Literature Data

Empathy is a multidimensional construct, essential in care-related professions

Extensive scientific literature highlights that the activity of healthcare professionals can be not only overwhelming, but also very much centered on technical aspects. This tendency has grown in the last decades, based on two circumstances:

  • first, the integration of numerous diagnostic and digital tools has improved the accuracy and reliability of medical decisions, but has also added a substantial cognitive load and reduced time for relational work (Lown & Rodriguez, 2016; Tai-Seale et al., 2019; Shachak & Reis, 2019);
  • second, the growing “industrial” character of modern healthcare—characterized by high patient volumes and productivity pressures—has increasingly constrained clinicians’ capacity for empathic engagement (Kerasidou, 2019).

In this context, emotional skills such as empathy are often deprioritized by clinicians, despite remaining critical for patients and families. Consequently, many care users perceive empathy in clinical encounters as insufficient or superficial (Kee et al., 2018; Howick et al., 2018). This perception probably reflects not only a lower level of empathy than expected, but also a poor quality of empathy, this being often provided only at a behavioral level, without a genuine cognitive or affective base.

Furthermore, even clinicians who initially demonstrate high sensitivity to patient needs may experience a progressive decline in empathy, due to sustained professional stress and emotional exhaustion, a phenomenon described as „empathy fatigue“ or „empathy–burnout interaction“ (Samra, 2018; Hunt et al., 2019; Wilkinson et al., 2017; Zenasni et al., 2018; West et al., 2018).

This decline is concerning, in light of robust evidence linking clinician empathy to key care parameters, such as patient satisfaction, treatment adherence, and even clinical outcomes (LaNoue et al., 2016; Mercer & Howie, 2016; Del Canale et al., 2022; Trzeciak et al., 2021). Empathy enables clinicians to understand patients’ feelings, perspectives, and needs, allowing the delivery of more individualized and effective care (Moudatsou et al., 2020). Conversely, persistent failures to provide empathy can undermine the quality and safety of care (Birkhäuer et al., 2017).

The abovementioned data highlight the need for targeted interventions to address empathy erosion in healthcare. Evidence shows that structured training in empathy—encompassing empathic communication, self-assessment, and perspective-taking—can have long-term positive effects on professional performance and well-being (Kelm et al.,2016; Batt-Rawden et al., 2017; Neumann et al., 2019; Evans et al., 2020; Stepien & Baernstein, 2020). In a “mirror effect”, empathy can equally enhance these professionals’ ability to comprehend reality and improve their own quality of life.

References:

  1. Batt-Rawden, S. A., Chisolm, M. S., Anton, B., & Flickinger, T. E. (2017). Teaching empathy to medical students: An updated, systematic review. Academic Medicine, 92(6), 861–873.
  2. Birkhäuer, J., Gaab, J., Kossowsky, J., et al. (2017). Trust in the health care professional and health outcome: A meta-analysis. PLOS ONE, 12(2), e0170988.
  3. Del Canale, S., Sayori, A., et al. (2022). Empathy in patient–physician interactions and healthcare outcomes. Patient Education and Counseling, 105(6).
  4. Evans, B. J., Stanley, R. O., Burrows, G. D., & Sweet, B. (2020). Empathy skills training in healthcare: A systematic review. Medical Education, 54(8), 691–706.
  5. Howick, J., Steinkopf, L., Ulyte, A., Roberts, N., & Meissner, K. (2018). How empathic is your healthcare practitioner? A systematic review and meta-analysis of patient ratings. BMJ Open, 8, e021783.
  6. Hunt, M., Denieffe, S., & Gooney, M. (2019). Burnout and empathy in healthcare professionals. Journal of Clinical Nursing, 28(7–8), 1580–1590.
    Kee, J., Johnson, M., Hunt, M., & Taylor, J. (2018). Patients’ perspectives on empathy in healthcare. Journal of Patient Experience, 5(3), 231–238.
  7. Kelm, Z., Womer, J., Walter, J. K., & Feudtner, C. (2016). Interventions to cultivate physician empathy: A systematic review. BMC Medical Education, 16, 310.
  8. Kerasidou, A. (2019). Empathy and compassion in healthcare: Is there a problem? BMC Medical Ethics, 20, 3.
  9. LaNoue, M., Roter, D., Enoch, C., & Stewart, M. (2016). Patient perception of clinician empathy and communication. Patient Education and Counseling, 99(3), 394–401.
  10. Lown, B. A., & Rodriguez, D. (2016). Lost in translation? How electronic health records affect physician–patient communication. Journal of General Internal Medicine, 31(5), 548–552.
  11. Mercer, S. W., & Howie, J. G. R. (2016). CQI: Empathy and enablement as predictors of patient outcomes. British Journal of General Practice, 66(650), e460–e467.
  12. Moudatsou, M., Stavropoulou, A., Philalithis, A., & Koukouli, S. (2020). The role of empathy in health and social care professionals. International Journal of Caring Sciences, 13(1), 642–651.
  13. Neumann, M., Scheffer, C., Tauschel, D., et al. (2019). Physician empathy: Definition, outcome-relevance and its measurement. Dtsch Arztebl Int, 116(45), 781–788.
  14. Samra, R. (2018). Empathy fatigue in clinical practice. Journal of Medical Ethics, 44(1), 61–68.
  15. Shachak, A., & Reis, S. (2019). The impact of electronic medical records on patient-doctor communication. Israel Journal of Health Policy Research, 8, 45.
  16. Stepien, K. A., & Baernstein, A. (2020). Educating for empathy in healthcare: A review. Medical Teacher, 42(3), 258–266.
  17. Tai-Seale, M., Olson, C. W., Li, J., et al. (2019). Electronic health record logs and the work of primary care physicians. Annals of Family Medicine, 17(2), 165–171.
  18. Trzeciak, S., Roberts, B., & Mazzarelli, A. (2021). Compassion and prosocial behavior in clinical care. Journal of Patient Experience, 8, 1–7.
  19. West, C. P., Dyrbye, L. N., & Shanafelt, T. D. (2018). Physician burnout and healthcare outcomes. Mayo Clinic Proceedings, 93(11), 1571–1580.
  20. Wilkinson, H., Whittington, R., Perry, L., & Eames, C. (2017). Examining the relationship between burnout and empathy in healthcare professionals: A systematic review. Burnout Research, 6, 18–29.
  21. Zenasni, F., Boujut, E., Woerner, A., & Sultan, S. (2018). Burnout and empathy in primary care: Three hypotheses. British Journal of General Practice, 68(669), 146–147.
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