Umeå University's logo

Empathy is crucial in forming a good relationship between patients and healthcare providers. Research on empathy in health care has largely focused on healthcare providers and students and less on the patient's perspective. This study's aim was to investigate patients' experience of empathy in healthcare interactions, to better understand and accommodate to patients' needs. Semi-structured interviews with patients were analyzed inspired by constructivist Grounded Theory. Three categories were formed-"I need you to focus on me," "I am more than my disease" and "I know myself and the disease" and the core category: "I want to be known as a whole human being." This study has provided a deeper insight on how empathy can be operationalized in healthcare interactions from a patient perspective. Patients experience health care interactions as dependent on empathic engagement and hampered by inequity due to knowledge hierarchies and lack of personal sharing. This study emphasizes patient & sacute; need for doctors to be more personal, and to experience a mutual sharing with their doctors to not feel vulnerable or left out in the consultation.

Background: Empathy has proven to be a fundamental component in the patient-doctor relationship and correlates to several positive outcomes in patient care. Despite this, research suggests that empathy decreases during medical education. To increase the understanding of empathy development during medical education, this study explores medical students’ experiences of learning empathy in the transition from theoretical to practical context.

Methods: Eleven semi-structured interviews with students at a medical school in Sweden. The interviews were transcribed verbatim and analysed using grounded theory.

Results: The analysis resulted in three categories and a core category "Lost in translation". Early on, students regard empathy as a valued and necessary skill. While students generally encounter high expectations of being empathic, they also met gendered expectations. There is a mismatch between the theoretical and the practical teaching of empathy. The core category refers both to the students feeling lost in their own professional development and empathy becoming lost in the translation from theory to clinical practice.

Conclusion: The results describe clashes between theory and clinical reality and the efforts of the students to develop and maintain empathy in this context. To encourage students to develop empathy it is necessary for both educators and practitioners to acknowledge, and attempt to bridge, the gap between the theoretical and the practical curriculum regarding empathy.

Objective: To explore the experiences of acculturation into secular Swedish society of former members of cults, with particular focus on mental health, needs and resources.

Design: Qualitative method using the Cultural Formulation Interview (CFI) from the DSM-5 as an interview guide. Analysis of participants’ experiences of acculturation through systematic text condensation.

Participants: Eleven Swedish former members of ideological or religion-based cults.

Setting: Swedish mainstream, secular society.

Results: Former cult members experience an ‘in-between time’ in the period after leaving the cult and find themselves in a confusing, chaotic state. They describe having lived in an honor culture where acts of violence were normalized. In the cult, they felt disconnected from themselves, and post-cult they try to regain access to their own values and feelings as well as create new bonds with family members and friends outside the cult. They find it hard to talk about their cult background and find relief in communicating with other former cult members. In their post-cult life, they eventually start seeing the world in a brighter, more hopeful way than before. However, they are also at risk of re-experiencing cult-related traumatic events and of new traumatic experiences within the post-cult acculturation process, and of persistent psychological distress.

Conclusion: Former cult members face a challenging acculturation process, having lost a functioning worldview upon leaving the cult but not yet gained another to take its place. While the in-between time is often transient, they may need support from the healthcare system, especially regarding mental health concerns, while establishing themselves into mainstream society.

Empathy in the doctor-patient relationship is of great importance and has long been considered a true professional virtue for doctors. Despite the general agreement concerning the importance of empathy, there is no consensus regarding the definition of empathy in medical research. While several quantitative studies, measuring empathy as an individual trait, show a decline in empathy among medical students, other studies have shown that empathy is influenced by contextual factors as well as the availability of role models. Therefore, further studies about the transition from medical school to clinical work also including the perspective of senior doctors are needed. The study presented in this article aims to better understand the clinical conditions for empathy through interviews with senior doctors about their lived experience of empathy. Twelve senior doctors, from different specialities were interviewed using a semi-structured approach. The data was analysed using content analysis. The analysis resulted in the main theme: Empathy as a silent art–a doctor‘s daily balancing act. This main theme comprised three categories: “A tacit, yet language-dependent process”, “A daily balancing act” and “An unsupported path towards mastery”. Doctors face many challenges in their daily balancing act between individual and structural conditions that may affect empathy. In order to maintain and further develop empathy, doctors need working conditions allowing for collegial reflection and conversations that promote empathy.

Objective: This study explores former cult members’ perceptions of consultations with healthcare professionals for mental illness that they relate to their cult involvement. The study also aims to identify the needs, obstacles, and facilitating factors related to these consultations.

Design: Qualitative methods using semi-structured interviews that were analyzed using systematic text condensation.

