Empathy as defined by Van-Servellen, 2009. Pg. 88 refers to “an objective awareness of an insight into the thoughts, feelings, and behavior of another.” empathy entails the being aware of and managing of one’s emotions and others’. In the healthcare setting, empathy would ensure that the healthcare has the ability to understand and manage the awareness of the patient and his or her own for the benefit of both of them. This paper aims at explaining how a health care provider could engage empathy in his or her communication and the benefits of such empathic communication relationship to both the patient and the healthcare service provider. This is achieved by defining empathy in patient care, highlighting the key determinants of empathy in patient care, outlining the health care empathy process and finally identifying and analyzing the barriers to provider-patient empathic relationship formation and effective use.
Empathy is not easy to measure. However, in using empathy, the health care provider should be careful enough not to be carried away by feelings of sympathy that would affect effective service provision or care for the patient. The extent to which empathic expressions can be increased or decreased depends on the personal characteristics of both the patient and the healthcare provider (Rudge, 2016).
According to (Moss, 2007), empathy establishes sympathetic feelings within people but seeks to build a greater interactive relationship with the other person. It is difficult to completely ‘get into another person’s shoes,’ but it is very important to attempt to do so.
Moss, 2007 outlines some of the guidelines that could be used to build up the empathic relationship between the patient and the provider. First, the healthcare provider needs to acknowledge both the verbal and non-verbal cues; using tentative questions; use of self-disclosure; involving the health care provider’s imagination; gently touching the patient’s hands, arms or shoulders can also be a good expression of empathic attunement and finally, the provider may involve mirroring, that is tone adjustment, posture or gestures to mirror those of the patient. Empathy arises from the provider’s natural desire to care for the patient.
These are the key factors that determine the success of in developing an empathic patient-provider relationship towards attaining the desired outcomes. Some of these key features according to (Hojat, 2007), are:
The center of human survival lies in understanding other’s feelings and behaviors. It is also an important factor in the physician-patient empathic relationship. If the patient can perceive that the health care provider understands him or her and his health condition, plus his or her feelings, then a sense of being connected and supported will be established in the patient’s mind. The notion of understanding and connection are key to building empathy in patient care. A better understanding of the patient helps in discovering the true state of the patient’s affairs thus correct diagnosis and treatment to the patient (Roberts & Machon, 2015). The accuracy of understanding the patient also determines how good the empathic relationship will be.
The healthcare provider’s ability to understand the patient should be coupled with similar ability to communicate back this understanding to the patient. Through the communication of the physician’s understanding of the patient back to the patient him or herself enables the physician to get the patient’s perceptions of the provider’s understanding. Hojat, (2007) further explains that a physician who has an empathic understanding of the patient and does not communicate this understanding to the patient is not considered to build up an empathic relationship with the patient and may not be able to diagnose the most appropriate treatment for the patient.
The best aspect of communication of understanding in patient care is the possibility of creating reciprocity or mutuality in the understanding of the two parties. Mutuality creates a positive belief in the patient concerning the physician. This not only enhances the empathic relationship but also it is beneficial to realizing positive outcomes from the medical care process.
World Health Organization suggests that empathic engagement in health care provider-patient encounters should bring forth enhanced physical, mental as well as social well-being. In the context of patient care, empathy encompasses three features: cognition, understanding, and communication (Scott, 2007). Mutual understanding and reciprocal feedback requirement in a physician-patient empathic relationship work to support the fact that the patient recognizes the physician’s empathy through physician’s verbal and non-verbal communication, and this contributes towards the desired outcomes.
