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PubMed2004

Effect of gender, age, and relevant course work on attitudes toward empathy, patient spirituality, and physician wellness.

BACKGROUND: The emphasis in medical education on viewing the patient as a whole person addresses current concerns about the negative impact of standard physician training that may lead to impaired patient-physician relationships. PURPOSES: To assess self-ratings of empathy, spirituality, wellness, and tolerance in a sample of medical students and practitioners to explore differences by gender, age, and training. METHODS: A survey was created that assesses empathy, spirituality, wellness, and tolerance in the medical setting. Surveys were completed anonymously by medical students and practitioners from the medical school. RESULTS: The youngest groups scored highest on empathy and wellness and lowest on tolerance. Participation in medical school wellness sessions correlated with higher empathy and wellness scores; participation in both empathy and spirituality sessions correlated with higher empathy scores. CONCLUSION: Exposure to educational activities in empathy, philosophical values and meaning, and wellness during medical school may increase empathy and wellness in medical practice.

Adult↗

PubMed2001

[Empathy in the physician-patient relation--tool or ethics?].

Empathy is a quality sought by patients, and an ideal that is pursued by the physicians themselves and in medical education. It is, however, necessary and important to define the boundaries between the concept of empathy and related concepts such as sympathy and compassion. This article is based on a study of literature addressing empathy and related concepts, and it attempts to illuminate the instrumental as well as moral significance of empathy in the physician-patient relationship. The concept of empathy is seen as the ability to understand another person's situation, and is in itself morally neutral. Our capacity for empathy is based on emotional as well as intellectual skills. Empathy is primarily a mode of understanding that can be expressed by means of communication, but is not in its essence a form of conduct or behaviour. Empathy concerns the physician's fundamental attitude towards the patient and carries an independent moral value. It is part of the moral foundation of medicine and can be seen as a virtue in medical practice.

Aged↗

PubMedDate not supplied

A course in empathy.

The purpose of this project was to determine whether an empathy skills training course would produce an improvement in student nurses' Empathy Scale scores. Empathic skills were defined as the ability to communicate an accurate understanding of another's feeling and experience, and were operationally measured with a paper-and-pencil test (the Empathy Scale, Gazda, et al., 1977). In a posttest-only control group experimental design, a random sample of two groups of nursing students completed these measures. Empathy Scale scores were the dependent variable and the empathy skills course was the independent variable. A t-test demonstrated that students who had completed the empathy skills course had significantly lower (more empathic) scores on the Empathy Scale (p less than .05). Analysis of demographic data using Pearson's correlation coefficient showed no significant relationship between scores on the Empathy Scale and age (r = -.16), nor between scores and years in the health care field (r = .06).

Communication↗

PubMed1990

A validity study of four empathy instruments.

The construct validity of four empathy instruments were evaluated through examining group differences and correlations between tests. Subjects were 18 registered nurses (RNs) and 32 nursing assistants (NAs). Instruments used were the Empathy Test (Layton, 1979), the Carkhuff (1969a, 1969b) Empathic Understanding in Interpersonal Processes Scale, the empathy subtest of the Barrett-Lennard (1962) Relationship Inventory, and LaMonica's (1981) Empathy Construct Rating Scale (ECRS). The first hypothesis, that RNs would score significantly higher than NAs on all empathy measures, was confirmed (p less than .0003 to p less than .027). The second hypothesis, that the various empathy measures would be positively related, was partially confirmed. The Carkhuff scale was significantly correlated with the ECRS (r = .25, p less than .05). The ECRS and the Barrett-Lennard also were correlated (r = .78, p less than .001). Results are interpreted using Barrett-Lennard's (1981) theory of empathy.

Data Collection↗

PubMed2007

Who cares? Revisiting empathy in Asperger syndrome.

A deficit in empathy has consistently been cited as a central characteristic of Asperger syndrome (AS), but previous research on adults has predominantly focused on cognitive empathy, effectively ignoring the role of affective empathy. We administered the Interpersonal Reactivity Index (IRI), a multi-dimensional measure of empathy, and the Strange Stories test to 21 adults with AS and 21 matched controls. Our data show that while the AS group scored lower on the measures of cognitive empathy and theory of mind, they were no different from controls on one affective empathy scale of the IRI (empathic concern), and scored higher than controls on the other (personal distress). Therefore, we propose that the issue of empathy in AS should be revisited.

