JMIR Publications

ABSTRACT

Background:

Most definitions of therapeutic empathy are based on practitioners’ perspectives and few account for patients’ views. We therefore do not understand what therapeutic empathy means to patients. Given that therapeutic empathy involves a relationship between patients and practitioners, the under-representation of the patient voice undermines the validity of therapeutic empathy definitions and subsequently, how the concept is measured, taught, and practiced.

Objective:

To explore patients’ and practitioners’ perspectives on the definition of therapeutic empathy and how it should therefore be measured.

Methods:

A qualitative study, underpinned by a social constructivist stance, was conducted. Patients and practitioners were purposively sampled from a Medical School and a School of Healthcare to represent a diversity of lived experiences and healthcare professions. In-depth, semi-structured interviews were undertaken and the data were analysed using reflexive thematic analysis. Data collection ceased upon reaching meaning saturation.

Results:

Sixteen participants (8 patients and 8 practitioners) were interviewed in June and July 2024. Reflexive thematic analysis generated three overarching themes that synthesise patients’ and practitioners’ views on therapeutic empathy and how it should be measured: 1) therapeutic empathy involves the practitioner showing the patient (that they are interested in the patient as a person, that they are actively listening, that they understand, that they are emotionally engaged, and that they are responding to their needs), 2) context matters (for example, the clinical scenario, time, and the patient), and 3) short, simple scales are a pragmatic approach to measurement.

Conclusions:

Patients and practitioners have similar views about what empathy is, and define therapeutic empathy as involving the practitioner demonstrating specific attitudes and behaviours to their patients. These attitudes and behaviours should be included in interventions to enhance therapeutic empathy, and in measures of the concept. However, contextual factors may act to influence the expression of therapeutic empathy in practice. The findings highlight the need for, and can inform the development of, a short therapeutic empathy scale that allows comparison between patients’, practitioners’, students’, and observers’ scores.