One of the most important skills of providers in the healthcare field is effective communication. Understanding of the patients concerns, needs, and questions are essential for the provider in order to administer quality healthcare services. Listening to patients tell their health story helps the provider get an inside view of how the patient understands their problem and patients perceive the provider is truly concerned about their wellbeing.
Effective communication will also lead the way to improved patients compliance to treatment, satisfaction of services and understanding of their problem. Research by (Norfolk, Birdie & Walsh, 2007) argues that, “The quality of doctor-patient communication remains central to the effectiveness of the medical consultation”. According to Gibson (1994) “patients are highly sensitive to the quality of their doctor’s communication and, in fact, consider doctors who communicate effectively to be more competent than those who do not”.
Incorporating the use of empathy as a communication technique to enhance the client-clinician relationship and build rapport is a valuable tool for healthcare providers to utilize. “The concept of empathy is relevant to the clinical situation because patients are people in need of help “(Spiro, Curnen, Peschel, St. James 1993 p. 82). Empathy. What does the word mean? Ciaramicoli and Ketcham (2000) define empathy as “the capacity to understand and respond to the unique experiences of another”.
Webster’s dictionary offers this definition, “the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another of either the past or present without having the feelings, thoughts, and experience fully communicated in an objectively explicit manner. The capacity of the provider to understand and respond to the patients self expression of their issue rests on the providers desire to empty themselves and become sensitive to the feelings and thoughts and then verbally respond this comprehension back to the patient.
In the work of Spiro et al. (1993 p. 81) empathy is further described as being pertinent to the clinical profession, in that the aim of healthcare providers is to assist those who are hurting and coping with a health problem and empathy communicates the message “I care and want to understand”. Coulehan et al. (2001) offer a clinical definition of empathy stating, “Empathy can be visualized as a positive feedback loop, or a neurologic track with afferent and efferent components”. The patient’s use of verbal and non verbal communications leads the physician to a more exact physical location of what is ailing the patient.
On the other side, the efferent component is made up of the provider’s responses that lead to gaining more information from the client. To this end, empathy helps the clinician know the patient beyond the clinical data. It fosters an understanding of how the problem directly affects the patient’s life and their hopes of continuity of that life. In this sense, empathy as a communication tool used in the healthcare setting is beneficial to cultivating the patient provider relationship.
Practioners who practice using empathic communication with their patients are increasing their opportunity to build trust into the patient-provider relationship. Trust is important in that the patient is expecting the goodwill of the healthcare provider to lead them down a path of health recovery and the provider, being seen as an expert, also has a level of expected trust from the patient. Servellen (2009 p. 12) states, “Mutual trust is essential to quality care outcomes, particularly to adherence and adaptation of changes required when one is ill or at risk for developing disease or illness.
When providers acknowledge the emotional content of dialogue being conveyed to them by the patient, it “Legitimizes [the] patients’ illness and suffering and contributes to feelings of connection with others” (Servellen, 2009 p. 87). Empathy helps the patient see past the white coat and sterile environment to a human being who experiences joy, sadness and pain just as they do. This sense of “connectedness” makes room for trust to form as it validates the client’s unique emotional experience of their problem.
A study by(Epstein et al. 2007) that looked at how physicians respond to patient’s worries revealed, “When physicians offer acknowledgement, empathy, encouragement, praise, and active help patients are more likely to feel that their physicians are trustworthy and supportive, and are more likely to report improved satisfaction with care, adherence, and chronic disease outcomes. Trust will benefit the provider in that the patient will reveal more pertinent detailed information surrounding their situation and how they are processing it emotionally (Servellen, 2009 p. 95).