Participants: Nineteen former cult members who had been in contact with Swedish healthcare professionals due to mental illness related to their cult involvement.

Results: Former cult members remain affected by cult belief systems, rules, and ideations even after leaving a cult. This leads to ambivalence and inner conflict for the former cult member in a healthcare consultation. Care providers are perceived as ignoring cult experiences and lacking knowledge of a cult’s impact on an individual.

Conclusions: To understand, help, and work with former cult members, healthcare professionals need to know about cults and the possible impacts of cult involvement. Person- and patient-centeredness in the form of non-judgmental attitudes, validation of experiences, and awareness of the psychosocial situation are important in consultations with these patients. More over, healthcare providers need to acknowledge cultural and existential aspects of a former cult member’s life, both in the present and from earlier experiences in the cult.

Purpose: To explore if and how a dialogue-based workplace intervention with a convergence dialogue meeting can support a return to work process from the managers' perspective.

Methods: Individual interviews were conducted with 16 managers (10 women and 6 men) who had an employee on sick leave because of stress-induced exhaustion disorder. The manager and employee participated in a dialogue-based workplace intervention with a convergence dialogue meeting that was guided by a healthcare rehabilitation coordinator. The intervention aimed to facilitate dialogue and find concrete solutions to enable return to work. The interviews were analyzed by the Grounded Theory method.

Results: A theoretical model was developed with the core category enhancing managerial capacity to act in a complex return to work process,where the managers strengthened their agential capacity in three levels (categories). These levels werebuilding competence, making adjustments, andsharing responsibilitywith the employee. The managers also learned to navigate in multiple systems and by balancing demands, control and support for the employee and themselves. An added value was that the managers began to take preventive measures with other employees. When sick leave was caused only by personal or social issues (not work), workplace actions or interventions were difficult to find.

Conclusions: From the managers' perspective, dialogue-based workplace interventions with a convergence dialogue meeting and support from a rehabilitation coordinator can strengthen managerial competence and capacity to act in a complex return to work process.

Background: Empathy has long been recognized as a fundamental part of the professionalism of doctors and is considered to be both necessary and beneficial to doctor-patient relationships, although empathy is notoriously difficult to define and measure. Previous research on empathy has mostly consisted of quantitative studies measuring and evaluating empathy levels in students or medical residents. The aim of our qualitative study was to explore the lived experience of empathy among medical interns in Sweden.

Method: We interviewed 16 medical interns, using semi-structured interviews. Content analysis was used to analyse the interviews.

Results: The analysis led to the emergence of a main theme of empathy as being multifaceted and conflictual, consisting of descriptions (subthemes) of “being” and “doing”; of being uncontrollable and contextual; biased and situated and essential and conflictual. Since the components of empathy were also found to be interwoven, to provide a more holistic presentation of the results, we applied a socio-ecological model to the results inspired by Bronfenbrenner.

Conclusions: We concluded that empathy is situated and contextual. By using the socioecological model empathy can be described as a systemic interaction between doctor and patient. Based on this we propose a more holistic approach to empathy in medical education to better prepare students for clinical practice.

OBJECTIVE: To analyse patient and professional perceptions about (in)equity of care and rehabilitation of chronic pain patients from primary health care to assessment at a specialty rehabilitation clinic.

SETTING AND METHODS: This qualitative study consists one focus group interview with eight general practitioners who refer patients to pain rehabilitation clinics, 10 individual interviews with patients who were assessed at a pain rehabilitation clinic and seven interviews with professionals participating in multimodal assessment teams at a pain rehabilitation clinic. Interview analysis was conducted by the grounded theory method.

RESULTS: The core category Via Dolorosa, the way of suffering and pain, captured how gender and sociocultural context may contribute to advantages and disadvantages during patient journeys from primary health care to a pain rehabilitation clinic. Patients and professionals perceived pain as a low-ranking illness, and women and men used different gendered strategies to legitimise the pain and to be taken seriously. Being 'a proper patient ready to change' and having 'likeness' between patients and professionals were viewed as advantageous in rehabilitation of pain patients. Patients with higher educational levels were perceived as easier to interact with and had better access to health care. Professional thoughts about gender norms influenced the rehabilitation options. The rehabilitation programme was seen by several professionals to be better suited for women than men, which could lead to unequal care.

CONCLUSION: From an equity and gender perspective, our study highlights the complexity in rehabilitation of chronic pain patients - both from patient and professional perspectives. Awareness of gendered and the biased preconceptions and norms is crucial when professionals struggle to offer equitable health care and rehabilitation.