Analyzing the “nature” and “specific effectiveness” of clinical empathy: A theoretical overview and contribution towards a theory-based research agenda
Introduction
While clinicians acknowledge the value of empathy as a core element in high-quality patient care [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], there is still a lack of providing sound empirical evidence that empathy deserves an unchallenged place in medical care and medical education. One explanation for the insufficient empirical findings is a rare synthesizing of existing multidisciplinary empathy theories, which could, in turn, lead both to a better understanding, operationalisation, and measurement of empathy as well as the ability to derive theory-guided research questions. In this way, we might be able to study clinical empathy (abbreviated as CE) through the systematic testing of theory-guided hypotheses [21]. The latter could provide sound empirical evidence of the profound therapeutic potential of CE, thus, bridging the gap between patient-centered medicine and evidence-based medicine [22]. For those reasons, the two objectives of the present paper are (1) to give a multidisciplinary theoretical overview of the “nature” and the “specific effectiveness” [23] of CE and (2) to use this theoretical base as a means of deriving relevant questions for an evidence-based empirical research in the future.
Section snippets
Method
To reach these two study objectives, we made an effort to identify current and past literature about theories and empirical results concerning the “nature” and “specific effectiveness” of empathy and CE. So, Section 3.1 gives a multidisciplinary overview of the key theories on the “nature” of empathy, which are particularly relevant for application to CE. By reviewing prior empirical studies of CE, we develop a model in Section 3.2, which describes the “specific effectiveness” of CE. However,
Empathy as an affective event
Empathy has its origin in the German word Einfühlung (“feeling into”) [24]. Lipps [25], [26] established Einfühlung as a standard term in psychology and, a few years later, Tichener sought to translate Lipps’ term Einfühlung by coining the word empathy in English based on the Greek empathein [27]. Since then various authors, who see empathy first and foremost as an affective action [28], [29], [30], [31], [32], [33], [34], [35] have attempted to define empathy. Friedlmeier summarizes their
Discussion
Towards a theory-based research agenda on the “nature” and “specific effectiveness” of clinical empathy.
Conclusion
In this paper, we proposed to expand the focus of empathy theories in order to attain an enhanced understanding, operationalisation and measurement of CE and to incorporate these theories into a theory-based research agenda on the “nature” and “specific effectiveness” of CE. The main conclusions of our theoretical analyses are the following hypotheses:
- (a)
CE is a fundamental determinant of quality in medical care because it enables the clinician to fulfill key medical tasks more accurately, thereby
Acknowledgments
We are grateful to the Else Kröner-Fresenius Foundation for providing Melanie Neumann with financial support during the course of this study (grant number P43/05//A33/05/F0). Stewart W. Mercer is supported by a Primary Care Research Career Award from the Chief Scientist Office of the Scottish Executive.
We would also like to thank Fawn Zarkov for her qualified support concerning our application of the English language.
Moreover, we are grateful to the anonymous reviewers for their very
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