Personal qualities or skills? A report of a study of nursing students' views of the characteristics of counsellors

The personal qualities associated with effective counselling have been discussed in the research and counselling literature. Counselling skills have been proposed as tools to be learned by student nurses. In this study of 162 students of nursing, respondents were asked to identify what they felt to be the important personal qualities of a counsellor. They were asked not to identify their own skills or qualifications. The findings were broadly in line with those of other studies in that students felt that qualities such as being non-judgemental, empathic and understanding were important. A notable finding was that 73% of respondents identified 'being a good listener' as a personal quality in contrast to the literature which usually describes listening as a skill. This paper describes the study, reports the findings, and offers a discussion of the question of the implications of identifying listening as a personal quality as well as--or instead of--a skill. The study has implications for the way in which counselling skills may be taught and how nurse educators might consider the qualities associated with counselling.     

本科护生共情能力的研究现状

共情被认为是一种可以习得的沟通技巧,主要包含认知和行为两方面,以用于将对患者的理解传达给患者。因此共情可以通过加强认知结构和行为表现的后天培训得以提高。本文综述了共情、共情能力的概念,共情在护理中的作用、应用以及大学生共情能力的测量工具,目的在于了解本科护生共情能力的研究现状,有针对地加强护生共情能力的培养。     

Concept analysis of perspective-taking: meeting informal caregiver needs for communication competence and accurate perception

AIM: This paper is a report of an analysis of perspective-taking as presented in the nursing and psychological literature between 1972 and 2004. BACKGROUND: Little is known about the caregiving processes that drive communication competence in patient and informal caregiver relationships. Evidence to date suggests that the empathic perspective-taking process plays a key role in promoting communication competence, perceptual accuracy and enhanced ability by caregivers to meet patients' needs arising in illness. Perspective-taking is a concept that has been explored extensively in health or social psychology, but not in nursing literature. METHOD: Guided by Morse's typology of attributes and rules of relation, the concept of perspective-taking is explored as it is presented in nursing and social psychology literature, and in accordance with Davis's empathy model. FINDINGS: Extant research and theory suggest that perspective-taking is an interpersonal empathic process involving a conscious effort in differentiating one's view from the view of another that can bring the caregivers' viewpoints in closer alignment with patients' viewpoints. Beginning evidence suggests that observers might achieve accurate perceptual accuracy about patients' illness experiences if they are prompted to imagine how patients perceive the situation and how they feel as a result. Research also needs to analyse the characteristics of the patient, informal caregiver and illness situation in order to comprehend more fully which caregiver dyads need assistance with perspective-taking to optimize their skill in providing sufficient patient care. CONCLUSION: The current emphasis for empirical research in caregiving is to uncover underlying caregiving processes that exist in pre-existing patient and informal caregiver relationships. Once further evidence is found to further corroborate the perspective-taking process and perceptual accuracy linkage and factors that moderate this linkage, then evidence-based interventions can be designed and tested to optimize empathic processes that minimize perceptual differences between patients and informal caregivers.     

Roses by other names? Empathy,sympathy, and compassion in mental health nursing

Empathy and related concepts such as sympathy and compassion are considered fundamental to mental health nurses’ work with consumers. However, there is often little consensus on the relationship between these interpersonal interaction factors and their similarities and differences. In this paper, these three concepts are discussed. Theoretical frameworks of empathy, sympathy, and compassion are presented with a social psychological model of empathy focused upon. From this, discussion is undertaken of how the mental health nursing process may be explained by such frameworks, as well as what unique aspects of the nursing relationship need to be considered. It is contended that precise definitions and understandings of empathy, sympathy, and compassion are vital, and the use of models allows researchers to consider where gaps are in current knowledge, and to identify what might be important to consider from a nurse education perspective.     

