Hostname: page-component-76fb5796d-dfsvx Total loading time: 0 Render date: 2024-04-26T08:14:23.144Z Has data issue: false hasContentIssue false
  • English
  • Français

Empathy in general practice consultations: A qualitative analysis

Published online by Cambridge University Press:  11 October 2011

Rolf Wynn
Rolf Wynn*
Affiliation:
Psychiatric Centre for Tromsø and Karlsøy, University Hospital of Northern Norway, Tromsø, (Norway)
*
Address for correspondence: Dr. R. Wynn, Psychiatric Centre for Tromsø and Karlsøy, University Hospital of Northern Norway, N-9291(Norway). Fax: ++47-776-27532 E-mail: rolf.wynn@unn.no
Get access Rights & Permissions [Opens in a new window]

Summary

Aims — Empathy is an important basis of all provider-patient interaction, including general practice. Little has been known about the details of how general practitioners express empathy to their patients. In the present study, it was a main aim to carry out a detailed qualitative study of actual sequences through which empathy was achieved, by focusing on the form, function, and categorisation of such sequences. Methods — The study drew on the qualitative method of conversation analysis. Transcriptions of 77 British general-practitioner-patient interactions were analysed in detail in order to identify and characterise sequences in which empathy was achieved. Results — Four types of empathy were identified, described, and analysed: cognitive empathy, affective empathy, sharing empathy, and nurturant empathy. Although sequences involving empathy typically were brief and occurred relatively rarely, the analyses demonstrated that the sequences often concerned matters of great importance to the interactants. Conclusions — The study underlined the need to focus also on phenomena that occur relatively rarely in consultations. For this purpose, the method of conversation analysis was a useful tool.

Declaration of Interest: there was no conflict of interest.

