Concept analysis in Nursing (QUALITY)
What is a concept in nursing? The art and science of modern nursing encompasses fundamental nursing concepts that include health, illness, stress and health promotion. They provide preventive, primary, acute and chronic care for sick and injured patients with health information, restorative care, medication administration and emergency care.
Concept analysis in Nursing (QUALITY)
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Running head: EMPATHY CONCEPT 1
A Concept Analysis of Empathy
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EMPATHY CONCEPT 2
Abstract
Empathy is an essential concept in nursing, and it underlies the practice of healthcare provision.
The concept of empathy can be a valuable tool for a nurse practitioner. Emotional connection on
a human level can considerably enhance the patient-caregiver interaction. This can be achieved
via the nurses ability to share the patients mood, show compassion, and desire to assist by
providing the best care possible. Overall, empathy can improve the quality of care, most
importantly in terms of mental health. This paper reviews the attributes, synonyms, and concepts
related to empathy as well as constructing models, similar, and opposite cases and providing an
overview of the available empirical methods for measuring and promoting empathy. The aim of
the analysis is to determine the definitional range and practical value, both objective and
perceived, of empathy in the healthcare setting. It is especially crucial that healthcare
practitioners, such as nurses, understand and, more importantly, possess the ability to empathize.
Keywords: Empathy, Model Case, Similar Case, Opposite Case, Preoperative Nurse.
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A Concept Analysis of Empathy
Purpose of the Analysis
The term empathy was coined more than a century ago by the British psychologist
Edward Bradford Titchener. Despite a long history of study and scholarly debate, empathy still
lacks a single universally agreed definition (Cuff, Brown, Taylor, & Howat, 2016, p. 144). The
variety of its definitions contributes to misunderstandings and misconceptions regarding this
term, as well as its being used interchangeably with synonymous terms. The purpose of this
concept analysis of empathy is to determine the definitional range and practical value, both
objective and perceived, of empathy in the healthcare setting. It is crucial that healthcare
practitioners, such as nurses, understand and, more importantly, possess the ability to empathize.
Uses of the Concept
In general terms, empathy is defined as the human ability to recognize and understand the
feelings of other individuals and to respond appropriately. However, its original definition was
different. Titchener defined it as a process of humanizing objects, of reading or feeling
ourselves into them (as cited in Cuff et al., 2016, p. 147). With time, this concept evolved.
Empathy received its dictionary definition as a term initially applied to psychology and
aesthetics. According to Oxford University Press, empathy is The power of identifying oneself
mentally with a person or object of contemplation (Butterfield, 2015, p. 211). Rogers classified
empathy as entering the private perceptual world of the other and becoming thoroughly at home
in it (as cited in Cuff et al., 2016, p. 148). Arguably, the best field-specific healthcare definition
of empathy is as follows: A cognitive and emotional understanding of anothers experience,
resulting in an emotional response that is congruent with a view that others are worthy of
compassion and respect and have intrinsic worth (Barnett & Mann as cited in Cuff et al., 2016,
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p. 146). Briefly, the modern interpretation of empathy is the ability to be in someone elses
shoes.
Attributes of the Concept
The three main attributes associated with the concept of empathy are understanding, relationship,
and communication. The practitioner-patient relationship is rooted in communication. Being able
to communicate openly with the patient is a crucial component. Aside from the verbal part,
communication presupposes respecting patients emotions and showing understanding via
adequate body language. Hence, empathy is attributed to both verbal and nonverbal
communication skills (Rohani, Kesbakhi, & Mohtashami, 2018, p. 1090). Effective
communication together with a dynamic relationship should also involve the distribution of
essential information, such as specialized knowledge of the patients medical and mental
condition. This helps to form a therapeutic bond between the caregiver and care recipient.
Understanding the patients experience and its attendant implications is the principal feature of
empathy and empathetic engagement (Foley & Davis, 2017, p. 72). An empathetic relationship
can enhance healthcare efficiency for patients in two ways. Firstly, it can allow a caregiver to
acknowledge the patients concerns, retrieve valuable information, establish a more accurate
diagnosis, and meet the overall needs of the patient (better outcomes of care). Secondly, an
empathetic relationship gives the patient a sense of being valued, listened to, and understood
(better patient outcomes) (Rohani et al., 2018, p. 1090). Understanding, communication, and
relationship are mutually conditioning attributes.
Empathy is often confused and used interchangeably with the related concepts of
sympathy and compassion. In healthcare literature, sympathy is defined as an emotional reaction
of pity towards another individual due to an unfavorable, discomforting, or hurtful situation in
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which they find themselves, especially towards those whose suffering is considered unfair,
undeserved, or excessive. In comparison, compassion implies mentally sharing suffering and can
be defined as acknowledgment of another individuals suffering and pain complemented by a
desire to help relieve them. One definition of compassion is a virtuous response that seeks to
address the suffering and needs of a person through relational understanding and action
(Sinclair et al., 2016, p. 438). Another definition suggests that compassion is sympathy plus pity
(Cuff et al., 2016, p. 145). Hence, sympathy and compassion are conceptually close but not
completely interchangeable. Simply put, An initial gloss on the distinction would be that while
empathy is feeling with another, sympathy is feeling for them (Smith, 2017, p. 716). Arguably,
empathy is an umbrella term combining and merging the features of sympathy and compassion.
