Empathy, personality traits, and emotional management in 2nd and 4th-year dentistry students: a single-center study

Background Patients fearing dental interventions are at risk of delaying or skipping much-needed treatments. Empathic communication could lead to a higher rate of compliance from patients within this group. Empathy, the big five personality traits, and emotion management abilities are all known to influence the quality of communication between dentists and patients. This study was conducted to analyze whether there is a correlation between these factors in dentistry students. Methods Dentistry students in their 2nd and 4th year of study were asked to complete questionnaires assessing empathy, emotion management, and personality traits. Out of a total of 148 eligible participants, 53 students (34%) volunteered to participate. For empathy, the Jefferson Scale of Physician Empathy (students’ version; JSPE-S) and the Interpersonal Reactivity Index (IRI) were used. Personality traits were assessed using the Short Big Five Inventory (BFI-s), and the Situational Test of Emotional Management (STEM) to measure emotional management ability. Results Higher scores for emotion management were significantly correlated with the female gender (p ≤ 0.005) and with higher scores in openness (p ≤ 0.05). Students with higher scores in openness also achieved higher scores on the IRI subscales: Perspective taking (p ≤ 0.05), Fantasy (p ≤ 0.01), Empathic concern (p ≤ 0.05), and Personal distress (p ≤ 0.05). For JSPE-S, no correlation with emotion management and personality traits was found. Conclusion Empathy and emotion management might not be significantly related in dentistry students. Regarding personality traits, students who scored higher on openness also indicated higher abilities in emotion management. These findings should be taken into consideration when planning communication courses for dentistry students, as it might be possible to independently train empathy and emotion management as part of emotional intelligence.

Is Sociodemographic Status Associated with Empathic Communication and Decision Quality in Diabetes Care?

Objective To assess the relationship between empathic communication, shared decision-making, and patient sociodemographic factors of income, education, and ethnicity in patients with diabetes. Research Design and Methods This was a cross-sectional study from five primary care practices in the Greater Toronto Area, Ontario, Canada, participating in a randomized controlled trial of a diabetes goal setting and shared decision-making plan. Participants included 30 patients with diabetes and 23 clinicians (physicians, nurses, dietitians, and pharmacists), with a sample size of 48 clinical encounters. Clinical encounter audiotapes were coded using the Empathic Communication Coding System (ECCS) and Decision Support Analysis Tool (DSAT-10). Results The most frequent empathic responses among encounters were “acknowledgement with pursuit” (28.9%) and “confirmation” (30.0%). The most frequently assessed DSAT components were “stage” (86%) and knowledge of options (82.0%). ECCS varied by education (p=0.030) and ethnicity (p=0.03), but not income. Patients with only a college degree received more empathic communication than patients with bachelor’s degrees or more, and South Asian patients received less empathic communication than Asian patients. DSAT varied with ethnicity (p=0.07) but not education or income. White patients experienced more shared decision-making than those in the “other” category. Conclusions We identified a new relationship between ECCS, education and ethnicity, as well as DSAT and ethnicity. Limitations include sample size, heterogeneity of encounters, and predominant white ethnicity. These associations may be evidence of systemic biases in healthcare, with hidden roots in medical education.

Conflict capability e mediazione: un approccio preventivo alla radicalizzazione e ai comportamenti antisociali in contesti familiari e microsociali

Understanding conflict dynamics among individuals and within society, and devising appropriate intervention strategies offer a relevant perspective for the prevention of radicalization processes. The article outlines an overview of some concrete instruments of analysis and intervention in microsocial conflicts, with special reference to family. We choose as a starting point the notion of “conflict capability”, the ability of human beings of appropriately handling conflict.The model presented here is based on a systemic understanding of social conflict and a transformative approach to foster human capabilities, and specifically women, of dealing with conflict. Friedrich Glasl’s “escalation model” offers a solid foundation in order to define conflict dynamics which is crucial for devising appropriate, context-specific interventions. For the family and microsocial context, we propose as intervention tools empathic communication and “problem solving without losers” proposed by Thomas Gordon, as well as a “systemic transformative” approach to mediation. The article also reflects on the importance of conflict capability in order to reinforce the practice of democracy, building on the contribution of authors such as Chantal Mouffe and Axel Honneth.

The Empathic Communication Analytical Framework (ECAF): A multimodal perspective on emotional communication in interpreter-mediated consultations

Empathic communication (EC) in healthcare occurs when patients express empathic opportunities, such as emotions, to which doctors respond empathically. This interactional process during which participants try to achieve specific communicative goals (e.g., seeking and displaying empathy) serves as a context in which doctors and patients perform verbal and nonverbal actions and collaboratively co-construct meaning. This applies to interpreter-mediated consultations (IMCs) too, where interpreters perform additional actions of a similar kind. However, there is a dearth of research on the ways in which participants perform these actions in the context of EC, and how these actions in turn help (re)shape the context of EC in IMCs (Theys et al., 2020). To date, any tools for studying EC investigate participants’ actions in isolation, without studying them in the context of EC or in relation to the participants’ awareness of their own and others’ ongoing interactions. In this article, we present the Empathic Communication Analytical Framework (ECAF). The tool draws on valid, complementary analytical tools that allow for a fine-grained, three-level multimodal analysis of interactions. The first level of analysis allows for instances of EC in spoken language IMCs to be identified and for participants’ verbal actions in the context of EC to be studied. The second level allows analysts to investigate participants’ verbal and nonverbal actions in the previously identified context of EC. The third level of analysis links the participants’ concurrent verbal and nonverbal (inter)actions to their levels of attention and awareness and shows how participants’ actions are shaped and in turn help to reshape the context of EC in IMCs. In this article, we present the various levels of the ECAF framework, discuss its application to real-life data, and adopt a critical stance towards its affordances and limitations by looking into one excerpt of EC in IMCs. It is shown that the three distinct yet interconnected levels of analysis in the ECAF framework allow participants’ concurrent multimodal interactions in the context of EC to be studied.

