nurses played a vital role in giving voice and visibility to patients with mBC in a healthcare system in which they often felt invisible. Second, nurses combined their clinical and psychosocial skills with a sense of authentic engagement to create a safe space for those with mBC to discuss their feelings, experiences, and topics, especially those that were unlikely to be discussed in their other social and clinical interactions. Finally, nurses supported patients in living as well as possible while managing symptoms, ongoing treatment, and attendant psychosocial impacts of an incurable and life-limiting condition. CONCLUSIONS This study underscores the central importance of metastatic breast care nurses in enhancing patient well-being, bridging gaps in care, and offering much-needed support. By addressing patients' emotional, clinical, and social needs, these specialist nurses contribute to a more holistic and compassionate approach to managing mBC.
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Affiliation(s)
- Marika Franklin
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Australia
| | - Sophie Lewis
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Australia
| | | | | | - Fran Boyle
- School of Medicine, Faculty of Medicine and Health, University of Sydney, Australia; The Mater Hospital, North Sydney, Australia
| | - Andrea L Smith
- The Daffodil Centre, University of Sydney, a Joint Venture with Cancer Council NSW, Australia.
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