Adult↗

PubMed2006

The multiple facets of empathy: a survey of theory and evidence.

Empathy is the ability to perceive and understand other people's emotions and to react appropriately. This ability is a necessary prerequisite for successful interpersonal interaction. Empathy is a multifaceted construct including low-level mechanisms like emotional contagion as well as high-level processes like perspective-taking. The ability to empathize varies between individuals and is considered a stable personality trait: some people are generally more successful in empathizing than others. In this chapter we will first present different conceptualizations of the construct of empathy, and refer to empathy-regulating processes as well as to the relationship between empathy and social behavior. Then, we will review peripheral physiological and brain imaging studies pertaining to low- and high-level empathic processes, empathy-modulating processes, and the link between empathy and social behavior. Further, we will present evidence regarding interindividual differences in these processes as an important source of information for solving the conundrum of how the comprehension of others' emotions is achieved by our brains.

Brain↗

PubMed1999

The development of empathy in students on a short, skills based counselling course: a pilot study.

This paper reports on a pilot study to measure the development of empathy in students on a short skills-based counselling course. Thirty-eight students from a total population of 56 produced mean empathy scores prior to and following the counselling training. The results indicate that changes in levels of student empathy occurred in all but one of the students with a wide variation in the degree of change. Whilst the results obtained in this study in no way allow any firm conclusions to be drawn, they do provide tentative evidence that student empathy levels can increase as a consequence of undertaking a short skills-based counselling course and, further more, comprehensive research in this area is indicated. This apparent increase in students' empathy appears to be a positive development, yet it could also create difficulties for the nurse due to the possibility of increased emotional demands created by this empathy. Despite the arguments for attempting to develop empathy in students being robust, there may be some individuals who would argue that short skills-based counselling training does not enable empathic development in the students. Whilst the authors argue that there is a need to demystify counselling training, they in no way suggest that there is no need for lengthy, more intensive counselling training. There appears to be a case for having both forms of counselling training.

Attitude of Health Personnel↗

PubMed1999

Empathy has not been measured in clients' terms or effectively taught: a review of the literature.

Empathy, the ability to communicate an understanding of a client's world, is said to be a crucial component of all helping relationships. The first part of this paper focuses on the failure of measures of empathy to reflect clients' views about the ability to offer empathy. It is argued that, if clients are able to perceive the amount of empathy in helping relationships, they are able to advise professionals about how to offer empathy. The second part of this paper examines the inconclusive research evidence that existing courses have enabled professionals to offer empathy, and the disagreement about how empathy is best taught. The literature reviewed in this paper substantiates these observations.

Education, Nursing↗

PubMed2001

Empathy from a nursing perspective: Moving beyond borrowed theory.

Empathy is a concept deeply rooted in and central to professional nursing. Although viewed as an important concept, little consensus exists in the professional literature about either the definition or the application of the concept to nursing practice. This article will compare two theories of empathy, one borrowed from Kohut's self-psychology model and one derived from King's Interacting Systems nursing framework. The two theories are examined to clarify issues pertaining to the concept of empathy and to identify the contributions and limitations of borrowed theory as the basis for nursing practice. The article explores similarities and difference in the two views of empathy and highlights the necessity of developing nursing science from theory based in nursing which reflects the very unique nature of nursing practice. Nursing as a profession is distinct and unique, and borrowed theory must be questioned for its fit and applicability to the profession. The article concludes that empathy is a nursing phenomenon needing to be studied from a nursing perspective. The results of continued use of borrowed theory pertaining to empathy is discussed including the delay and misdirection of ongoing activity to develop the concept of empathy.

Empathy↗

PubMed2003

Could empathy be a predictor of hypnotic ability?

