Providing support to patients in emotional encounters: A new perspective on missed empathic opportunities
ABSTRACT Studies have repeatedly found that providers miss 70-90% of opportunities to express empathy. Our study sought to characterize provider responses to patients' emotions, with the overall goal of better understanding reasons for lack of empathic response.
We analyzed 47 visits between patients and their providers. We defined empathic opportunities as instances where patients expressed a strong negative emotion. We then developed thematic categories to describe provider response.
We found a total of 29 empathic opportunities within 21 visits. Provider responses were categorized as ignore, dismiss, elicit information, problem-solve, or empathize. An empathic statement occurred at some point in the response sequence in 13/29 opportunities (45%). When problem-solving was the initial response, empathic statements rarely occurred in subsequent dialogue. Among the 16 instances with no empathic statements, providers engaged in problem-solving in 8 (50%).
Similar to other studies, we found providers missed most opportunities to respond empathically to patient emotion. Yet contrary to common understanding, providers often addressed the problem underlying the emotion, especially when the problem involved logistical or biomedical issues, as opposed to grief.
With enhanced awareness, providers may better recognize situations where they can offer empathy in addition to problem-solving.
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ABSTRACT: Objectives To investigate general practitioners’ (GPs’) and psychiatrists’ responses to emotional disclosures in consultations with patients with depression. Methods Thirteen patient consultations with GPs and 17 with psychiatrists were video-recorded and then analysed using conversation analysis (CA). Results Psychiatrists responded to patients’ emotional disclosures by attempting to clarify symptoms, by rational argumentation, or by offering an interpretation of the emotions from their own perspectives. GPs responded by claiming to understand the emotions or by formulating the patients’ statements, but without further exploring the emotions. Conclusion GPs displayed a greater engagement with patients’ emotions than psychiatrists. Their approach could be described as empathic, corresponding to a mentalizing stance. The different approaches taken by psychiatrists could represent conceptual differences and might affect fruitful interdisciplinary work. Psychiatric nurses’ responses to patients’ emotions must also be studied to complete our knowledge from psychiatry. Practice implications Experiences from training in mentalization could be used to develop physicians’ empathic or mentalizing approach. As most patients with depression are treated in primary care, developing GPs’ mentalizing capacity instead of offering didactic training could have a substantial effect in the population.Patient Education and Counseling 04/2014; 95(1). DOI:10.1016/j.pec.2013.12.018 · 2.60 Impact Factor
- Patient Education and Counseling 07/2012; 88(3):357-8. DOI:10.1016/j.pec.2012.06.023 · 2.60 Impact Factor
- Patient Education and Counseling 01/2013; 90(1):1-3. DOI:10.1016/j.pec.2012.11.018 · 2.60 Impact Factor