Tietbohl Caroline K
Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), Children's Hospital Colorado, 129263University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Qual Health Res. 2022 Feb;32(3):413-425. doi: 10.1177/10497323211056312. Epub 2021 Dec 11.
Interest in systematic approaches to improving clinical empathy has increased. However, conceptualizations of empathy are inconsistent and difficult to operationalize. Drawing on video recordings of primary care visits with older adults, I describe one particular communication strategy for conveying empathy-empathic validation. Using conversation analysis, I show that the design of empathic validations and the context in which they are delivered are critical to positive patient responses. Effective empathic validations must (a) demonstrate shared understanding and (b) support the patient's position. Physicians provided empathic validation when there was no medical solution to offer and within this context, for three purposes: (1) normalizing changes in health, (2) acknowledging individual difficulty, and (3) recognizing actions or choices. Empathic validation is a useful approach because it does not rely on patients' ability to create an "empathic opportunity" and has particular relevance for older adults.
人们对改善临床同理心的系统方法的兴趣有所增加。然而,同理心的概念并不一致,且难以实施。基于对老年人初级保健就诊的视频记录,我描述了一种传达同理心的特定沟通策略——同理心验证。通过会话分析,我表明同理心验证的设计及其传达的背景对于患者的积极反应至关重要。有效的同理心验证必须(a)表现出共同理解,(b)支持患者的立场。当没有医疗解决方案可提供时,医生会进行同理心验证,在此背景下,有三个目的:(1)使健康变化正常化,(2)承认个人困难,(3)认可行动或选择。同理心验证是一种有用的方法,因为它不依赖患者创造“同理心机会”的能力,并且对老年人尤为重要。