From: Empathy promoting interventions for health professionals: a systematic review of RCTs
First author, publication year | Rater/ Process | Outcome: measure | Participants analyzed (intervention / control | Difference within group | Difference between groups | ||
---|---|---|---|---|---|---|---|
Intervention Estimatea (SD or 95 % CI) | Comparison group Estimatea (SD or 95 % CI) | Estimatea (SD or 95 % CI) | P-value | ||||
Type of outcome: Attitude | |||||||
Riess 2012b | Health professional/ questionnaire only | Attitude towards empathy: Jefferson Scale of Physician Empathy | 99 (54 / 45) | 1.2 (SD 9.3) | −1.1 (SD 6.7) | Effect size 0.3 | NS |
Type of outcome: Knowledge / Skills | |||||||
Riess 2012b | Health professional/ questionnaire only | Physician’s knowledge of the neurobiology and physiology of empathy: Neurobiology and Physiology of Empathy Test | 99 (54 / 45) | 2.3 (SD 2.4) | 0.4 (SD 2.3) | Effect size 0.8 | <0.001 |
Riess 2012b | Health professional/ questionnaire only | Physician’s skill at decoding subtle facial expressions of emotion: Ekman test | 99 (54 / 45) | 2.1 (SD 2.5) | 0.2 (SD 2.2) | Effect size 0.8 | <0.001 |
Type of outcome: Behavior | |||||||
Daeppen 2012c | External observer/ simulated interview | MITI 3.0 behavioral coding system Global Scores: Empathy | 131 (66 / 65) | Before: NA After: 4.0 (SD 0.6) | Before: NA After: 3.4 (SD 0.7) | NA | NA |
Butow 2008d | External observer/ simulated interview | Key doctor behaviors; category: creating an environment where emotion is likely to be expressed: Basic empathy subscale | 30 (15 / 14) | Before: Median 5.0 (IQR 4.0, 5.0) After: Median 5.0 (IQR 4.5, 5.0) | Before: Median 4.0 (IQR 3.8, 5.0) After: Median 4.0 (IQR 3.0, 5.0) | ND | NS |
Delvaux 2005e | External observer/ simulated interview | Empathy, educated guesses, alerting to reality, confronting, negotiating, summarizing: CRCWEM rated utterances directed to patients | 56 (27 / 29) | ND | ND | RR 1.8 (95 % CI 1.0, 3.4) | NS |
Delvaux 2005e | External observer/ simulated interview | Empathy, educated guesses, alerting to reality, confronting, negotiating, summarizing: CRCWEM rated utterances directed to relatives | 56 (27 / 29) | ND | ND | RR 1.1 (95 % CI 0.4, 3.2) | NS |
Razavi 2002 | External observer/ simulated interview | Emotional depth of utterances: CRCWEM neutral (level 0) utterances | 115 (57 / 58) | ND | ND | ND | NS |
Razavi 2002f | External observer/ simulated interview | Use of emotional “distress” words: Frequency score | 115 (57 / 58) | Before: 9.2 (SD 4.9) After: 12.9 (SD 5.6) | Before 10.8 (SD 5.6) After: 9.1 (SD 5.4) | ND | <0.001 |
Razavi 2002f | External observer/ simulated interview | Use of emotional “distress” words: Density score | 115 (57 / 58) | Before: 3.6 (SD 2.1) After: 4.4 (SD 2.2) | Before: 4.0 (SD 2.8) After: 3.6 (SD 2.7) | ND | 0.04 |
Tulsky 2011g | External observer/ actual interview | Emotion handling skills: Number of empathic statements per conversation | 48 (24 / 24) | Before: 0.4 (SD 1.0) After: 0.8 (SD 1.3) | Before: 0.3 (SD 0.7) After: 0.4 (0.8) | RR 1.9 (95 % CI 1.1, 3.3) | 0.024 |
Tulsky 2011g | External observer/ actual interview | Emotion handling skills: Number of continuer response to empathic opportunities | 48 (24 / 24) | ND | ND | OR 2.1 (95 % CI 1.1, 4.2) | 0.028 |
Bonvicini 2008 | External observer/ actual interview | Physicians’ empathic expression: GRS, Empathy | 155 (79 / 76) | Before: 8.4 (95 % CI (7.8, 9.0) After: 11.6 (95 % CI 11.0 12.2) | Before: 8.1 (95 % CI (7.6, 8.6) After: 7.4 (95 % CI 7.0 7.8) | 1.4 (ND) | <0.01 |
Bonvicini 2008 | External observer/ actual interview | Physicians’ empathic expression: Hierarchical ECCS | 155 (79 / 76) | Before: 2.7 (95 % CI (2.5, 2.8) After: 4.0 (95 % CI 3.9 4.1) | Before: 2.6 (95 % CI 2.4, 2.8) After: 2.5 (95 % CI 2.3 2.7) | 3.9 (ND) | <0.01 |
Delvaux 2005e | External observer/ actual interview | Empathy, educated guesses, alerting to reality, confronting, negotiating, summarizing: CRCWEM rated utterances directed to patients | 56 (27 / 29) | ND | ND | RR 1.4 (95 % CI 0.7, 2.8) | NS |
Fallowfield 2002h | External observer/ actual interview | Empathy: Number of empathic expressions | 160 (80 / 80) | ND | ND | RR 1.5 (ND) | 0.005 |
