Empathy, Emotions and Patient-centredness: a Case Study on Communication Strategies

Authors

  • Ana Muñoz-Miquel

DOI:

https://doi.org/10.7146/hjlcb.v59i1.116990

Keywords:

empathy; emotions; patient-centredness; communication strategies; fact sheets for patient; medical consultation

Abstract

One of the abilities most often associated with patient-centred communication (PCC) is empathy. But how can it be achieved? There is an extensive literature acknowledging the importance of communication skills in healthcare settings. However, few studies focus on the specific strategies that can help overcome the challenges posed by PCC, especially in dealing with, understanding and responding to emotions. This is especially evident in the field of written communication. Starting from the assumption that the way in which medical information is conveyed can significantly influence receivers’ emotional response, and thus their understanding, this paper explores oral and written communication strategies that might be useful for fostering empathy. These strategies are based on the results of two funded research projects carried out by the Gentt Group (Universitat Jaume I, Spain), in which qualitative methods (interviews, focus groups and role-play with real actors) were used to improve doctor-patient communication in intralingual and interlingual contexts, in two genres: fact sheets for patients and medical consultations. The results show that avoiding ambiguous and alarming words, providing explicit explanations, using ‘you’ or the inclusive plural when addressing the patient, framing statements in a positive way, and explaining medical terms can all help enhance empathy, both in oral and written modes. In oral genres, non-verbal communication can also play a key role in showing genuine understanding. The importance of obtaining feedback from real patients and the potential of intralingual translation and role-play for improving the communication skills of medical professionals, translators and interpreters are also discussed. 

