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Improving empathy in healthcare consultations – a secondary analysis of interventions

Improving empathy in healthcare consultations – a secondary analysis of interventions
Improving empathy in healthcare consultations – a secondary analysis of interventions
A recent systematic review of randomized trials suggested that empathic communication improves patient health outcomes. However, the methods for training healthcare practitioners (medical professionals; HCPs) in empathy and the empathic behaviours demonstrated within the trials were heterogeneous, making the evidence difficult to implement in routine clinical practice. In this secondary analysis of seven trials in the review, we aimed to identify 1. the methods used to train HCPs, 2. the empathy behaviours they were trained to perform and 3. Behaviour Change Techniques (BCTs) used to encourage the adoption of those behaviours. This detailed understanding of interventions is necessary to inform implementation in clinical practice. We conducted a content analysis of intervention descriptions, using an inductive approach to identify training methods and empathy behaviours and a deductive approach to describe the BCTs used. The most commonly used methods to train HCPs to enhance empathy were: face-to-face training (n=5), role-playing (n=3) and videos (self or model; n=3). Duration of training was varied, with both long and short training having high effect sizes. The most frequently targeted empathy behaviours were: providing explanations of treatment (n=5); providing non-specific empathic responses (e.g. expressing understanding), displaying a friendly manner and using non-verbal behaviours (e.g. nodding, leaning forward, n=4). The BCT most used to encourage HCPs to adopt empathy behaviours was “Instruction on how to perform behaviour” (e.g. a video demonstration, n=5), followed by “Credible Source” (e.g. delivered by a psychologist, n=4) and “Behavioural practice” (n=3 e.g. role-playing). We compared the effect sizes of studies but could not extrapolate meaningful conclusions due to high levels of variation in training methods, empathy skills and BCTs. Moreover, the methods used to train HCPs were often poorly described which limits study replication and clinical implementation. This analysis of empathy training can inform future research, intervention reporting standards and clinical practice.
Empathy, Communication, consultations
0884-8734
Smith, Kirsten
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Bishop, Felicity
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Dambha-Miller, Hajira
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Ratnapalan, Mohana
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Lyness, Emily
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Vennik, Jane
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Hughes, Stephanie
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Bostock, Jennifer
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Morrison, Leanne
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Mallen, Christian
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Yardley, Lucy
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Everitt, Hazel
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Little, Paul
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Howick, Jeremy
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Smith, Kirsten
9da65772-0efa-4267-87ff-563f9757b34e
Bishop, Felicity
1f5429c5-325f-4ac4-aae3-6ba85d079928
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Ratnapalan, Mohana
28361114-c167-4de3-a23c-b6cef4443377
Lyness, Emily
6d59d191-a210-4c77-b9eb-cb6b1d669042
Vennik, Jane
6ee78166-5a7a-433b-87fc-018771f20b19
Hughes, Stephanie
a6d39500-67ff-4d7a-a1dc-8e42f80945ff
Bostock, Jennifer
bdb3d9f2-9e5a-4d33-bb38-94bf6298db75
Morrison, Leanne
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Mallen, Christian
b6745975-69e1-42b6-b617-37f393237024
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Everitt, Hazel
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Little, Paul
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Howick, Jeremy
0d21085b-6b93-4a4e-8d87-1cc3a83f8768

Smith, Kirsten, Bishop, Felicity, Dambha-Miller, Hajira, Ratnapalan, Mohana, Lyness, Emily, Vennik, Jane, Hughes, Stephanie, Bostock, Jennifer, Morrison, Leanne, Mallen, Christian, Yardley, Lucy, Everitt, Hazel, Little, Paul and Howick, Jeremy (2020) Improving empathy in healthcare consultations – a secondary analysis of interventions. Journal of General Internal Medicine. (doi:10.1007/s11606-020-05994-w).

Record type: Article

Abstract

A recent systematic review of randomized trials suggested that empathic communication improves patient health outcomes. However, the methods for training healthcare practitioners (medical professionals; HCPs) in empathy and the empathic behaviours demonstrated within the trials were heterogeneous, making the evidence difficult to implement in routine clinical practice. In this secondary analysis of seven trials in the review, we aimed to identify 1. the methods used to train HCPs, 2. the empathy behaviours they were trained to perform and 3. Behaviour Change Techniques (BCTs) used to encourage the adoption of those behaviours. This detailed understanding of interventions is necessary to inform implementation in clinical practice. We conducted a content analysis of intervention descriptions, using an inductive approach to identify training methods and empathy behaviours and a deductive approach to describe the BCTs used. The most commonly used methods to train HCPs to enhance empathy were: face-to-face training (n=5), role-playing (n=3) and videos (self or model; n=3). Duration of training was varied, with both long and short training having high effect sizes. The most frequently targeted empathy behaviours were: providing explanations of treatment (n=5); providing non-specific empathic responses (e.g. expressing understanding), displaying a friendly manner and using non-verbal behaviours (e.g. nodding, leaning forward, n=4). The BCT most used to encourage HCPs to adopt empathy behaviours was “Instruction on how to perform behaviour” (e.g. a video demonstration, n=5), followed by “Credible Source” (e.g. delivered by a psychologist, n=4) and “Behavioural practice” (n=3 e.g. role-playing). We compared the effect sizes of studies but could not extrapolate meaningful conclusions due to high levels of variation in training methods, empathy skills and BCTs. Moreover, the methods used to train HCPs were often poorly described which limits study replication and clinical implementation. This analysis of empathy training can inform future research, intervention reporting standards and clinical practice.

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More information

Accepted/In Press date: 12 June 2020
e-pub ahead of print date: 14 July 2020
Keywords: Empathy, Communication, consultations

Identifiers

Local EPrints ID: 441635
URI: http://eprints.soton.ac.uk/id/eprint/441635
ISSN: 0884-8734
PURE UUID: 185d2d99-f001-46e5-ba2e-3015d02879b8
ORCID for Felicity Bishop: ORCID iD orcid.org/0000-0002-8737-6662
ORCID for Hajira Dambha-Miller: ORCID iD orcid.org/0000-0003-0175-443X
ORCID for Mohana Ratnapalan: ORCID iD orcid.org/0000-0002-6505-6107
ORCID for Jane Vennik: ORCID iD orcid.org/0000-0003-4602-9805
ORCID for Leanne Morrison: ORCID iD orcid.org/0000-0002-9961-551X
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X
ORCID for Hazel Everitt: ORCID iD orcid.org/0000-0001-7362-8403

Catalogue record

Date deposited: 23 Jun 2020 16:30
Last modified: 29 Jul 2020 01:52

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Contributors

Author: Kirsten Smith
Author: Felicity Bishop ORCID iD
Author: Emily Lyness
Author: Jane Vennik ORCID iD
Author: Jennifer Bostock
Author: Leanne Morrison ORCID iD
Author: Christian Mallen
Author: Lucy Yardley ORCID iD
Author: Hazel Everitt ORCID iD
Author: Paul Little
Author: Jeremy Howick

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