A Model Case
The following model case provides a clear example of empathy. A preoperative nurse
enters a patient room to obtain consent and start preparing the patient for surgery. The nurse sees
the patient crying and asks, What is wrong? How can I help? The patient states that he is very
nervous about the surgery because he has never had surgery before, and he does not know why it
is necessary. Empathy permits the nurse to remember being faced with an unknown situation and
to recall feelings of uncertainty and fear. The preoperative nurse empathizes with the patient
even though the nurse has not experienced this type of surgery. Empathy allows the preoperative
nurse to understand why a patient would be nervous, and the nurse has the prerequisite
knowledge to understand the reason for the surgery. The nurse responds by consoling the patient
and stating, I understand why you would be nervous. It is normal to feel nervous and anxious
when dealing with a new situation. The preoperative nurse then explains the procedure and the
reason why the patient must undergo surgery. The preoperative nurse has demonstrated empathy
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through communication with the patient, acknowledging and understanding the patients
emotions, and understanding his experience.
A Similar Case
A similar case that clearly illustrates empathy and its role in the patient-practitioner
relationship is a patient diagnosed with late-stage cancer who was previously unaware of his
condition. The chances of conquering the disease are low, but remission is possible. The patient
hears the news from a doctor and, naturally, sees the most pessimistic scenario as the only
possible one. A nurse feels empathy towards the patient. Even though the nurse has not
personally experienced this disease, she tries to put herself in the patients shoes and imagine
how he feels. This empathic act helps the nurse to find words of encouragement that sound
sincere, letting the patient know he is cared for, understood, and supported. Since treatment
depends mainly on the psychological state and determination of the patient, the patient must be
optimistic and ready to endure the necessary procedures. Even though a positive result is not
guaranteed, the focus is now on the patient.
An Opposite Case
A preoperative nurse enters a patient room to obtain consent and start preparing the
patient for surgery. The nurse sees the patient crying and asks, What is wrong? The patient
states that he is very nervous about the surgery because he has never had surgery before, and he
does not know why the surgery is needed. The preoperative nurse responds to the patient, I can
imagine how anxious you must be, but the surgeon should be here soon, and you should ask the
surgeon that question. I am not supposed to explain that to you. The nurse then leaves the
patients room. In such a case, a sympathetic nurse would feel and, perhaps, express pity towards
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the patient, but the components of being in his shoes, associating with him, and acting to reassure
the patient are all absent.
Antecedents and Consequences
The significant antecedents of empathy are the intention to help and awareness of the
sufferers state and needs. Here, the intention to help means readiness to be open to someones
suffering. This is a need to serve people in distress or pain as an intrinsic, consistent, and
unconditional quality or feeling existing in a potential care provider. Everyone who becomes a
healthcare practitioner should be motivated by the personal intention to help people. Awareness
is the ability to monitor the patients condition and know their habits to determine when they
need help, assistance, or emotional support (Foley & Davis, 2017, p. 72). Awareness is closely
related to attention, but it also includes a component of personal involvement with the patient in
terms of intuitively feeling and not only medically determining their state.
A far-reaching, long-term positive consequence of empathy is patient-centered quality
healthcare, where the attitudes of the care practitioner translate into patient satisfaction with the
care provided (Foley & Davis, 2017, p. 73). It is especially important that the patient feels
satisfied. Mental well-being is as important as physical well-being as a component of health. The
nurses desire to help results in quality care and an increase in the patients mental satisfaction,
coupled with a positive physiological reaction to adequate, targeted, thoughtful care.
Empirical Methods for Measuring Empathy
Empathy is a necessary constituent in the new patient-centered care delivery. The
importance and positive effects of empathy as a nursing tool are best evidenced by research on
the role of empathy in severe, fatal, or potentially incurable conditions, such as cancer.
Researchers generally agree that empathy is an essential communication skill in healthcare,
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especially in such settings (Alkan, 2017; Rohani et al., 2018). In the context of oncology-related
care, empathy is especially needed. The nurses mastery of empathy results in more effective
patient-centered consultations as a part of intervention programs (Rohani et al., 2018, p. 1089).
These and other studies suggest that nurses need to be capable of empathy, since this facilitates
the treatment process in healthcare practices in general and particularly in cases with seriously ill
patients.
Recent studies investigating empathy as an integral part of the healthcare framework have
identified a trend of erosion of empathy in healthcare education and clinical practice (Sinclair et
al., 2016, p. 438). This is disturbing, since empathy can be a valuable tool for nurses, without
which modern healthcare is unimaginable. This finding establishes two requirements: adequate
measurement strategies and strategies to promote empathy. The available methods for measuring
empathy levels include 1) self-report measures through written questionnaires; 2) behavioral
measures (tests aimed at evaluating experimental stimuli and performance), and 3)
neuroscientific measures with brain imaging tests (Neumann, Chan, Boyle, Wang, & Westbury,
2015, p. 259). Strategies for promoting empathy and ensuring that this component is present in
the healthcare framework include, but are not limited to, incorporating empathy parameters in
job interviews; empathy education and training within healthcare organizations via courses and
workshops; talking about empathy and automating its use by including it in all communications
within the setting, such as emails, phone conversations, and educational modules; an organized
advisory board of patients and caregivers; and surveying patients to receive feedback on care
provided and improve care based on data retrieved (Nelson, 2017). These strategies, selected and
combined in optimal ways, can help build and promote a culture of empathy.
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Conclusion
It is vitally important that healthcare practitioners, such as nurses, understand and, more
importantly, possess the ability to empathize. The concept of empathy, which has multiple
definitions, is a complex interpersonal construct revolving around awareness and uniting the
features of compassion and sympathy. Empathy lies at the core of modern healthcare together
with patient-practitioner relationships. The ability to empathize is a nurse practitioners tool in
enhancing care provision and patient satisfaction. Some researchers have demonstrated that
additional research is needed to determine the levels of nurse understanding, inherent empathy,
and training needed to foster a culture of empathy among healthcare practitioners.
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References
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