References

Arrighi, Emilia/Jovell, Albert J./Navarro, María Dolores 2010: El valor terapéutico en oncología. La perspectiva de pacientes, familiares y profesionales. In Psicooncología 2-3:7, 363-374.
Baile, Walter F./Buckmanb, Robert/Lenzia, Renato/Globera, Gary/Bealea, Estela A./Kudelkab, Andrzej P. 2000: SPIKES—A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer. In The Oncologist 5:4, 302-311. doi: 10.1634/theoncologist.5-4-302.
Bazerman, Charles 2012: Issue brief: Discourse communities. In National Council of Teachers of English [online]. http://www2.ncte.org/ (accessed 13 June 2019).
Bellés-Fortuño, Begoña/Molés-Cases, Teresa 2019: El aprendizaje de la competencia comunicativa aplicada al contexto clínico: presentación de un estudio piloto. In Castellano Martínez, José María/Ruiz Mecua, Aurora (eds.), La Traducción y la Interpretación en contextos especializados: un enfoque multidisciplinar para la Transmisión del conocimiento científico. Madrid: Comares, 37-45.
Bittner, Anja/Jonietz, Ansgar/Bittner, Johannes/Beickert, Luise/Harendza, Sigrid 2015: Translating medical documents into plain language enhances communication skills in medical students – A pilot study. In Patient Education and Counseling 98, 1137-1141. doi: 10.1016/j.pec.2015.05.024
Brown, Jo/Kidd, Jane/Noble, Lorraine/Papageorgiou, Alexia (eds.) 2015: Clinical Communication in Medicine. New Jersey: John Wiley & Sons.
Cushing, Annie 2015: History of the Doctor-Patient Relationship. In Brown, Jo/Kidd, Jane/Noble, Lorraine/Papageorgiou, Alexia (eds.), Clinical Communication in Medicine. New Jersey: John Wiley & Sons, 6-20.
Dam, Helle V./Brøgger, Matilde N./Zethsen, Karen K. (eds.) 2018: Moving Boundaries in Translation Studies. London: Routledge.
Dean, Marleah/Street Jr., Richard L. 2015: Patient-Centered Communication. In Wittenberg, Elaine/Ferrell Betty/Goldsmith, Joy/Smith, Thomas/Ragan, Sandra/Glajchen, Myra/Handzo, George F. (eds.), Textbook of Palliative Care Communication. Oxford: Oxford University Press, 238-245.
Du Pré, Athena/Foster, Elissa 2015: Transactional Communication. In Wittenberg, Elaine/Ferrell Betty/Goldsmith, Joy/Smith, Thomas/Ragan, Sandra/Glajchen, Myra/Handzo, George F. (eds.), Textbook of Palliative Care Communication. Oxford: Oxford University Press, 14-21.
Epstein, Ronald M./Street, Jr., Richard 2007: Patient-Centered Communication in Cancer Care. Promoting Healing and Reducing Suffering. Bethesda: National Cancer Institute.
Ezpeleta-Piorno, Pilar 2012: An example of genre shift in the medicinal product information genre system. In Linguistica Antverpiensia 11, 167-187.
Fage-Butler, Antoinette M. 2013: Improving patient information leaflets: Developing and applying an evaluative model of patient-centredness for texts. In Communication and Medicine 10:2, 105-115. doi: 10.1558/cam.v10i2.105.
Fage-Butler, Antoinette M. 2015: Package leaflets for medication in the EU: The possibility of integrating patients’ perspectives in a regulated genre? In Medical Writing, 24:4, 210-214. doi:10.1179/2047480615Z.000000000325.
Fage-Butler, Antoinette M./Jensen, Matilde N., 2015: Patient- and family-centered written communication in the palliative care setting. In Wittenberg, Elaine/Ferrell Betty/Goldsmith, Joy/Smith, Thomas/Ragan, Sandra/Glajchen, Myra/Handzo, George F. (eds.), Textbook of Palliative Care Communication. Oxford: Oxford University Press, 102-110.
Gabbard, Jennifer/Smith, Thomas 2015: Communication in Palliative Medicine. In Wittenberg, Elaine/Ferrell Betty/Goldsmith, Joy/Smith, Thomas/Ragan, Sandra/Glajchen, Myra/Handzo, George F. (eds.), Textbook of Palliative Care Communication. Oxford: Oxford University Press, 44–53.
García-Izquierdo, Isabel/Montalt, Vicent 2013: Equigeneric and intergeneric translation in Patient-Centred care. In Hermes 51, 39-53.
García-Izquierdo, Isabel/Montalt, Vicent 2017: Understanding and enhancing comprehensibility in texts for patients in an institutional health care context in Spain - A mixed methods analysis. In Revista Española de Lingüística Aplicada 30:2, 592-610. doi: 10.1075/resla.00008.gar.
GarcíaIzquierdo, Isabel/Muñoz-Miquel, Ana 2015: Los folletos de información oncológica en contextos hospitalarios: la perspectiva de pacientes y profesionales sanitarios. In Panace@ 42:16, 225-231.
Grupo Gentt 2016: Entrevista a Anna Lluch. In Panace@ 17:44, 172-174.
Gustin, Jillian/Stowers, Katie H./von Gunten, Charles F. 2015: Communication Education for Physicians In Wittenberg, Elaine/Ferrell Betty/Goldsmith, Joy/Smith, Thomas/Ragan, Sandra/Glajchen, Myra/Handzo, George F. (eds.), Textbook of Palliative Care Communication. Oxford: Oxford University Press, 355-365.
Hacker, Sandra (coord.) 2004: Communicating with Patients - Advice for medical practitioners. Australia: National Health and Medical Research Council.
