Articles: empathy.
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Social science & medicine · Jan 1990
ReviewA model of empathic understanding and adherence to treatment regimens in practitioner-patient relationships.
Empathic understanding in practitioner relationships is postulated as necessary for adherence to therapeutic regimens. It is considered to be one of the most important practitioner relationship skills leading ultimately to patient health benefit. Research literature from a wide-range of health disciplines including personality theory, social psychology, psychotherapy, psycho-analysis, and practitioner-patient communication highlights the key role of empathic processes in personal health care. ⋯ The model addresses theoretical relationships between practitioners' empathic understanding, patients' knowledge of their illness and motivation to get better, adherence to treatment advice, and outcome. Recent work on the selection and training of medical and nursing staff in empathic skills is reviewed. A number of areas for future research are outlined including the effect of individual practitioner differences in the components of empathy, empathic compatibility in practitioner-patient dyads, fluctuations in levels of practitioner empathy during long-term care, specific practitioner behaviours which communicate empathy, and the relationship between factors of patient satisfaction and the perception of empathic understanding.
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Overall, our findings suggest that the moderating effects of maternal affective arousal in the socialization of children's empathic responding are complex. On the one hand, at low levels of mothers' affective intensity, positive relations were found between children's sad facial reactions and mothers' prosocial suggestions. At the highest levels of affective responding, however, mothers' altruistic responding was significantly and positively related to children's sad facial responses, and mothers' altruism and inductive reasoning was negatively related to children's distressed facial reactions (Table 2). ⋯ Results not found in previous research were that high-intensity parental affect combined with negative control practices was associated with a lessening of children's sympathetic orientations, whereas situational definitions were positively associated with children's facial distress reactions to peer distress. The variability in these findings may be explained, in part, by the interpretation that parental affect may potentiate the impact of the semantic content of parental messages to the child. That is, if the content of the message is inductive, the mother's intense affect may heighten the meaningfulness of the relation between the child's behavior and its consequences for the peer's situation or feelings (unless, of course, the parent overwhelms the child with information).
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It is often said that medical school admits students who are compassionate, nurturant and person-oriented, and transforms them into cold, impersonal graduates. These attributes describe two ends of a personality trait continuum referred to as psychological femininity. The Femininity Scale of the Personal Attributes Questionnaire was administered to a class of medical students four times over 3 years. ⋯ Such findings suggest a different state of affairs within medical training than is usually portrayed. Rather than viewing medical school as having a universally adverse effect on student compassion, medical school has virtually no effect on self-reports of warmth, kindness, helpfulness, etc. Students at different ends of the femininity continuum may require different interventions aimed at teaching communication skills and interpersonal sensitivity.