This study examined whether trait empathy is related to hypnotic ability and absorption. Sixty-four graduate students and mental health professionals completed the Harvard Group Scale of Hypnotic Susceptibility, Form A; the Davis Interpersonal Reactivity Index; and the Tellegen Absorption Scale as measures of hypnotic ability, empathy, and absorption. Correlation analysis determined that statistically significant relationships exist between empathy and hypnotic ability (r = .41); empathy and absorption (r = .43); and absorption and hypnotic ability (r = .31). The results also indicate that empathy and absorption are both predictors of hypnotic ability, although absorption does not appear to contribute a statistically significant amount of the explained variance in hypnotizability that is independent of empathy. It may be that the conceptual ground shared by both empathy and absorption is what predicts hypnotic ability.

Adult↗

PubMed2002

A relationship between smell identification and empathy.

Olfaction is a sense that has close relationships with the limbic system and emotion. Empathy is a vicarious feeling of others' emotional states. The two functions are known to be subserved by common neuroanatomical structures, including orbitofrontal cortex, mediodorsal thalamus, and the amygdala. This study demonstrates a correlation between smell identification and empathy, using the Mehrabian and Epstein Empathy Questionnaire and Alberta Smell Test. Right nostril smell identification correlated with empathy, whereas the left nostril did not. Given the predominantly ipsilateral representation in the olfactory system, this is in accordance with right hemisphere dominance for emotional functions and empathy. Further, the emotional component of empathy (feeling another's emotions) correlated with smell, whereas a cognitive component (comprehending another's emotions) did not. This study is the first to demonstrate a relationship between empathy and smell in normal subjects, suggesting common neural substrates.

Adult↗

PubMed2000

Basic empathy in older adults: conceptualization, measurement, and application.

Older adults comprise the most rapidly increasing age group in America. In addition, an increasing number of older adults are involved in helping behaviors or volunteering. Although empathy has been identified as a critical component of a helping relationship, few studies concerning empathy have been conducted with older adults and few instruments have been developed that can be used with this population. The purpose of this study was to explore the relationship between two measures of empathy in older adults. The Hogan Empathy Scale and an Adjective Check List Empathy Scale were used to assess basic empathy in 43 older adults between the ages of 63 and 96. Results indicated that the mean scores of older adults were lower than mean scores in younger populations. Scores on both measures were comparable suggesting that both instruments could be used to measure basic empathy in older adults.

Aged↗

PubMed2006

Structural anatomy of empathy in neurodegenerative disease.

Empathy is a complex social behaviour mediated by a network of brain structures. Recently, several functional imaging studies have investigated the neural basis of empathy, but few corroborative human lesion studies exist. Severe empathy loss is a common feature of frontotemporal lobar degeneration (FTLD), and is also seen in other neurodegenerative diseases. In this study, the neuroanatomic basis of empathy was investigated in 123 patients with FTLD, Alzheimer's disease, corticobasal degeneration and progressive supranuclear palsy using the Interpersonal Reactivity Index (IRI). IRI Empathic Concern and Perspective taking scores were correlated with structural MRI brain volume using voxel-based morphometry. Voxels in the right temporal pole, the right fusiform gyrus, the right caudate and right subcallosal gyrus correlated significantly with total empathy score (P < 0.05 after whole-brain correction for multiple comparisons). Empathy score correlated positively with the volume of right temporal structures in semantic dementia, and with subcallosal gyrus volume in frontotemporal dementia. These findings are consistent with previous research suggesting that a primarily right frontotemporal network of brain regions is involved in emotion processing, and highlights the roles of the right temporal pole and inferior frontal/striatal regions in regulating complex social interactions. This is the first large-scale lesion study to investigate the neural basis of empathy using correlational analytic methods. The results suggest that the right anterior temporal and medial frontal regions are essential for real-life empathic behaviour.

Aged↗

PubMed1982

Empathy and attitudes among medical students: the effects of group experience.

This study compares the level of empathy of medical students with the levels of empathy among other university students. It also explores the impact of the psychiatric clerkship with group experience on the medical students' empathy for and attitudes toward mental patients as compared with the level of attitudes and empathy of medical students without group experience. The results indicated that psychiatric teaching can change and enhance empathy and increase positive attitudes toward mental illness among medical students. These results were dependent upon the students' participation in a self-exploratory group experience. An additional goal of the study was to test the impact of medical students' psychiatric clerkships on the relationship between the level of self-reported empathy and the level of empathy as judged by their peer group. It was found that these separate vantage points merged as a consequence of group participation.