A review of empathy education in nursing

BRUNERO S, LAMONT S and COATES M. Nursing Inquiry 2010; 17 : 65–74
A review of empathy education in nursing
The ability for nurse educators to improve the empathy skill set of nurses has been the subject of several studies with varied outcomes. The aim of this paper is to review the evidence for empathy education programmes in nursing and make recommendations for future nurse education. A review of CINAHL, Medline, Psych Info and Google Scholar was undertaken using the keywords empathy, person centredness, patient centredness, client centredness, education and nursing. The studies included were required to have measured the effectiveness of empathy training in postgraduate and or undergraduate nurses. The included studies incorporated both qualitative and quantitative methods and were published in peer-reviewed journals. Studies were ranked for level of evidence according to The Joanna Briggs Institute criteria. Seventeen studies from the literature review were found that met the inclusion criteria. Of the 17 studies, 11 reported statistically significant improvements in empathy scores versus six studies that did not. Several variables may affect empathy education that need to be accounted in future studies such as; gender, cultural values and clinical speciality experience. Models of education that show most promise are those that use experiential styles of learning. The studies reviewed demonstrated that it is possible to increase nurses' empathic ability.     

Empathy: a review of the literature with suggestions for an alternative research strategy

Although empathy is regarded as a necessary component of good quality nursing care, defining and measuring empathy have both been fraught with problems. A historical overview helps to explain these difficulties, as nurses have tended to accept the views of psychotherapists uncritically, and have used scales developed for clients in counselling with people who are physically ill. Methodological difficulties combined with the results of studies demonstrating low levels of empathic ability in nurses have culminated in disenchantment with this topic. A framework is used to show why nurses cannot always demonstrate empathic awareness of every patient's need and an alternative approach for exploring the nature of empathy is suggested.     

Empathy: we know what we mean, but what do we teach?

This article resulted from a paper, presented by the author, at the Hildegard Peplau seminar on the interpersonal role of psychiatric nurses, given at the Highland College of Nursing and Midwifery, Inverness. It discusses empathy — the ability to see things from another person's point of view. That ability is held to be the core characteristic of a helping relationship, but a review of the literature reveals that there is little agreement about how empathy should be defined. Consequently, it is argued that there is a need for nurse teachers to define what they mean by empathy. Failure to do so may result in confusion about what is being taught. Furthermore, it is proposed that all teachers should be trained in experiential teaching methods, and that the effects of structured empathy training should be investigated within an experimental research design.     

Developing empathy in nursing students: a cohort longitudinal study

Aims and objectives. To determine whether a specific training course will enhance empathic skills in student nurses during a 3‐year degree course. The study considers levels of empathy in student nurses and assesses whether these can be increased. Background. Empathy is accepted as a critical component of supportive relationships. Many scholars have argued that empathy provides health professionals with the capacity to improve the health of patients, so it should ideally be taught to make health professionals more responsive to patient needs. Design. Cohort longitudinal study. Methods. Data were collected using the Italian version of the Balanced Emotional Empathy Scale (BEES). The study was designed to guarantee repeated measurements of levels of emotional empathy in the pre‐ and postintervention phases. This allowed us to evaluate the development and improvement of empathy and to measure the effects of extra training on the students’ empathy skills. Two groups took part in the study: the Intervention and the Control Groups. Students in the Intervention Group attended additional seminars and laboratories in small groups with tutors to learn and develop communicative and empathic abilities. Results. One hundred and three participants (76% women) completed the study. Data showed that the training course was effective, especially for women: BEES scores 31·60 at pre‐intervention phase and 42·91 at the end of the academic course. Results regarding men were less clear, and the study discusses these unexpected, anomalous findings. Conclusion. According to literature, men and women have different empathic traits, and we found that they show disparate empathic tendencies. More women than men took advantage of the training course. In any case, our data show that specific training courses are effective. Relevance to clinical practice. As our study shows, empathy is a skill that may be taught. So it would be advisable to introduce these into the traditional nursing curriculum.     

护士情绪智力和沟通满意度对共情影响的路径分析

目的 探讨护士情绪智力、沟通满意度对共情的影响路径和关系效应.方法 2019年9月—12月,采用一般资料问卷、Jefferson共情量表、 情绪智力量表及人际沟通满意度量表对河南省某三级甲等医院的1475名护士进行调查,采用AMOS 21.0软件建立模型并进行路径分析.结果 护士沟通满意度与共情呈正相关(r=0.519...     

