Articles: empathy.
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This essay will argue for the centrality of empathy in the doctor-patient relationship-as a core of ethically sound, responsible therapeutics. By "empathy," I intend an explicitly hermeneutic practice, informed by a reflexive understanding of patient and self. After providing an overview of the history of the concept of empathy in clinical medicine, I discuss current definitions and the use of Balint groups in residency training as a way to develop empathic competence in novice physicians.
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Theoretical medicine · Sep 1996
Review Case ReportsEngagement and suffering in responsible caregiving: on overcoming maleficience in health care.
The thesis of this article is that engagement and suffering are essential aspects of responsible caregiving. The sense of medical responsibility engendered by engaged caregiving is referred to herein as 'clinical phronesis,' i.e. practical wisdom in health care, or, simply, practical health care wisdom. The idea of clinical phronesis calls to mind a relational or communicative sense of medical responsibility which can best be understood as a kind of 'virtue ethics,' yet one that is informed by the exigencies of moral discourse and dialogue, as well as by the technical rigors of formal reasoning. ⋯ When, however, responsibility is construed qualitatively as an evaluative feature of medical rationality, rather than quantitatively as a form of 'calculative reasoning' only, responsibility can be viewed more broadly as not only a matter of science and will, but of language and communication as well--in particular, as the task of responsibly narrating and interpreting the patient's story of illness. In summary, the question is not whether phronesis can 'save the life of medical ethics'--only responsible humans can do that. Instead, the question should be whether phronesis, as an ethical requirement of health care delivery, can 'prevent the death of medical ethics.'
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The tension between power and caring in nursing is evident through the volume of nursing literature related to power and powerlessness and through nurses' discomfort with notions of power. A dialectical examination of the concepts of power and caring reveals that at one level they appear to be polar opposites. Additional layers of the dialectic reflect different relationships between power and caring until they are seen as intertwined and mutually generative concepts in an approach to caring labeled "empowered caring".
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Ostomy/wound management · Jun 1996
Comparative StudyNurse caring behaviors: comparing five tools to define perceptions.
We asked which of five tools that measure perceptions of caring attributes (Larson's Care Q, Larson's Care/Sat, Nyberg's CAS, Duffy's CAT, Wolf's CBI) have the greatest usefulness in studies with patients and nurses. A convenience sample of 26 nurse administrators completed all five tools. Data was collected on completion time, demographic characteristics, and how results compared with earlier research using the same instruments. ⋯ Duffy's CAT had negatively worded items. Similar results were obtained with Wolf's CBI as previously described in the literature and it had consistent language, short completion time, easy to understand instructions, and easy to analyze results which could be used in a correlational design study. We conclude that Larson's Care Q (using a simpler method of administration) or Wolf's CBI could be valuable in determining perceptions of caring in patients and nurses.