Is empathy associated with a derived sense of meaning among resident physicians working with patients nearing the end of life on a hematology-oncology ward?

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 28-28
Author(s):  
Daniel Curtis McFarland ◽  
Jonathan Komisar
Keyword(s):  
End Of Life ◽  
Response Rate ◽  
Cognitive Empathy ◽  
Reactivity Index ◽  
Demographic Information ◽  
Resident Physicians ◽  
Dying Patients ◽  
Internal Medicine Residents ◽  
Empathy Score ◽  
Oncology Ward

28 Background: An association between empathy and physician-in-training based meaning derived from patient deaths has not been explored previously. If meaning is associated with empathy, an intervention to enhance meaning may counteract empathy decline and promote clinician resilience. This study sought to understand if empathy might be associated with the ability to find meaning in the clinical situations that residents face in oncology. Methods: Internal Medicine residents rotating on a Hematology/Oncology ward were asked “Do you derive a sense of meaning from working with dying patients? Yes or No.” The Interpersonal-Reactivity Index (IRI) was used to measure empathy and demographic information. Results: 64 responded (66.7% response rate). 43 (67.2%) derived a sense of meaning while 21 (32.8%) did not. The ‘meaning’ group empathy score (IRI) was 60.7 (SD 10.8) and the ‘no meaning’ group empathy score (IRI) was 51.7 (SD 11.5) (p < .01). Empathy subscale differences were notable for decreased cognitive empathy via the Fantasy Score (14.0 versus 9.9) (p < .01) and decreased affective empathy via the Empathic Concern scale (18.8 versus 15.9) (p < .05). Conclusions: The majority of physicians-in-training derived a sense of meaning from working with patients at the end of life and had significantly higher levels of empathy. The ability to impart meaning-finding has been demonstrated in patients and could be taught to physicians-in-training and lead to higher empathy levels. [Table: see text]

Empathic disequilibrium in two different measures of empathy predicts autistic traits in neurotypical population

2020 ◽  
Author(s):  
Ido Shalev ◽  
Florina Uzefovsky
Keyword(s):  
Developmental Trajectories ◽  
Autistic Traits ◽  
Cognitive Empathy ◽  
Autism Spectrum ◽  
Reactivity Index ◽  
Autism Spectrum Conditions ◽  
Autism Spectrum Quotient ◽  
Empathy Score ◽  
Empathy Quotient ◽  
Social Difficulties

Background. Features of autism spectrum conditions (ASC) are normally distributed within the population, giving rise to the notion of the autistic spectrum. One of the hallmark features of ASC is difficulties in social communication, which relies heavily on our ability to empathize with others. Empathy comprises of both cognitive (CE) and emotional (EE) components that, together, allow us to understand another's emotions and be affected by them appropriately, while maintaining a self-other distinction. Although CE and EE depend on distinct neural and developmental trajectories, it was suggested that the two empathic capacities can influence, balance, and regulate each other. Previous findings regarding the role of emotional and cognitive empathy in ASC have been mixed. Therefore, our study aimed to investigate whether the intra-personal empathy imbalance between the cognitive and emotional components, a measure we termed empathic disequilibrium (ED), can be associated with autistic traits at the neurotypical range.Methods. Participants were 671 neurotypical young-adults who self-reported their empathy, assessed using two highly validated questionnaires - the Interpersonal Reactivity Index and the Empathy Quotient, autistic traits using the Autism spectrum quotient, and the related traits, alexithymia, and systemizing.Results. Controlling for the total empathy score, greater ED was found to be positively correlated with autistic traits. Specifically, autistic traits were found to be elevated in groups of individuals with relatively higher EE than CE, underscoring their imbalance.Conclusions. Our study offers a novel perspective on the understanding of the social difficulties associated with autistic tendencies in the general population, and has potentially important clinical implications for understanding of ASC. We also propose a novel characterization of ASC based on the imbalance between EE and CE, which we term ED, as opposed to examining EE and CE separately.