This refers to the steps through which empathy in patient care is established within the health care system. This process details how the health provider could use empathy to communicate to the patient with an aim to achieve the desired outcomes (Van-Servellen, 2009). Four basic steps summarize the empathic process. These are:
Use of empathy between the health care provider and the patient will determine the quality of the clinical relationship, this, in turn, helps in proper adherence to the medication regimen by the patient; the patient adopting healthier lifestyle and reducing the possibilities of illness (Nicholas-Smith, 2015). Moreover, the empathic relationship between the care provider and the patient, created through empathic communication skills, leads to increased patient satisfaction since empathy leads to an exchange of cognitive information, which enhances the patient’s perception of the healthcare provider. Furthermore, empathetic communication skills lead to the establishment of the patient-provider partnership, which directly relates to increased interpersonal trust and patient satisfaction levels (Academy of Marketing Science, & Stieler, 2017).
Also, empathetic communication skills also lead to increased responsiveness both for the patient and the health provider. This refers to the provider’s willingness to assist, promptness in responding regarding such issues as pain relief and administering medications.
Empathetic communication skills also help create a good environment for effective health care services delivery. This is because the patient’s trust to the provider would enhance patient concentration, readiness and willingness to receive the medication process (Academy of Marketing Science, & Stieler, 2017).
Moreover, empathy is important in the healthcare setting for both patient and the provider as it increases connectedness hence giving the provider an easy time in dealing with the patient and chance to provide the most appropriate medical care. This is because connectedness makes the patient free to share all the necessary information that the provider needs to know that would help in providing the necessary care.
Additionally, empathic response reduces a patient’s feelings of alienation. These feelings can be caused by many factors such as the patient’s condition, mostly for conditions can be seen physically for example scars, or those conditions that may be distressful as a result of triggering social judgment, for example sexually transmitted infections or HIV/AIDs. These conditions may lead to stigmatization thus causing alienation (Roberts & Machon, 2015).
Alienation can be shown by the patient distancing him or herself from others (self- imposed alienation) or having feelings such as grief or regretful during the recovery process. These feelings can have serious implications for the people who need treatment or hinder them from regularly and correctly follow medical regimens as a result of the patient feeling lonely and, in some cases, even distancing him or herself from reality (Freeth, Thorne, & Shooter, 2007).
Through empathic response, the provider is able to acknowledge patients and help make them feel accepted and understood hence reducing social stigmatization and feelings of loneliness, thereby encountering alienation. This enables the patient to continue treatment, seek advice where necessary and endure the throughout the treatment process to recover.
These are the conditions or factors that may hinder the establishment of a good empathic relationship or reduce the effectiveness of the empathic relationship created from realizing the desired outcomes. These barriers originate from the provider, the patient or environment.
Provider barriers
Providers may not know how or why to use empathy effectively in providing health care. In addition, some provider’s characteristics such as cognitive and effective capabilities may also inhibit their abilities to create and effectively use empathic relationships. Empathy requires passion. The provider may lose some of his or her empathy from the knowledge of science and detachment, or due to the burdens of overwork in the healthcare facilities. They may not have control or distracting circumstances as they encounter patients therefore effectively develop empathic responses. Some health providers, on the other hand, are easily distracted by other demanding or pressing concerns such as pressure to complete work assigned to them, to attend a meeting or other personal distraction such as financial strains, relationship problems, minor health issues or emotional disturbances. These affect the provider’s ability to concentrate on the patient (Scott, 2007).
Furthermore, some providers may not be able to relax personal self-control to experience the patient’s situation sufficiently, or some providers have the tendency to regard the patient in terms familiar to them before understanding their conditions. Such rigidity will, in turn, narrow the focus of the provider such that he or she cannot take in new information or insight that may enable him or she understand the patient’s conditions better and take in the situations to him or herself.
Finally, lack of an individual passion for identifying and witnessing the patient’s agony and pain also hinders empathic relationships. Empathy requires an emotional knowledge of the patient and limitedly feeling of the patient’s pain as if it were your own. Sharing of unpleasant and painful thoughts may lead to some providers blocking the patient from sharing more of these thoughts to alleviate these feelings. Providers have different abilities to witness painful thoughts and feelings may be due to personal factors such as the provider’s vulnerability to certain patient conditions. The provider’s tolerance to different patient conditions affects the empathic relationship.
