Empathy

Renato  C. Vilella; Anil Kumar Reddy Reddivari; Caroline Schoo

Empathy

Free Review Questions

Definition/Introduction

The history of the term "empathy" (translated from the German word Einfuhlung, that means feeling into) started over 100 years ago, introduced by the psychologist Edward Titchener.[1]

Definition

Empathy is a complex psychological influencing social interaction; it plays a role in the understanding of other's feelings, suffering, and behavior with a significant link to compassion. It is a motivated phenomenon that allows people to connect emotionally, mainly by sharing experiences and feelings.[2][3][4]

Empathy has been shown to be linked to neuroanatomical structures such as the amygdala, anterior cingulate cortex, and anterior insula. Furthermore, a multidimensional approach to empathy classifies it as either being cognitive, affective, or behavioral empathy. [5]

Measuring Empathy

In order to measure empathy, several scales have been designed that help to identify the capacity of an individual to be more empathic or less empathic. As empathy involves a wide range of psychological concepts, many scales are currently being used to identify empathy. Some of these include the Empathic Accuracy Task (EAT), Empathy Components Questionnaire, and the very old Interpersonal Reactivity Index (IRI). [6][7][8][7][6]

Issues of Concern

Influence of Empathy on the healthcare team and delivery

A healthcare professional has to bring empathy to the table when they are dealing with a patient as it helps them to comprehend the emotional and the cognitive state of the patient involved. This connection can help healthcare professionals to build a therapeutic relationship with the patients that can eventually lead to better health outcomes. This influence is not only determined by the words chosen but also by facial expressions, body language, and vocalization. The emotional and cognitive connection is invaluable in the current day healthcare delivery to achieve the best patient-provider relationship.[3][9][3]

As empathetic behavior by providers gets modulated by motivation, health care providers should also have empathic support from their institutions to deliver the same high-quality care for the patients.[4]

Clinical Significance

Clinical significance of empathy:

Understanding a patient's feelings, concerns, and expectations can help a physician to provide better care.
Imagining things from the patient's point of view can reveal a different perspective to address them.
Empathy can break down some perceived barriers between the patient and the healthcare team.[10]

Increasing empathy in the practice:

Cognitive empathy modulated by motivation can help to make better providers. There are many motivational triggers to increase empathy; those strategies apply to the interprofessional team and patient's care and is achievable by regular and thoughtful training.

Creating a desire to alleviate suffering
Increase kindness
Increase positive and friendly attitude

These kinds of modulation can increase patient satisfaction and improve the diagnostic process and treatment outcome.[2]

Disorders of Empathy

Disturbance in an appropriate empathic/vicarious response can be associated with some conditions such as[1][8]:

Psychopathy
Autism spectrum disorders
Alzheimer disease
Frontotemporal dementia

Nursing, Allied Health, and Interprofessional Team Interventions

Training

Education and training by various seminars showed to be effective in training medical students for empathic communication; therefore, training of health care professionals is essential to prepare them for excellent patient care.[11]

Nursing

Empathy for nursing is describable as both a human trait and a professional state. Empathy plays a vital role in decision making to deliver patient-centered care.[12]

Understanding and Educating

As empathic responses may be dysfunctional in patients with Alzheimer's disease and frontotemporal dementia, the professional that deals with these patients need to be trained/educated to understand empathic behavior and deliver proper care for these specific cases.

Details

References

[1]

Lockwood PL. The anatomy of empathy: Vicarious experience and disorders of social cognition. Behavioural brain research. 2016 Sep 15:311():255-266. doi: 10.1016/j.bbr.2016.05.048. Epub 2016 May 25 [PubMed PMID: 27235714]

[2]

Weisz E, Zaki J. Motivated empathy: a social neuroscience perspective. Current opinion in psychology. 2018 Dec:24():67-71. doi: 10.1016/j.copsyc.2018.05.005. Epub 2018 May 16 [PubMed PMID: 29966924]

Level 3 (low-level) evidence

[3]

