जनरल प्रैक्टिस जर्नल

Empathy for Patient Centeredness and Patient Empowerment

Abstract

Mudiyanse RM

Empathy involve internal process of experiencing what is perceived from the outside world through our senses leading to imaginations and projections, so that such experience will turn the belief of “I and you” in to “I am you” or at least “I might be you”. According to Hojat, empathy in clinical practice is predominantly a cognitive attribute that involves understanding and communicating this understanding with an intention to help by alleviating pain and suffering. Unlike sympathy, empathy is trainable through experiential learning that involves all 4 domains of learning; cognitive, psychomotor, affective and interpersonal domains. Intellectual understanding of the situations (cognitive),emotional feeling and motivation (affective) results in actions with commitment (psychomotor) leading to the expression of his/her intension to help others (interpersonal). Enhancing empathy is beneficial as a parallel improvement of the professional development and patient outcomes is expected. The relationship between the intensity empathy and its beneficial outcomes has a linear relationship. However the relationship of sympathy and its beneficial outcomes shows an inverted U shape, indicating beneficial effects of enhancing sympathy progress only up to a certain limit and after that it start declining. The affective nature of sympathy leads to spontaneous reactions causing distress and deterioration of the efficacy leading to confusions and vicarious trauma. Therefore sympathetic reactions are not productive for health care professional. Empathy is a trainable attribute that contributes to the efficacy in communication, therapeutic adherence and success of treatment and finally to the satisfaction of patients as well as health care professional. Empathetic doctors are less liable for malpractice suits. Empathy promotes feeling of sameness, parallel position and respect that is conducive for patient centered attitudes. However unlike egocentric sympathy, empathy demonstrates altruism and recognizes “separateness” while retaining the feeling of sameness. The health care provider understands that the healthcare receiver is not he or her but another independent individual. Therefore empathy promotes the view that “one needs to look after themselves”. This perception motivates health care professionals to another commitment, which is to empower their patients through deliberate practices like motivational counseling. Sympathetic health care professional will focus on patient satisfaction while empathetic health care professional will focus on patient empowerment. All the religions promote empathy; understanding, feeling and supporting others to alleviate pain. Perception of separateness while experiencing the suffering of the others that will prevent attachments and vicarious trauma is also probably embedded in all regions. I have quoted explicit in examples from Buddhist philosophy due limited knowledge about teaching in other religions regarding these concepts