Relationships between nurses’ empathy,self-compassion and dimensions of professional quality of life: A cross-sectional study

BackgroundJob stress and burnout are common among healthcare professionals, and nurses in particular. In addition to the heavy workload and lack of recourses, nurses are also confronted with emotionally intense situations associated with illness and suffering, which require empathic abilities. Although empathy is one of the core values in nursing, if not properly balanced it can also have detrimental consequences, such as compassion fatigue. Self-compassion, on the other hand, has been shown to be a protective factor for a wide range of well-being indicators and has been associated with compassion for others.ObjectivesThe main goal of this study was to explore how empathy and self-compassion related to professional quality of life (compassion satisfaction, compassion fatigue and burnout). In addition, we wanted to test whether self-compassion may be a protective factor for the impact of empathy on compassion fatigue.Methods and participantsUsing a cross-sectional design, 280 registered nurses from public hospitals in Portugal's north and center region were surveyed. Professional quality of life (Professional Quality of Life), empathy (Interpersonal Reactivity Index) and self-compassion (Self-compassion Scale) were measured using validated self-report measures.ResultsCorrelations and regression analyses showed that empathy and self-compassion predicted the three aspects of professional quality of life. Empathic concern was positively associated with compassion satisfaction as well as with compassion fatigue. Mediation models suggested that the negative components of self-compassion explain some of these effects, and self-kindness and common humanity were significant moderators. The same results were found for the association between personal distress and compassion fatigue.ConclusionsHigh levels of affective empathy may be a risk factor for compassion fatigue, whereas self-compassion might be protective. Teaching self-compassion and self-care skills may be an important feature in interventions that aim to reduce burnout and compassion fatigue.     

Caring for families with a family history of cancer: why concerns about genetic predisposition are missing from the palliative agenda

Care of the family is integral to palliative care, but little attention has been paid to the way nurses, or other healthcare professionals, are responding to the needs of families who are concerned about whether their family history of cancer is associated with an inherited genetic predisposition. This paper discusses how palliative care nurses perceive the care needs of patients with a family history of cancer. Data were collected through recorded, semi-structured interviews with 10 nurses who had worked in specialist palliative care. The findings show that there are cogent arguments and concerns about raising the issue of an inherited genetic predisposition at the end of life (especially when the patient is close to death and there is a lack of knowledge about genetics). Nevertheless, exemplar cases are used to illustrate the reasons why it is important that nurses working in specialist palliative care settings are aware of the needs of this patient group. The paper highlights that nurses not only need an appropriate knowledge base but also an insight of what can be achieved when supporting patients with a family history of cancer.     

Empathy: a crucial component of the helping relationship

The literature reviewed in this paper substantiates the widely held view that empathy is crucial to all forms of helping relationships. While most studies cited are more than a decade old, the relationship between empathy and helping remains unchallenged in the 1990s. Additionally, while there is confusion about whether empathy is a personality dimension, an experienced emotion, or an observable skill, it is shown that empathy involves an ability to communicate an understanding of a client's world. Finally, a definition of empathy considered to be relevant to clinical nursing is introduced, which includes the need to understand client's distress, and to provide supportive interpersonal communication. It is argued that there is a need to revisit the role of empathy in the context of current health care delivery.     

Meanings and aspects of quality of life for cancer patients: a descriptive exploratory qualitative study

Given the importance of quality of life (QoL) for cancer patients, it is important to work out what this concept means not only for cancer patients, and for the nurses who care for them, but also the aspects of which it is composed. Therefore, an interpretive research study was conducted to explore in-depth meanings and aspects of QoL as expressed by cancer nurses. Participants were selected from different inpatient and outpatient oncology services and a palliative setting in Adelaide, South Australia. Results showed that many aspects contribute to an individual's QoL. These include the physical, the psychological, the spiritual, and both environmental and social interactions. More importantly, participants stated that spirituality is multifaceted and that there may be aspects in life that may be taken for granted. The meaning of patients' QoL was viewed by nurses as a patient's overall happiness and satisfaction. Also, nurses identified that providing choices to patients made an important contribution to a patient's QoL. Therefore, this exploration into the in-depth meanings and aspects of QoL for cancer patients from nurses' perspectives identified that, in addition to the aspects related to QoL that have been identified previously in the literature, aspects related to spirituality would need to be extensively covered, and providing choices to patients would be important in patients' QoL in an Australian setting.     