Jenkins 2002i | External observer/ actual interview | Empathy: Presence of empathic expressions | 93 (48 / 45) 186 (97/89) | Before: 57 59 % (ND) After: 56 58 % (ND) | Before: 44 49 % (ND) After: 38 42 % (ND) | ND | ND |
Razavi 2002 | External observer/ actual interview | Emotional depth of utterances: CRCWEM neutral (level 0) utterances | 115 (57 / 58) | ND | ND | ND | NS |
Razavi 2002f | External observer/ actual interview | Use of emotional “distress” words: Frequency score | 115 (57 / 58) | Before: 4.4 (SD 3.8) After: 7.0 (SD 5.8) | Before 4.6 (SD 4.9) After: 4.3 (SD 4.2) | ND | NS |
Razavi 2002f | External observer/ actual interview | Use of emotional “distress” words: Density score | 115 (57 / 58) | Before: 3.7 (SD 3.4) After: 2.7 (SD 4.8) | Before: 3.3 (SD 3.0) After: 3.1 (SD 2.9) | ND | NS |
Razavi 2002j | External observer/ actual interview | Use of emotional “anxiety” words: Density score | 115 (57 / 58) | ND | ND | ND | 0.028 |
Robbins 1979k | External observer/ actual interview | Empathy: Carkhuff scale - Empathy level | 51 (26 / 25) | Before: 2.3 (ND) After: 2.7 (ND) | Before: 2.3 (ND) After: 2.3 (ND) | ND | ND |
Robbins 1979k | External observer/ actual interview | Empathy: Carkhuff scale - Number of empathic responses | 51 (26 / 25) | Before: 2.0 (ND) After: 4.1 (ND) | Before: 2.3 (ND) After: 2.3 (ND) | ND | ND |
Tulsky 2011l | Patient/ actual interview | Empathy: Perceived Empathy Scale | 48 (24 / 24) | Before: NA After: 0.4 (95 % CI 0.3, 0.5) | Before: NA After: 0.2 (95 % CI 0.1, 0.3) | NA | NA |
Shapiro 2009 | External observer/ questionnaire only | Expressed empathy: SPIR Scale | 79 (38 / 41) | Before: 6.0 (SD 5.7) After: 8.3 (SD 5.0) | Before: 7.3 (SD 6.7) After: 6.6 (SD 5.1) | ND | 0.04 |
Blair-Irvine 2012m | Health professional/ questionnaire only | Assessment of psychosocial construct: Empathy (4-item 7-point Likert scale) | 172 (84 / 88) | Before: 5.1 (SD 1.0) After: 5.5 (SD 0.9) | Before: 5.7 (SD 1.1) After: 5.2 (SD 1.0) | ND | 0.04 |
Riess 2012n | Health professional/ questionnaire only | Empathic responsiveness in personal life: BEES | 99 (54 / 45) | 0.9 (SD 14.5) | 2.7 (SD 14.1) | Effect size 0.12 | NS |
Rask 2009o | Health professional/ questionnaire only | Nurse’s perception of patient’s experiencing empathy during their communication: NPRI, Empathy subscale | 23 (12 / 11) | Before: 21.4 (SD 2.4) After: 24.0 (SD 2.9) | Before: 22.1 (SD 3.6) After: 23.2 (SD 3.2) | Effect size 0.42 | NS |
Shapiro 2004p | Health professional/ questionnaire only | Empathy: ECRS | 16 (10 / 6) | ND | ND | ND | ND |
Shapiro 2004p | Health professional/ questionnaire only | Empathy: BEES | 16 (10 / 6) | ND | ND | ND | ND |
Daniels 1988q | Health professional/ questionnaire only | Empathy: Carkhuff index of communication | 53 (24 / 29) | Before: 1.7 (SD 0.3) After: 2.4 (SD 0.2) | Before: 1.8 (SD 0.4) After: 1.9 (SD 0.3) | ND | <0.05 |
Daniels 1988q | Health professional/ questionnaire only | Empathy: ECRS | 53 (24 / 29) | Before: NA After: 188.8 (42.1) | Before: NA After: 151.9 (40.9) | ND | NA |
Wolf 1987 | Health professional/ questionnaire only | Ability to respond to patients’ emotional concerns in hypothetical scenarios, MCI | 134 (65 / 69) | Before: 0.7 (SD 0.7) After: 2.0 (SD 1.0) | Before: 0.9 (SD 0.9) After: 1.1 (SD 0.8) | ND | <0.001 |
Wolf 1987 | Health professional/ questionnaire only | Exhibit greater preferences for responses that addressed patients’ emotions: HRI | 134 (65 / 69) | Before: 33.0 (SD 7.9) After: 17.9 (SD 6.7) | Before33.1 (SD 9.5) After: 22.3 (SD 8.8) | ND | <0.001 |
Robbins 1979k | Health professional/ questionnaire only | Affective sensitivity - empathy: Affect Sensitivity Scale | 51 (26 / 25) | Before: 26.2 (ND) After: 28.8 (ND) | Before: 26.5 (ND) After: 28.0 (ND) | ND | NS |
Riess 2012n | Patient/ questionnaire only | Physician’s empathy: CARE | 99 (54 / 45) | 0.7 (SD 7.9) | −1.5 (SD 6.0) | Effect size 0.31 | 0.04 |
Rask 2009o | Patient/ questionnaire only | Patient perception of nurse empathy: PPRI, Empathy subscale | 23 (12 / 10) | Before: 22.8 (SD 1.9) After: 22.8 (SD 1.8) | Before: 22.4 (SD 1.7) After: 23.5 (SD 2.9) | Effect size 0.05 | NS |
Smith 1995r | Patient/ questionnaire only | Patient Satisfaction Questionnaire, Patient perception of physician’s empathy | 26 (14 / 12) | ND | ND | ND | NS |