End-of-life transitions for family member on the solid tumour oncology ward: the 3 Wishes Project

2021 ◽  
pp. bmjspcare-2021-003138
Author(s):  
Gwenyth Day ◽  
Danielle Bear ◽  
Marilyn Swinton ◽  
Daniel Karlin ◽  
Peter Phung ◽  
...  
Keyword(s):  
End Of Life ◽  
Family Member ◽  
Life Transitions ◽  
Patients With Cancer ◽  
Dying Patients ◽  
Oncological Patients ◽  
Hospitalised Patients ◽  
Semistructured Interviews ◽  
Oncology Ward ◽  
Caregiver Role

ObjectivesAlthough death is not uncommon for hospitalised patients with cancer, there are few interventions in oncology that are designed to create a dignified, compassionate end-of-life (EOL) experience for patients and families. The 3 Wishes Project (3WP), a programme in which clinicians elicit and implement final wishes for dying patients, has been shown effective in intensive care units (ICUs) at improving the EOL experience. The objective was to initiate 3WP on an oncology ward and evaluate its effect on family member experiences of their loved one’s EOL. We hypothesised that the 3WP can be implemented in the non-ICU setting and help oncological patients and their families with transition to the EOL.MethodsWhen the patient’s probability of dying is greater than 95%, patients and families were invited to participate in the 3WP. Wishes were elicited, implemented and categorised. Audiorecorded, semistructured interviews were conducted with family members, transcribed and analysed using content analysis.Results175 wishes were implemented for 52 patients with cancer (average cost of US$34). The most common wish (66%) was to personalise the environment. Qualitative analysis of 11 family member interviews revealed that the 3WP facilitates three transitions at the EOL: (1) the transition from multiple admissions to the final admission, (2) the transition of a predominantly caregiver role to a family member role and (3) the transition from a focus on the present to a focus on legacy.ConclusionThe 3WP can be implemented on the oncology ward and enhance the EOL experience for hospitalised patients with cancer.

Improving the End-of-Life Experience for Family Members of Cancer Patients Who Die on the Oncology Ward: The Three Wishes Project (SCI922)

2021 ◽  
Vol 61 (3) ◽  
pp. 681-682
Author(s):  
Gwenyth Day ◽  
Marilyn Swinton ◽  
Danielle Bear ◽  
Peter Phung ◽  
Allegra Bell ◽  
...  
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
Life Experience ◽  
Family Members ◽  
Oncology Ward

End-of-Life Needs of Dying Patients and Their Families in Mainland China: A Systematic Review

2021 ◽  
pp. 003022282199734
Author(s):  
Guobin Cheng ◽  
Chuqian Chen
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Healthcare Professionals ◽  
Web Of Science ◽  
Empirical Studies ◽  
Symptom Control ◽  
Mainland China ◽  
Spiritual Needs ◽  
Care Needs ◽  
Dying Patients

Objective To map the current research status and understand existing findings regarding end-of-life care needs in Mainland China. Method First-hand, empirical studies on the needs of dying patients and/or their families in Mainland China were searched in Web of Science, Scopus, Proquest, Taylor & Francis Online and CNKI in December 2019. Findings were synthesized. Results A total of 33 (10 qualitative) studies were involved. Chinese dying patients and their families had physical, psychological, social, and spiritual needs and needs for knowledge and information. Prevalent needs of dying patients were mainly symptom control and decent look, being treated kindly by professional caregivers, family accompany, dignity, and comfortable environment. Families mainly need healthcare professionals to take good care of patients and wishes for information, knowledge, and facilities to help themselves become better caregivers. Conclusions Findings lay the foundation for effective and tailored services for Chinese clients and provided insights for future investigations.

Chilean Version of the Empathy Quotient (EQ) Scale: Adaptation and Psychometric Properties

2021 ◽  
Vol 24 ◽  
Author(s):  
Ana María Fernández ◽  
Carmen Gloria Baeza ◽  
Paula Pavez ◽  
Nerea Aldunate
Keyword(s):  
Social Skills ◽  
Psychometric Properties ◽  
Emotional Reactivity ◽  
Structural Model ◽  
Cognitive Empathy ◽  
Reactivity Index ◽  
Community Group ◽  
The Social ◽  
Empathy Quotient ◽  
Aggression Questionnaire