Hausberg, Maria C./Hergert, Anika/Kröger, Corinna/Bullinger, Monika/Rose, Matthias/Andreas, Sylke 2012: Enhancing medical students’ communication skills: development and evaluation of an undergraduate training program. In BMC Medical Education 12:16. doi: 10.1186/1472-6920-12-16.
Hill-Madsen, Aage 2015: Lexical Strategies in Intralingual Translation between Registers. In Hermes 54, 85-105.
Hojat, Mohammadreza/Mangione, Salvatore/Nasca, Thomas J./Rattner, Susan/Erdmann, James B./Gonnella, Joseph S./Magee, Mike 2004: An empirical study of decline in empathy in medical school. In Medical Education 38:9, 934-941.
Illingworth, Rosie 2015: Patient-Centredness. In Brown, Jo/Kidd, Jane/Noble, Lorraine/Papageorgiou, Alexia (eds.), Clinical Communication in Medicine. New Jersey: John Wiley & Sons, 40-48.
Hirsh, Di/Clerehan, Rosemary/Staples, Margaret/Osborne Richard H./Buchbinder, Rachelle 2009: Patient assessment of medication information leaflets and validation of the Evaluative Linguistic Framework (ELF). In Patient Education and Counseling 77, 248-254. doi: 10.1016/j.pec.2009.03.011.
Jensen, Matilde N. 2015: Optimising Comprehensibility in Interlingual Translation: The Need for Intralingual Translation. In Maksymski, Karin/ Gutermuth, Silke/Hansen-Schirra, Silvia (eds.), Translation and Comprehensibility. Berlin: Frank & Timme, 163-194.
Jensen, Matilde N./Zethsen, Karen K. 2012: Translation of patient information leaflets — Trained translators and pharmacists-cum-translators: A comparison. In Linguistica Antverpiensia 11, 31-49.
Kalavana, Theano V. 2015: Responding to Emotions. In Brown, Jo/Kidd, Jane/Noble, Lorraine/Papageorgiou, Alexia (eds.), Clinical Communication in Medicine. New Jersey: John Wiley & Sons, 91-97.
Kurtz, Suzanne/Silverman, Jonathan/Draper, Juliet 1998: Teaching and Learning Communication Skills in Medicine. Oxford: Radcliffe Medical Press.
Lane, Rob 2015: Breaking Bad News. In Brown, Jo/Kidd, Jane/Noble, Lorraine/Papageorgiou, Alexia (eds.), Clinical Communication in Medicine. New Jersey: John Wiley & Sons, 98-103.
Lang, Stefan/Esser, Marc 2012: Improving patient communication by writing with empathy. In Medical Writing 21:4, 305-307. doi: 10.1179/2047480612Z.00000000048.
Makoul, Gregory/van Dulmen, Saldra 2015: What Is Effective Doctor–Patient Communication? Review of the Evidence. In Brown, Jo/Kidd, Jane/Noble, Lorraine/Papageorgiou, Alexia (eds.), Clinical Communication in Medicine. New Jersey: John Wiley & Sons, 30-39.
Martí Ferriol, José Luis 2016: Selection and validation of a measurement instrument for readability calculations in patient information leaflets for oncological patients in Spain. In Journal of Research Design and Statistics 3:1, 110-125.
Mason, Ian 2000: Audience Design in Translating. In The Translator 6:1, 1-22. doi: 10.1080/13556509.2000.10799053.
Mayer, Richard E./Gallini, Joan K. 1990: When Is an Illustration Worth Ten Thousand Words? In Journal of Educational Psychology 82:4, 715-726.
Montalt, Vicent 2017: Patient-centred translation and emerging trends in medicine and healthcare. In EST Newsletter – Hot Topics in Translation Studies: Medical Translation and Interpreting, 10-11.
Montalt, Vicent/Ezpeleta-Piorno, Pilar 2018: Roleplay as a research tool used in GENTT’s current projects. Paper presented at the IV Gentt International Seminar: Roleplay as an educational and research tool in doctor-patient interaction in multilingual and multicultural settings, 9 November 2018. Castelló de la Plana: Universitat Jaume I.
Montalt, Vicent/García-Izquierdo, Isabel 2016a: Exploring the links between the oral and the written in patient-doctor communication. In Ordóñez-López, Pilar/Edo-Marzá, Nuria (eds.), Medical Discourse in Professional, Academic and Popular Settings. Bristol: Multilingual Matters, 103-124.
Montalt, Vicent/García-Izquierdo, Isabel 2016b: ¿Informar o comunicar? Algunos temas emergentes en comunicación para pacientes. In Panace@ 17:44: 81-84.
Montalt, Vicent/Muñoz-Miquel, Ana/García-Izquierdo, Isabel 2016: Translating genres for patients: challenges for audience design. Paper presented at the 8th EST Congress, 15-17 September 2016. Aarhus: Aarhus University.
Muñoz-Miquel, Ana 2012: From the original article to the summary for patients: Reformulation procedures in intralingual translation. In Linguistica Antverpiensia 11, 187-206.
Muñoz-Miquel, Ana/Ezpeleta-Piorno, Pilar/Saiz-Hontangas, Paula 2018: Intralingual translation in healthcare settings: Strategies and proposals for medical translation training. In MonTI 10, 177-204. doi: 10.6035/MonTI.2018.10.7.