Keywords

empathygeneral practiceconsultationsinteractionsconversation analysis
Type
Original Papers
Information
Epidemiology and Psychiatric Sciences , Volume 14 , Issue 3 , September 2005 , pp. 163 - 169
Copyright
Copyright © Cambridge University Press 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Bachelor, A. (1988). How clients perceive empathy: A content analysis of ‘received’ empathy. Psychotherapy 25, 227–240.CrossRefGoogle Scholar
Barrett-Lennard, G.T. (1981). The empathy cycle: Refinement of a nuclear concept. Journal of Counceling Psychology 28, 91–100.Google Scholar
Beach, W.A. (1995). Preserving and constraining options: ‘Okays’ and ‘official’ priorities in medical interviews. In The Talk of the Clinic (ed. Morris, G.H. & Chenail, R.J.), pp. 259–289. Lawrence Erlbaum Associates: Hillsdale.Google Scholar
Belief, P.S. & Maloney, M.J. (1991). The importance of empathy as an interviewing skill in medicine. Journal of the American Medical Association 266, 1831–1832.Google Scholar
Burnard, L. (Ed.) (1995). Users Reference Guide for the British National Corpus. Oxford University Computing Sciences: Oxford.Google Scholar
Cape, J.D. (1996). Psychological treatment of emotional problems by general practitioners. The British Journal of Medical Psychology 69, 85–99.CrossRefGoogle Scholar
Del Piccolo, L., Benpensanti, M.G., Bonini, P., Cellerino, P., Saltini, A. & Zimmermann, C. (1999). [The Verona Medical Interview Classification System/Patient (VR-MICS/P): the tool and its reliability]. Epidemiologia e Psichiatria Sociale 8, 56–67.CrossRefGoogle ScholarPubMed
Drew, P., & Heritage, J. (1992). Analyzing talk at work: An introduction. In Talk at Work: Interaction in Institutional Settings (ed. Drew, P. & Heritage, J.), pp. 3–65. Cambridge University Press: Cambridge.Google Scholar
Drew, P., Chatwin, J. & Collins, S. (2001). Conversation analysis: a method for research into interactions between patients and healthcare professionals. Health Expectations 4, 58–70.CrossRefGoogle Scholar
Duan, C. & Hill, C.E. (1996). The current state of empathy research. Journal of Counselling Psychology 43, 261–274.CrossRefGoogle Scholar
Frankel, R.M. (1990). Talking in interviews: A dispreference for patient-initiated questions in physician-patient encounters. In Interaction Competence (ed. Psathas, G.). pp. 231–262. University Press of America: Washington D CGoogle Scholar
Greenfield, S., Kaplan, S.G. & Ware, J.E. (1989). Assessing the effects of physician-patient interaction on the outcomes of chronic disease. Medical Care 27, 110–127.Google Scholar
Haakana, M. (2001). Laughter as a patient's resource: dealing with delicate aspects of medical interaction. Text 21, 187–219.Google Scholar
Heaven, C, Maguire, P. & Green, C. (2003). A patient-centred approach to defining and assessing interviewing competency. Epidemiologia e Psichiatria Sociale 12, 86–91.CrossRefGoogle ScholarPubMed
Heritage, J. (1984). Garfinkel and Ethnomethodology. Cambridge University Press: Cambridge.Google Scholar
Heritage, J. (1988). Explanations as accounts: A conversation analytic approach. In Analysing Everyday Explanation: a Casebook of Methods (ed. Antaki, C.), pp. 127–144. Sage: London.Google Scholar
Hojat, M, Gonnella, J.S., Nasca, T.J., Mangione, S., Vergare, M. & Magee, M. (2002). Physician empathy: Definition, components, measurement, and relationship to gender and speciality. American Journal of Psychiatry 159, 1563–1569.CrossRefGoogle Scholar
Horvath, A.O. & Symons, B.D. (1991). Relationship between working alliance and outcome in psychotherapy: a meta-analysis. Journal of Consulting and Clinical Psychology 38, 139–149.Google Scholar
Hutchby, I & Drew, P. (1995). Conversation analysis. In Handbook of Pragmatics (manual) (ed. Verschueren, J., Ostman, J.O. and Blommaert, J.), pp. 182–189. John Benjamins: Amsterdam.CrossRefGoogle Scholar
Hutchby, I. & Woofitt, R. (1998). Conversation Analysis. Principles, Practices and Applications. Polity Press: Cambridge.Google Scholar
Jefferson, G. (1984). Notes on a systematic deployment of the acknowledgement tokens ‘yeah’ and ‘mm hm’. Papers in Linguistics 17, 197–206.CrossRefGoogle Scholar
Jurkovitch, G.J., Pananen, L. & Rivara, F.P. (2000). Giving bad news: the family perspective. Journal of Trauma 48, 865–870.CrossRefGoogle Scholar
Kaplan, H.I. & Sadock, B.J. (1998). Svnopsis of Psychiatry. Lippincott Williams & Wilkins: Philadelphia.Google Scholar
Levinson, W., Gorawara-Bhat, R. & Lamb, J. (2000). A study of patient clues and physician responses in primary care and surgical settings. Journal of the American Medical Association 284, 1021–1027.CrossRefGoogle ScholarPubMed