These are conditions in the patient that may limit the level and frequency at which the provider achieves empathic understanding.
Some patients may not have an openness to in-depth exploration and sharing of their painful thoughts and feelings. Out of self-known reasons, such as regarding self-disclosure as a weakness or embarrassment to share their conditions, some patients will keep most of the information to themselves and not share it even with their care providers. Since empathic understanding requires the provider to get all the relevant information, failure to relay all this information will affect the empathic understanding.
Moreover, some patients accept being known fully but cannot communicate in words what they are experiencing. This may be as a result of language differences, health literacy problems or inability to communicate due to the illness. This may as well inhibit the ability to create an empathic understanding and response until the patient and the provider establish common reference terms for getting the information communicated and understood.
These refer to the administrative and organizational features of the clinical setting. The absence of distracting noise allows for good listening and communication. There should be enough time allocated for the provider to attend to extremely stressful patient conditions and proper administrative controls to guide provider-patient relationship (Lee, 2016). Proper record keeping and consultation services about different conditions also enhance the empathic relationship.
Moreover, the clinic should match the right personnel in terms of knowledge and experience in dealing with different patient conditions to the different patients, since lack of the required knowledge in dealing with the patient affects the provider’s understanding of the patient’s circumstance. This should also be accompanied by ensuring the providers have some patients that they can comfortably handle a work burden overload may distract the patient’s attention to the patients.
Finally, creating privacy, for instance, rooms with locks and that is sound absorbent may encourage openness of the patient to share painful thoughts or feelings about their conditions fully, this is necessary for the provider to build up an empathic relationship. Some patients fear to share their thoughts or feelings because of the thought that people other than the provider may hear their thoughts and may despise them (Lee, 2016). This is so necessary for dealing with distressful health conditions that may cause stigmatization such as HIV/AIDs.
Conclusion
Empathy is an essential communication skill in the healthcare practice. Establishing an empathic provider-patient relationship requires patient openness to communicate and medically express his or her painful thoughts and feelings in depth and the provider’s ability to witness and empathically understand the patient’s thoughts and take back these feelings to him or herself. It not only benefits the provider in delivering patient care services, but also the patient in the recovery process. However, creating, effectively using and maintaining empathic provider-patient relationship requires the coordination of the provider, the patient, and the healthcare environment to eliminate or reduce the barriers to the empathic patient-provider relationship. Care should be taken when using empathic communication skill, not to confuse empathy with sympathy or pity or the provider to get carried away by emotional feelings to the extent that he or she cannot effectively deliver health care services to the patient.
References
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Hojat, M. (2007) Empathy in patient care: antecedents, development, measurement, and outcomes. New York, Springer.
Lee, T.H. (2016) An epidemic of empathy in health care: how to deliver compassionate, connected patient care that creates a competitive advantage. Available at https://www.overdrive.com/search?q=D1DCCDFA-FC73-4CDE-BEF1-9C4EB306D6AC. [Accessed on 22nd May 2018].
Moss, B. (2007) Communication Skills for Health and Social Care. SAGE Publications Ltd.
Nicholas-Smith, K. (2015) Empathy in Healthcare. Social Design (MA). Available at https://cdm16847.contentdm.oclc.org/cdm/ref/collection/p16847coll2/id/11 [Accessed on 22nd May 2018].
Roberts, G.W., & Machon, A. (2015) Appreciative health care practice: a guide to compassionate, person-centered care. Keswick, M & K Update Ltd. Available at https://public.eblib.com/choice/publicfullrecord.aspx?p=2091721 [Accessed on 22nd may 2018].
Rudge, T. (2016) (Re)Thinking Violence in Health Care Settings: A Critical Approach. Routledge Pub.
Scott, R.W. (2007) Guide for the new health care professional. Sudbury, Mass, Jones & Bartlett Publishers.
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