Abstract We evaluated the psychometric properties of the empathy quotient (EQ) scale translated to Spanish in Chile. We estimated its structural validity, and its construct validity with other convergent measures of empathy and attachment, as well an inversely associated construct such as aggression. We used a general sample of students and community individuals (n = 336). Participants completed the EQ, Interpersonal Reactivity Index (IRI), and Buss-Perry Aggression Questionnaire (BPAQ). Another exclusively community group (n = 102) completed Collins Adult Attachment scale and the EQ. CFA and ESEM analyses confirmed the structural model fit of the data to three previously reported dimensions of the EQ: cognitive empathy (CE), emotional reactivity (ER) and social skills (SS). Sex-differences in emotional reactivity, and the predicted relationships with the convergent measures were observed. The current Chilean version of the EQ resulted in an appropriate multidimensional measurement of empathy. Finally, providing a specific social skills dimension extends the traditional conception of cognitive and affective empathy to the social realm in the Chilean context.

scholarly journals Evidence on the economic value of end-of-life and palliative care interventions: a narrative review of reviews

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Xhyljeta Luta ◽  
Baptiste Ottino ◽  
Peter Hall ◽  
Joanna Bowden ◽  
Bee Wee ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cost Effectiveness ◽  
End Of Life ◽  
Resource Use ◽  
Economic Value ◽  
Healthcare Delivery ◽  
Dying Patients ◽  
Home Based ◽  
Population Type ◽  
Care Models

Abstract Background As the demand for palliative care increases, more information is needed on how efficient different types of palliative care models are for providing care to dying patients and their caregivers. Evidence on the economic value of treatments and interventions is key to informing resource allocation and ultimately improving the quality and efficiency of healthcare delivery. We assessed the available evidence on the economic value of palliative and end-of-life care interventions across various settings. Methods Reviews published between 2000 and 2019 were included. We included reviews that focused on cost-effectiveness, intervention costs and/or healthcare resource use. Two reviewers extracted data independently and in duplicate from the included studies. Data on the key characteristics of the studies were extracted, including the aim of the study, design, population, type of intervention and comparator, (cost-) effectiveness resource use, main findings and conclusions. Results A total of 43 reviews were included in the analysis. Overall, most evidence on cost-effectiveness relates to home-based interventions and suggests that they offer substantial savings to the health system, including a decrease in total healthcare costs, resource use and improvement in patient and caregivers’ outcomes. The evidence of interventions delivered across other settings was generally inconsistent. Conclusions Some palliative care models may contribute to dual improvement in quality of care via lower rates of aggressive medicalization in the last phase of life accompanied by a reduction in costs. Hospital-based palliative care interventions may improve patient outcomes, healthcare utilization and costs. There is a need for greater consistency in reporting outcome measures, the informal costs of caring, and costs associated with hospice.

End-of-Life Decisions Among Cancer Patients Compared With Noncancer Patients in Flanders, Belgium

2006 ◽  
Vol 24 (18) ◽  
pp. 2842-2848 ◽  
Author(s):  
Lieve Van den Block ◽  
Johan Bilsen ◽  
Reginald Deschepper ◽  
Greta Van Der Kelen ◽  
Jan L. Bernheim ◽  
...  
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
Response Rate ◽  
Decision Making Process ◽  
End Of Life Decisions ◽  
Symptom Alleviation ◽  
Incidence Studies ◽  
Life Decisions ◽  
End Of Life Decision ◽  
Life Decision

Purpose Incidence studies reported more end-of-life decisions with possible/certain life-shortening effect (ELDs) among cancer patients than among noncancer patients. These studies did not correct for the different proportions of sudden/unexpected deaths of cancer versus noncancer patients, which could have biased the results. We investigated incidences and characteristics of ELDs among nonsudden cancer and noncancer deaths. Methods We sampled 5,005 certificates of all deaths in 2001 (Flanders, Belgium) stratified for ELD likelihood. Questionnaires were mailed to the certifying physicians. Data were corrected for stratification and nonresponse. Results The response rate was 59%. Among 2,128 nonsudden deaths included, ELDs occurred in 74% of cancer versus 50% of noncancer patients (P < .001). Symptom alleviation with possible life-shortening effect occurred more frequently among cancer patients (P < .001); nontreatment decisions occurred less frequently (P < .001). The higher incidence of lethal drug use among cancer patients did not hold after correcting for patient age. Half of the cancer patients who died after an ELD were incompetent to make decisions compared with 76% of noncancer patients (P < .001). Discussion with patients and relatives was similar in both groups. In one fifth of all patients the ELD was not discussed. Conclusion ELDs are common in nonsudden deaths. The different incidences for symptom alleviation with possible life-shortening effect and nontreatment decisions among cancer versus noncancer patients may be related to differences in dying trajectories and in timely recognition of patient needs. The end-of-life decision-making process is similar for both groups: consultation of patients and relatives can be improved in a significant minority of patients.