Linell, P. & Bredmar, M. (1996). Reconstructing topical sensitivity: Aspects of face-work in talks between midwives and expectant mothers. Research on Language and Social Interaction 29, 347–379.Google Scholar
Matthews, D.A., Suchman, A.L. & Branch, W.T. (1993). Making ‘connections’: enhancing the therapeutic potential of patient-clinician relationships. Annals of Internal Medicine 118, 973–977.CrossRefGoogle ScholarPubMed
McCabe, R., Heath, C., Burns, T. & Priebe, S. (2002). Engagement of patients with psychosis in the consultation: conversation analytic study. British Medical Journal 325, 1148–1151.CrossRefGoogle ScholarPubMed
Mead, N., Bower, P. & Hann, M. (2002). The impact of general practitioners’ patient-centredness on patient's post-consultation satisfaction and enablement. Social Science and Medicine 55, 283–299.CrossRefGoogle ScholarPubMed
Paasche-Orlow, M. & Roter, D. (2003). The communication patterns of internal medicine and family practice physicians. Journal of the American Board of Family Practitioners 16, 485–493.CrossRefGoogle ScholarPubMed
Palmer, D. (2000). Identifying delusional discourse: issues of rationality, reality and power. Sociology of Health and Illness 22, 661–678.CrossRefGoogle Scholar
Psathas, G. (1995). Conversation Analysis. The Study of Talk-in-interaction. Qualitative research methods series no 35. Sage Publications: Thousand Oaks, CA.CrossRefGoogle Scholar
Perakyla, A. (1997). Reliability and validity in research based on tapes and transcriptions. In Qualitative Research (ed. Silverman, D.). pp. 201–220. Sage: London.Google Scholar
Priebe, S. & Gruyters, T. (1995). The importance of the first three days: predictors of treatment outcome in depressed in-patients. British Journal of Clinical Psychology 34, 229–236.CrossRefGoogle ScholarPubMed
Rogers, C. (1959). A theory of therapy, personality and interpersonal relationships as developed in the client-centred framework. In Psychology: a Study of Science, Vol. 3 (ed. Koch, S.), pp. 184–256. McGraw-Hill: New York.Google Scholar
Roter, D.L., Hall, J.A. & Katz, N.R. (1987). Relations between physicians’ behaviours and analogue patients’ satisfaction, recall and impressions. Medical Care 32, 175–181.Google Scholar
Roter, D.L., Hall, J.A., Kern, D.E., Barker, R., Cole, K.A. & Roca, R.P. (1995). Improving physicians’ interviewing skills and reducing patients’ emotional distress: a randomized clinical trial. Archives of Internal Medicine 155, 1877–1884.CrossRefGoogle ScholarPubMed
Roter, D.L., Larson, S., Fischer, G.S., Arnold, R.M. & Tulsky, J.A. (2000). Experts practice what they preach: A descriptive study of best and normative practices in end-of-life discussions. Archives of Internal Medicine 160, 3477–3485.CrossRefGoogle ScholarPubMed
Sacks, H., Schegloff, E. & Jefferson, G. (1974). A simplest systematics for the organisation of turn-taking in conversation. Language 50, 696–735.CrossRefGoogle Scholar
Saltini, A., Cappellari, D., Cellerino, P., Del Piccolo, L. & Zimmermann, C. (1998). An instrument for evaluating the medical interview in general practice: VR-MICS/D (Verona Medical Interview Classification System (Doctor). Epidemiologia e Psichiatria Sociale 7, 210–223.CrossRefGoogle ScholarPubMed
Sarnat, H., Arad, P., Hanauer, D. & Shohami, E. (2001). Communication strategies used during pediatric dental treatment. Pediatric Dentistry 23, 337–342.Google ScholarPubMed
Stewart, M.A. (1995). Effective physician-patient communication and health outcomes: a review. Canadian Medical Association Journal 152, 1423–1432.Google ScholarPubMed
Ten Have, P. (1999). Doing Conversation Analysis: a Practical Guide. Sage: London.Google Scholar
Van Den Brink-Muinen, A. & Caris-Verhalen, W. (2003). Doctors' responses to patients’ concerns: testing the use of sequential analysis. Epidemiologia e Psichiatria Sociale 12, 92–97.CrossRefGoogle ScholarPubMed
Wooley, F.R., Kane, R.L., Hughes, C.C. & Wright, D.D. (1978). The effects of doctor-patient communication on satisfaction and outcome of care. Social Science and Medicine 12, 123–128.Google Scholar
Wynn, R. (1995). The Linguistics of Doctor-Patient Interaction. Novus Press: Oslo.Google Scholar
Wynn, R. (1996). Medical students, doctors - is there a difference? Text 16, 423–448.Google Scholar
Wynn, R. (1999). Provider-Patient Interaction. Norwegian Academic Press: Kristiansand.Google Scholar
Zimmermann, C., Del Piccolo, L. & Mazzi, M.A. (2003). Patient cues and medical interviewing in general practice: examples of the application of sequential analysis. Epidmiologia e Psichiatria Sociale 12, 115–123.CrossRefGoogle ScholarPubMed