Neubauer, Kathryn/Dixon, William/Corona, Rosalie/Bodurtha, Joann 2015: Cultural Humility. In Wittenberg, Elaine/Ferrell Betty/Goldsmith, Joy/Smith, Thomas/Ragan, Sandra/Glajchen, Myra/Handzo, George F. (eds.), Textbook of Palliative Care Communication. Oxford: Oxford University Press, 79-89.Palos, Guadalupe R. 2015: Cultural Considerations in Palliative Care and Serious Illness. In Wittenberg, Elaine/Ferrell Betty/Goldsmith, Joy/Smith, Thomas/Ragan, Sandra/Glajchen, Myra/Handzo, George F. (eds.), Textbook of Palliative Care Communication. Oxford: Oxford University Press, 153-160.
Petkovic, Jennifer/Epstein Jonathan/Buchbinder, Rachelle/Welch, Vivian/Rader, Tamara/ Lyddiatt, Anne/Clerehan, Rosemary/Christensen, Robin/Boonen, Annelies/Goel, Niti/Maxwell, Lara J./Toupin-April, Karine/De Wit, Maarten/Barton, Jennifer/Flurey, Caroline/Jull, Janet/Barnabe, Cheryl/Sreih, Antoine G./Campbell, Willemina/Pohl, Christoph/Duruöz, Mehmet Tuncay/Singh, Jasvinder A./Tugwell, Peter S./Guillemin, Francis 2015: Toward Ensuring Health Equity: Readability and Cultural Equivalence of OMERACT Patient-reported Outcome Measures. In The Journal of Reumathology 42 (12), 2448-2459. doi: 10.3899/jrheum.141168.
Prieto-Velasco, Juan Antonio 2017: Recepción y percepción de las imágenes en textos médicos para pacientes: estudio experimental sobre la repulsión. In Panace@ 18 (45), 50-60.
Quinn Rosenzweig, Margaret 2012: Breaking bad news: A guide for effective and empathetic communication. In The Nurse Practitioner 37:2, 1-4. doi: 10.1097/01.NPR.0000408626.24599.9e.
Ragan, Sandra L. 2015: Overview of Communication. In Wittenberg, Elaine/Ferrell Betty/Goldsmith, Joy/Smith, Thomas/Ragan, Sandra/Glajchen, Myra/Handzo, George F. (eds.), Textbook of Palliative Care Communication. Oxford: Oxford University Press, 1-9.
Ruiz-Moral, Roger/Pérula de Torres, Luis/Monge, Diana/García Leonardo, Cristina/Caballero, Fernando 2017: Teaching medical students to express empathy by exploring patient emotions and experiences in standardized medical encounters. In Patient Education and Counseling 100:9, 1694-1700. doi: 10.1016/j.pec.2017.04.018.
Saiz Hontangas, Paula/Ezpeleta-Piorno, Pilar/Muñoz-Miquel, Ana 2016: El uso de imágenes en guías para pacientes: una primera aproximación desde la perspectiva del nivel de activación del paciente. In Panace@ 44:17, 99-110.
Shaw, Joanne/Dunn, Steward/Heinrich, Paul 2012: Managing the delivery of bad news: An in-depth analysis of doctors’ delivery style. In Patient Education and Counseling 87:2, 186-192. doi: 10.1016/j.pec.2011.08.005.
Silverman, Jonathan 2015: Relationship Building. In Brown, Jo/Kidd, Jane/Noble, Lorraine/Papageorgiou, Alexia (eds.), Clinical Communication in Medicine. New Jersey: John Wiley & Sons, 72-75.
Silverman, Jonathan/Kurtz, Suzanne/Draper, Juliet. 1998: Skills for Communicating with Patients. Oxfod: Radcliffe Medical Press.
Skelton, John 2008: Role Play and Clinical Communication: Learning the Game. Oxford: Radcliffe Publishing.
Sparks, Lisa/Villagran, Melinda M./Parker-Raley, Jessica/Cunningham, Cory B. 2007: Patient-centered approach to breaking bad news: Communication guidelines for health care providers. In Journal of Applied Communication Research 35:2, 177-196. doi: 10.1080/00909880701262997.
Suojanen, Tytti/Koskinen, Kaisa/Tuominen, Tina 2015: User-centered translation. London & New York: Routledge.
Tate, Peter/Tate, Elizabeth 2014: The Doctor’s Communication Handbook. New York: CRC Press (Taylor and Francis Group).
Thompson, Teresa L./Parrott, Roxanne/Nussbaum, John F. 2011: Routledge Handbook of Health Communication. New York: Taylor & Francis.
Vandekieft, Gregg K. 2001: Breaking Bad News. In American Family Physician 64:12, 1975-1979.
Wittenberg, Elaine/Ferrell Betty/Goldsmith, Joy/Smith, Thomas/Ragan, Sandra/Glajchen, Myra/Handzo, George F. (eds.) 2015: Textbook of Palliative Care Communication. Oxford: Oxford University Press.
Young, Amber/Tordoff, June/Smith, Alesha 2017: ‘What do patients want?’ Tailoring medicines information to meet patients’ needs. In Research in Social and Administrative Pharmacy, 13:6, 1186-1190. doi: 10.1016/j.sapharm.2016.10.006.
Zethsen, Karen K. 2009: Intralingual translation: an attempt at description. In Meta 54:4, 795-812. doi: 10.1556/084.2018.19.1.4.
Zethsen, Karen K. 2018: Access is not the same as understanding. Why intralingual translation is crucial in a world of information overload. In Across Languages and Cultures 19:1, 79-98. doi: 10.7202/038904ar.

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Published

2019-11-01

How to Cite

Muñoz-Miquel, A. (2019). Empathy, Emotions and Patient-centredness: a Case Study on Communication Strategies. HERMES - Journal of Language and Communication in Business, 59(1), 71–89. https://doi.org/10.7146/hjlcb.v59i1.116990

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