Meyza KZ, Bartal IB, Monfils MH, Panksepp JB, Knapska E. The roots of empathy: Through the lens of rodent models. Neuroscience and biobehavioral reviews. 2017 May:76(Pt B):216-234. doi: 10.1016/j.neubiorev.2016.10.028. Epub 2016 Nov 4 [PubMed PMID: 27825924]

[4]

Riess H. The Science of Empathy. Journal of patient experience. 2017 Jun:4(2):74-77. doi: 10.1177/2374373517699267. Epub 2017 May 9 [PubMed PMID: 28725865]

[5]

Uribe C, Puig-Davi A, Abos A, Baggio HC, Junque C, Segura B. Neuroanatomical and Functional Correlates of Cognitive and Affective Empathy in Young Healthy Adults. Frontiers in behavioral neuroscience. 2019:13():85. doi: 10.3389/fnbeh.2019.00085. Epub 2019 May 1 [PubMed PMID: 31118891]

[6]

Coll MP, Viding E, Rütgen M, Silani G, Lamm C, Catmur C, Bird G. Are we really measuring empathy? Proposal for a new measurement framework. Neuroscience and biobehavioral reviews. 2017 Dec:83():132-139. doi: 10.1016/j.neubiorev.2017.10.009. Epub 2017 Oct 13 [PubMed PMID: 29032087]

[7]

Batchelder L, Brosnan M, Ashwin C. The Development and Validation of the Empathy Components Questionnaire (ECQ). PloS one. 2017:12(1):e0169185. doi: 10.1371/journal.pone.0169185. Epub 2017 Jan 11 [PubMed PMID: 28076406]

Level 1 (high-level) evidence

[8]

Konrath S, Meier BP, Bushman BJ. Development and validation of the Single Item Trait Empathy Scale (SITES). Journal of research in personality. 2018 Apr:73():111-122. doi: 10.1016/j.jrp.2017.11.009. Epub 2017 Nov 14 [PubMed PMID: 29527069]

Level 1 (high-level) evidence

[9]

Moudatsou M, Stavropoulou A, Philalithis A, Koukouli S. The Role of Empathy in Health and Social Care Professionals. Healthcare (Basel, Switzerland). 2020 Jan 30:8(1):. doi: 10.3390/healthcare8010026. Epub 2020 Jan 30 [PubMed PMID: 32019104]

[10]

Brown EL, Agronin ME, Stein JR. Interventions to Enhance Empathy and Person-Centered Care for Individuals With Dementia: A Systematic Review. Research in gerontological nursing. 2020 May 1:13(3):158-168. doi: 10.3928/19404921-20191028-01. Epub 2019 Nov 11 [PubMed PMID: 31697393]

Level 1 (high-level) evidence

[11]

Wündrich M, Schwartz C, Feige B, Lemper D, Nissen C, Voderholzer U. Empathy training in medical students - a randomized controlled trial. Medical teacher. 2017 Oct:39(10):1096-1098. doi: 10.1080/0142159X.2017.1355451. Epub 2017 Jul 27 [PubMed PMID: 28749198]

Level 1 (high-level) evidence

[12]

Adams SB. Empathy as an Ethical Imperative. Creative nursing. 2018 Aug:24(3):166-172. doi: 10.1891/1946-6560.24.3.166. Epub [PubMed PMID: 30567759]

[13]

Heyes C. Empathy is not in our genes. Neuroscience and biobehavioral reviews. 2018 Dec:95():499-507. doi: 10.1016/j.neubiorev.2018.11.001. Epub 2018 Nov 3 [PubMed PMID: 30399356]

[14]

Craig AD. How do you feel--now? The anterior insula and human awareness. Nature reviews. Neuroscience. 2009 Jan:10(1):59-70. doi: 10.1038/nrn2555. Epub [PubMed PMID: 19096369]

[15]

Rolls ET. The cingulate cortex and limbic systems for emotion, action, and memory. Brain structure & function. 2019 Dec:224(9):3001-3018. doi: 10.1007/s00429-019-01945-2. Epub 2019 Aug 26 [PubMed PMID: 31451898]