Attitude↗

PubMed1993

Measuring medical students' empathy skills.

Empathy is an important skill for the medical practitioner or medical students to develop when interviewing patients. It helps the interviewer establish effective communication, which is important for accurate diagnosis and patient management. Two facets of medical education limit students' development of accurate empathy: the traditional format of interviewing training and the social ethos of medical training and medical practice, which stress clinical detachment. A number of researchers and educators have developed consulting skills training programmes, designed to enhance students' empathic skills and ability. One difficulty for researchers has been the conceptual complexity of the term 'empathy' and greater difficulty in measuring the dimension. This paper reviews the range of approaches to the measurement of empathy and reports on a research study designed to evaluate a two-stage measurement technique, involving a pencil-and-paper test of empathy and independent observer ratings of medical students' actual interview behaviours. Results lead to the conclusion that pencil-and-paper tests of empathy cannot incorporate the range of complex cognitive, emotional and behavioural components of the empathy construct. On the other hand, trained observers have been able to use items on a specially developed History-taking Rating Scale to discriminate between the empathic behaviours of a group of students trained in consulting skills with those of a group of control students who each carried out videotaped history-taking interviews with hospitalized patients.

Adult↗

PubMed1999

The child molester empathy measure: description and examination of its reliability and validity.

The aim of the two studies presented here was to produce and refine a measure of victim empathy for the assessment of child molesters. In the first study, 61 nonfamilial child molesters completed the Child Molester Empathy Measure (CMEM), a questionnaire designed specifically for this study. The measure assessed empathy in three contexts: (a) toward a child who was in a motor vehicle accident and was disfigured, (b) toward a child who had been sexually molested by an unknown assailant over a period of time, and (c) toward the offender's own victim(s). Results indicated that the measure was both internally reliable and produced stable responses over time. The results also revealed a relative deficit in empathy toward the offender's own victim(s). The goal of the second study was to replicate the data obtained in the first study and compare child molesters' responses with the responses of a group of nonoffenders. Twenty-nine child molesters and 36 community males (nonoffenders) completed the questionnaire. This study also confirmed the internal reliability and test-retest reliability of the CMEM. The discriminant validity of the measure was supported by the child molesters' demonstrated relative deficiency in empathy toward an unknown offender's victim of sexual abuse. However, the child molesters displayed equal empathy toward the accident victim relative to nonoffenders. Additionally, the child molesters displayed significantly less empathy toward their own victims than toward the general sexual abuse victim. The results are discussed in terms of their theoretical and practical implications.

Accidents, Traffic↗

PubMed2004

The role of empathy in responses to persuasive risk communication: overcoming resistance to HIV prevention messages.

This article offers a theoretical analysis of the role of empathy as a key mediator of the suasive effects of health messages, and it discusses the testing of an empirical tool for studying the state of empathy in responses to persuasive messages. It is argued that felt empathy evokes cognitive and emotional processing conducive to important health-promoting responses. This assertion was tested by operationalizing empathy as a response state via a new measure, the Empathy Response Scale (ERS). Two pilot tests and one major study, all set in the challenging area of HIV/AIDS prevention, provided preliminary data supporting the theoretical analysis and the ERS as a measure of the state of empathy. The article concludes with discussions of directions for future tests of the empathy theory and scale, as well as applications of the current framework for developing persuasive messages.

Adolescent↗

PubMed1990

The Young Children's Empathy Measure: reliability, validity and effects of companion animal bonding.

The Young Children's Empathy Measure is a brief measure of young children's cognitive and affective perspective taking developed to assess preschool children's empathy. The Cronbach alpha coefficient of internal reliability for the empathy score was acceptable and interrater reliability across four rates was very high. The children's empathy scores were correlated with their ages and social development, but not with their IQs. Empathy toward children was correlated with empathy for pets, and children with a strong pet bond had higher scores on empathy for children than young children without pets.

Child↗