Effects of One-day e-learning Education on Perinatal Psychological Support Among Midwives: a Randomised Controlled Study

Background: Although midwives are expected to play a key role for psychological support throughout perinatal periods, their educational chances are limited. Versatile teaching strategies such as e-learning may be promising in expanding education. The objective of our study was to clarify the effects of an e-learning educational programme on midwives’ empathic communication skills.Methods: From April 2019 to September 2019, a randomised controlled trial of a one-day e-learning educational programme on perinatal psychological issues (both perinatal mental health assessment and empathic communication) was conducted to improve empathic communication skills of midwives. Two types of measurements (paper-and-pencil multiple-choice test and video-viewing tests of simulated patient) were used to measure the competency of empathic communication skills.Results: Participants (N = 115) were randomly allocated to two groups (Intervention: n = 58, Control: n = 57). The intervention group was at a significantly higher level for both post-tests of empathic communication skills compared with the control group. Both intervention and control groups showed improvements in acquiring knowledge about perinatal mental health assessments.Conclusions: The results of our study show that a one-day e-learning programme helped improve the midwives' empathic communications skills. Therefore, an effective one-day e-learning educational programme of perinatal mental health will expand opportunity to learn about empathic communication skills for midwives.Trial registrations: UMIN000036052

The dignity of burn patients: a qualitative descriptive study of nurses, family caregivers, and patients

Background As an ethical principle, showing respect for human dignity is a professional duty of all nurses. The aggressive nature of severe burn injuries makes it hard to respect the existential values and dignity of burn patients. However, only a few studies have been conducted on the preservation of the dignity of burn patients. The purpose of this study is to identify and describe burn patients’ dignity as perceived by nurses, family caregivers, and burn patients. Methods The present study has a descriptive, qualitative research design. Nurses, family caregivers and patients in the biggest burns hospital in the south of Iran were selected via purposeful sampling from October 2017 to August 2018 (n = 25). Data were collected using semi-structured, in-depth, individual interviews. Thereafter, data analysis was performed through conventional content analysis. Results Three main themes were extracted from the information obtained in the interviews: empathic communication, showing respect, and providing comprehensive support. Conclusion The care provided to burn patients should be combined with effective communication, spending time with them, and attending to their repetitive requests, so that they can freely express their feelings and concerns. In addition, the patients’ human values and beliefs should be respected and all aspects of their existence should be taken into account to preserve their dignity. Workshops designed based on the findings of the present study can help with improving the quality of burn nursing care.

Empathic communication in dignity therapy: Feasibility of measurement and descriptive findings

Objective Dignity therapy (DT) is a guided process conducted by a health professional for reviewing one's life to promote dignity through the illness process. Empathic communication has been shown to be important in clinical interactions but has yet to be examined in the DT interview session. The Empathic Communication Coding System (ECCS) is a validated, reliable coding system used in clinical interactions. The aims of this study were (1) to assess the feasibility of the ECCS in DT sessions and (2) to describe the process of empathic communication during DT sessions. Methods We conducted a secondary analysis of 25 transcripts of DT sessions with older cancer patients. These DT sessions were collected as part of larger randomized controlled trial. We revised the ECCS and then coded the transcripts using the new ECCS-DT. Two coders achieved inter-rater reliability (κ = 0.84) on 20% of the transcripts and then independently coded the remaining transcripts. Results Participants were individuals with cancer between the ages of 55 and 75. We developed the ECCS-DT with four empathic response categories: acknowledgment, reflection, validation, and shared experience. We found that of the 235 idea units, 198 had at least one of the four empathic responses present. Of the total 25 DT sessions, 17 had at least one empathic response present in all idea units. Significance of results This feasibility study is an essential first step in our larger program of research to understand how empathic communication may play a role in DT outcomes. We aim to replicate findings in a larger sample and also investigate the linkage empathic communication may have in the DT session to positive patient outcomes. These findings, in turn, may lead to further refinement of training for dignity therapists, development of research into empathy as a mediator of outcomes, and generation of new interventions.

Scaffolding Autonomy

Adolescents and adults with intellectual and/or developmental disabilities who have partial capacities to exercise autonomy require respect as well as protection throughout medical decision making. Using an ethical lens that prioritizes respect for persons based on a conception of relational autonomy over beneficence, this chapter explores two contrasting yet related cases where developmental issues may complicate shared decision making. Young adolescents and some adults with intellectual or developmental disabilities may have limited capacities to form and express their values and yet may also need sensitive empathic communication and cognitive scaffolding to make decisions that enact their fundamental values. This chapter examines the conscious and unconscious emotional aspects of conveying diagnoses, prognoses, and other aspects of shared decision making. Empathic scaffolding looks different for each patient in their specific care and familial context but tracks how the patient’s sense of futurity and agency are affected by the clinician’s communication—is the communication accessible, empowering, and offering options that the patient can work with? Empathic health care communication also requires that the clinicians strive for awareness of how their own unconscious psychological processes might be conveying emotional messages to vulnerable patients, including, for example, their suppressed grief after witnessing pediatric patients go through failed bone marrow transplants. Shared decision making thus requires much more than a procedural commitment to respecting individual autonomy but rather calls for addressing the inescapable emotional, relational basis of clinician-patient decision making at vulnerable moments for especially vulnerable patients.