Responses from the caregiver that send messages of intellectual understanding help form trust in the patient by letting the patient know the caregiver is willing to be guided by the patient in gaining a more accurate understanding of their thoughts and feelings which adds to the therapeutic value of the encounter. Facing health conditions that require medical treatment can create feelings of alienation in some people. The alienation may stem from the patient feeling denounced due to the condition causing their outward appearance to appear different from others ( e. . , using a portable oxygen tank, eczema ) or it can be a form of personal punishment for believing that they did not act responsibly with the care of their health. (e. g. , contracting herpes, unwanted pregnancy) Servellen (2009 p. 96).
Healthcare providers are able to dislodge the feelings of alienation with empathic responses that convey acceptance which becomes therapeutically valuable to the patient because it helps the patient to, “seek advice, continue treatment, and endure, for the purpose of getting better” (Servellen, 2009 p. 6). When dealing with all patients-including those suffering from illnesses that have been or that remain subject to societal prejudices-members of the healthcare profession must remember that empathy will be the bridge that helps the patient cross over into a place of personal acceptance of their condition and increase their continued treatment. Utilizing active listening skills within the context of empathy will be of great help to enhance the patient-provider communication interactions.
It is clear that when healthcare professionals use empathy as a communication technique it will build trust, encourage an exchange of information and create a safe environment conducive to problem solving which are beneficial to both the provider and patient. In order to manifest the positives the provider must participate in the process by putting to use their active listening skills. To actively listen empathically the provider will use a combination of verbal and non verbal responses to let the client know they are engaged in the conversation and are really striving to understand.
Servellen (2009 p. 92) puts it this way, “With active listening, providers take in data using all communication channels simultaneously-visual, auditory, and kinesthetic-to fully perceive the patient’s needs and concerns. ” Head nodding, facial expressions matching the speaker, open relaxed body expression and eye contact are all forms of non-verbal active listening. Each one sends a signal to the speaker that the listener is engaged which encourages the speaker to continue.
Verbal cues of active listening are asking both open and closed questions and reflecting content of the patient’s statement ( e. . “So you were fine until this morning when you woke up with pain in your belly, and it’s been growing more severe ever since”. example from work by Coulehan et al. 2001). This type of listening encourages the patient to openly express their feelings and concerns while the provider takes the newly found information to help further the dialogue to a place where the patient is helped emotionally and the provider [is lead] “To a clearer, more accurate “fix” on the patient’s perspective and feelings”(Coulehan, 2001).
To continue clarifying what empathy is, looking at what empathy is not will help this process. Although Empathy is putting oneself in anothers shoes and making a mental and emotional connection with the feeling being expressed, it is not showing sadness or pity for the patient as a result of the emotional relatedness. A response of sadness or show of mercy would be defined as sympathy. Servellen (2009 p. 89) states, “People who sympathize are unable to separate their own feelings from those of the other”. Spiro et al. 1993) offer this definition of sympathy, “Sympathy is the fact or power of sharing the feelings of another, especially in sorrow or trouble; fellow feeling, compassion or commiseration. ” Sympathy in the patient-provider relationship does not really serve the patient’s needs of expressing feelings and concerns which are shared in the context of helping the provider understand their condition both physically and emotionally. Empathy is the vehicle and empathic responses are the passengers that carry reflective messages of understanding and validation back to the patient. Sympathy does not allow for this to happen.
Sympathy tends to put distance between the patient and provider whereas empathy is the glue binding the two together (Servellen, 2009). Empathy and sympathy are best defined by Arthurs Ciaramicoli and Ketcham (2000) Empathic listening is always centered on the other person, and its goal is to Make the other feel uniquely understood. This means moving away from generalities to specifics, from dull to sharp, common to rare, old to new, Ordinary to extraordinary, familiar to strange. Sympathy goes back to the past, expressing a general feeling of understanding based on common experiences.
Empathy always focuses on the present, on what is happening now, at this very moment. When defined this way, it is very clear that empathy is a much more appropriate communication resource in the healthcare setting. The patient remains the center of the encounter as the provider elicits responses that will further their investigation of the condition while creating a trusting relationship. Here is an example of a patient talking with their provider about a health condition with the provider using empathy in their responses.