The use of expressive methods for developing empathic skills

Empathy is one of the fundamental concepts in nursing, and it is an ability that can be learned. Various education models have been tested for improving empathic skills. Research has focused on using oral presentations, videos, modeling, practiced negotiation based on experiences, and psychodrama methods, such as role playing, as ways to improve empathy in participants. This study looked at the use of expressive arts to improve empathic skills of nursing students. The study was conducted with 48 students who were separated into five different groups. All groups lasted for two hours, and met for 12 weeks. Expressive art and psychodrama methods were used in the group studies. The Scale of Empathic Skill was administered to participants before and after the group studies. Before the group study took place, the average score for empathic skill was 127.97 (SD = 21.26). After the group study, it increased to 138.87 (SD = 20.40). The average score for empathic skill increased after the group (t = 3.996, p = .000). Results show that expressive methods are easier, more effective, and enjoyable processes in nursing training.     

Communication skills of nurses during interactions with simulated cancer patients

AIM: In this paper the balance of affective and instrumental communication employed by nurses during the admission interview with recently diagnosed cancer patients was investigated. RATIONALE: The balance of affective and instrumental communication employed by nurses appears to be important, especially during the admission interview with cancer patients. METHODS: For this purpose, admission interviews between 53 ward nurses and simulated cancer patients were videotaped and analysed using the Roter Interaction Analysis system, in which a distinction is made between instrumental and affective communication. RESULTS: The results reveal that more than 60% of nurses' utterances were of an instrumental nature. Affective communication occurred, but was more related to global affect ratings like giving agreements and paraphrases than to discussing and exploring actively patients feelings by showing empathy, showing concern and optimism. CONCLUSION: In future, nurses should be systematically provided with (continuing) training programmes, in which they learn how to communicate effectively in relation to patients' emotions and feelings, and how to integrate emotional care with practical and medical tasks.     

Barriers in providing psychosocial support for patients with cancer

There is sound evidence to support the notion that the provision of effective psychosocial care improves the outcomes of patients with cancer. Central to the implementation of this care is that health professionals have the necessary communication and assessment skills. This study aimed to identify key issues related to providing effective psychosocial care for adult patients admitted with hematological cancer, as perceived by registered nurses with 3 or more years of clinical experience. An exploratory qualitative design was used for this study. Two focus group interviews were conducted with 15 experienced cancer nurses. The provision of psychosocial care for patients with cancer is a dynamic process that has a professional and personal impact on the nurse. The 5 analytic themes to emerge from the data were as follows: When is it a good time to talk? Building relationships; Being drawn into the emotional world; Providing support throughout the patient's journey; and Breakdown in communication processes. The findings from this study indicate an urgent need to develop a framework to provide nurses with both skill development and ongoing support in order to improve nurses' ability to integrate psychosocial aspects of care and optimize patient outcomes.     

Registered Nurses'' Perceptions of Their Communication with Spanish-Speaking Migrant Farmworkers in North Carolina: An Exploratory Study

Communication forms the foundation for all that nurses do. Recently, nurses working with migrant farmworkers have become challenged as the language of this population has become predominantly Spanish. To explore how nurses in North Carolina are managing communication issues, 55 nurses at 12 state health care agencies that serve migrant farmworkers was surveyed. Data were collected to determine what nurses believed about various communication issues involving these Spanish-speaking clients, including how they were presently communicating with them, in what areas of nursing functions they believed communication barriers were problematic, what they were doing to improve their communication, and what they envisioned the potential solutions were concerning communication barriers. Language differences proved to be substantial barriers to adequate nursing care for these individuals. Nurses cited many problems and said that they were receiving little assistance from their agencies to improve direct communication with the clients. Responses indicated a need for and a willingness by nurses to focus on improving communication with Spanish-speaking clients. Classes held at their agencies were seen as the most effective way of learning Spanish.     

精神科护士共情倾向与关怀能力的相关性研究

目的探讨精神科护士共情倾向与关怀能力之间的关系。方法采用人际反应指针量表和关怀能力量表调查147名精神科护士的共情倾向、关怀能力及其二者之间的关系。结果精神科护士共情各维度得分由高至低依次为共情性关心、幻想、观点采择、个人痛苦;关怀能力总分为(180.99±19.48)分,各维度得分均低于常模(P<0.01);精神科护士共情倾向的各维度(共情性关心、观点采择、幻想、个人痛苦)以及护士的职称、护龄是关怀能力的影响因素。结论精神科护士的关怀能力有待进一步提高,共情倾向影响护士实施关怀照护行为,建议对护士进行有针对性的管理和培训,提高护士的共情能力,有助于改善护士对病人的关怀,进而提高护理服务质量。