Shattering the Glass Podium: Successes and Setbacks of Women in Collegiate Choral Conducting

2021 ◽  
pp. 875512332110183
Author(s):  
Melissa Baughman
Keyword(s):  
Gender Discrimination ◽  
Online Survey ◽  
Response Rate ◽  
The United States ◽  
Choral Conducting ◽  
Demographic Information ◽  
Choral Conductors ◽  
The Status ◽  
Study Participants ◽  
Experiences Of Women

The purpose of this study was to explore the status and experiences of women in collegiate choral conducting positions. Out of all collegiate choral conductors ( N = 992) at institutions accredited by the National Association of Schools of Music in the United States, 68.65% ( n = 681) were men and 31.35% ( n = 311) were women at the time of this study; I invited the women collegiate choral conductors to serve as study participants. Ninety-six respondents completed an online survey, resulting in a response rate of 30.86%. I collected data through a researcher-designed survey. First, I asked respondents to provide demographic information and respond to Likert-type and open-ended prompts related to three domains: gaining entry into the profession, navigating the profession, and issues surrounding gender. I analyzed data through descriptive statistics and qualitative methods of assigning codes, combining codes into themes, and displaying the data. I addressed general discrepancies in the self-reported attitudes of respondents. Although women reported an overall attitude of satisfaction as choral conductors in their Likert-type responses, many respondents detailed several instances of gender discrimination and other challenges in their open-ended responses. Implications for the music profession, including specific strategies to help empower women in collegiate choral conducting settings, are discussed.

Discussion and documentation of future care: a before-and-after study examining the impact of an alternative approach to recording treatment decisions on advance care planning in an acute hospital

2017 ◽  
Vol 10 (2) ◽  
pp. e12-e12 ◽  
Author(s):  
Alexandra C Malyon ◽  
Julia R Forman ◽  
Jonathan P Fuld ◽  
Zoë Fritz
Keyword(s):  
End Of Life ◽  
Advance Care Planning ◽  
Treatment Decisions ◽  
Care Planning ◽  
New Approach ◽  
Significance Level ◽  
Oncology Ward ◽  
Future Care ◽  
Advance Care ◽  
The Impact

ObjectiveTo determine whether discussion and documentation of decisions about future care was improved following the introduction of a new approach to recording treatment decisions: the Universal Form of Treatment Options (UFTO).MethodsRetrospective review of the medical records of patients who died within 90 days of admission to oncology or respiratory medicine wards over two 3-month periods, preimplementation and postimplementation of the UFTO. A sample size of 70 per group was required to provide 80% power to observe a change from 15% to 35% in discussion or documentation of advance care planning (ACP), using a two-sided test at the 5% significance level.ResultsOn the oncology ward, introduction of the UFTO was associated with a statistically significant increase in cardiopulmonary resuscitation decisions documented for patients (pre-UFTO 52% to post-UFTO 77%, p=0.01) and an increase in discussions regarding ACP (pre-UFTO 27%, post-UFTO 49%, p=0.03). There were no demonstrable changes in practice on the respiratory ward. Only one patient came into hospital with a formal ACP document.ConclusionsDespite patients’ proximity to the end-of-life, there was limited documentation of ACP and almost no evidence of formalised ACP. The introduction of the UFTO was associated with a change in practice on the oncology ward but this was not observed for respiratory patients. A new approach to recording treatment decisions may contribute to improving discussion and documentation about future care but further work is needed to ensure that all patients’ preferences for treatment and care at the end-of-life are known.

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