Empathy in the Physician's Pain Practice: Benefits, Barriers, and Recommendations

Banja, John D.

doi:10.1111/j.1526-4637.2006.00159.x

Cited by 38 publications

(31 citation statements)

References 18 publications

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“…Yet some authors have suggested that challenging encounters with these patients “can trigger a professional’s self-protective and defensive coping mechanisms that, in turn, can provoke decidedly unempathic responses.” 33 When providers express empathy, they not only calm and comfort patients 34 , but also strengthen the patient-provider relationship by nurturing a collaborative atmosphere. Patients ultimately have more positive, productive relationships with providers who they view as being concerned about them and their suffering 35 .…”

Section: Discussionmentioning

confidence: 99%

A mixed methods study of patient–provider communication about opioid analgesics

Hughes

Korthuis²,

Saha³

et al. 2015

Patient Education and Counseling

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Objective To describe patient-provider communication about opioid pain medicine and explore how these discussions affect provider attitudes towards patients. Methods We audio-recorded 45 HIV providers and 423 patients in routine outpatient encounters at four sites across the country. Providers completed post-visit questionnaires assessing their attitudes towards patients. We identified discussions about opioid pain management and analyzed them qualitatively. We used logistic regression to assess the association between opioid discussion and providers’ attitudes towards patients. Results 48 encounters (11% of the total sample) contained substantive discussion of opioid-related pain management. Most conversations were initiated by patients (n=28, 58%) and ended by the providers (n=36, 75%). Twelve encounters (25%) contained dialogue suggesting a difference of opinion or conflict. Providers more often agreed than disagreed to give the prescription (50% vs. 23%), sometimes reluctantly; in 27% (n=13) of encounters, no decision was made. Fewer than half of providers (n=20, 42%) acknowledged the patient’s experience of pain. Providers had a lower odds of positive regard for the patient (adjusted OR=0.51, 95%CI: 0.27–0.95) when opioids were discussed. Conclusions Pain management discussions are common in routine outpatient HIV encounters and providers may regard patients less favorably if opioids are discussed during visits. The sometimes-adversarial nature of these discussions may negatively affect provider attitudes towards patients. Practice Implications Empathy and pain acknowledgement are tools that clinicians can use to facilitate productive discussions of pain management.

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Section: Discussionmentioning

confidence: 99%

A mixed methods study of patient–provider communication about opioid analgesics

Hughes

Korthuis²,

Saha³

et al. 2015

Patient Education and Counseling

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“…Each of the established domains of the PCMS is an important component of the overall care that pharmacists provide to migraine sufferers. Empathy is extremely important in the patient–healthcare provider relationship 21,22 . Listening to patients complain about their headaches and providing empathic responses can help build relationships with patients, which can lead to better treatment outcomes.…”

Section: Discussionmentioning

confidence: 99%

Development and Construct Validation of the Pharmacists' Care of Migraineurs Scale

2009

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Objectives.-To develop the pharmacists' care of migraineurs scale (PCMS) and to evaluate its psychometric properties. Background.-Migraine is often managed suboptimally in primary care. Migraineurs frequently come into contact with community pharmacists, who have the opportunity to make a positive impact on migraineur treatment outcomes. A valid and reliable tool that measures and documents the care provided by pharmacists to migraineurs is critical to the development and evaluation of educational programs and interventions.Methods.-Relevant domains of pharmacist care and their respective composite items (behaviors) were identified through an extensive literature search and the use of 2 pharmacist and 2 migraineur focus groups sessions. The resultant 45 PCMS items composed a survey questionnaire mailed to a nationwide random sample of 6000 pharmacists. Data were subjected to an exploratory principal axis factoring procedure to discern the factor structure, and as such describe the latent domains composing the pharmacist caring behaviors constructs.Results.-A total of 580 usable responses were returned, with an additional 60 returned as undeliverable, thus yielding a response rate of 9.7%. Exploratory factor analysis using principal axis factoring yielded 9 factors. However, upon examining the scree plot, communalities, and factor loadings, a reanalysis forcing a 7-factor solution yielded a more interpretable and plausible factor structure. The 7-factor solution included the following domains: (1) empathy; (2) prospective drug utilization review for newly diagnosed migraineurs; (3) medication counseling; (4) nonpharmacologic treatment plan; (5) headache sufferer triage; (6) dissemination of public health information; (7) maintenance of knowledge on migraine. Following the application of scale purification procedures, the final instrument is composed of 41 items and demonstrated a Cronbach's alpha reliability of 0.947. Cronbach's alpha reliabilities for the 7 domains ranged from 0.67 to 0.91, indicative of good to excellent internal consistency reliabilities for all the domains.Conclusions.-The PCMS demonstrated very good construct validity and reliability. While additional validity testing is warranted, the PCMS should allow for benchmarking in the evaluation of interventions designed to improve pharmacists' care to migraineurs and for identifying correlates to effective community pharmacist migraineur care.Key words: migraine, pharmacists, migraineur care, scale Abbreviations: OTC over-the-counter, PCMS pharmacists' care of migraineurs scale, PDUR prospective drug utilization review

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“…cognitive-emotional grasp) of that person's perspective and what he or she is experiencing, feeling, and thinking." (Banja 2006) • • "Purely cognitive, contrasting it with sympathy. Sympathetic physicians risk overidentifying with patients… clinical empathy should be based in detached reasoning."…”

Section: The Concept Of Empathy In Scientific Literaturementioning

confidence: 99%

Empathy Beyond the Conceptual Level: Core Nonspecific Factors of Psychotherapy

Mommaerts

Goubert²,

Devroey³

2012

pbm

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The human mind contains much more than concepts. By only taking into account the conceptual level, a cared-for person may feel utterly lonely and abandoned, not deeply in contact with the caregiver, not deeply understood for who he or she really is. A chronic pain patient, for instance, may react to a purely conceptual-level communication, with its lack of deeper contact, by an increasing sense of loneliness. This in itself may substantially contribute to the suffering of chronic functional pain or even functional disorders in general. In dealing with chronic pain patients, as with any patients, it is therefore very important to develop a sense of empathy that goes beyond this, towards deeply understanding the patient as complete person. This sheds a profound light on the all-important nonspecific factors of psychotherapy, which according to many researchers form the only profoundly active principle in psychotherapy.

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Empathy in the Physician's Pain Practice: Benefits, Barriers, and Recommendations

Cited by 38 publications

References 18 publications

A mixed methods study of patient–provider communication about opioid analgesics

A mixed methods study of patient–provider communication about opioid analgesics

Development and Construct Validation of the Pharmacists' Care of Migraineurs Scale

Empathy Beyond the Conceptual Level: Core Nonspecific Factors of Psychotherapy

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