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Clinical practice

Empathic Communication in Healthcare Settings: a Patient Placebo?

Begoña Bellés Fortuño

December 2018 | Building rapport | Clinical practice | Research

Begoña Bellés Fortuño, of the Universitat Jaume I in Spain, introduces us to a study currently being carried out into the placebo effects of empathic communication in patient care.

Communication is intrinsically complex in everyday life, and when taking place in healthcare settings, it becomes a vital issue. Many are the elements of communication: the speaker, the listener, the topic and the social context, the latter being a key element in the interaction process, which has been described as the interactive force of communication (Steen, 1999).

Empathic communication undoubtedly has practical implications for practitioners who want to improve not only their communication abilities but also their relationship skills with patients. The questions arising and being discussed here are: How does a clinician become empathic? and Are patients’ emotions present in the medical consultation?

Emotion and empathy are key elements when dealing with patients and also when talking with their closest relatives, especially those of patients with severe illnesses. There can be many different types of patient profile, from many cultural backgrounds and with different linguistic needs; the globalisation phenomenon has shaped an ethnically and linguistically diverse healthcare setting. Emotion, understood as a socio-pragmatic and psycho-linguistics phenomenon, influences and affects the communication process as well as its elements and participants, especially in the healthcare environment. Therefore, clinicians and healthcare providers in general should be able to handle some basic communication techniques to improve patient-provider communication. The American Medical Association recommends using 17 communication techniques, such as ‘speaking slowly’, using back-channelling, and avoidance of complicated vocabulary and sentence structure, to name but a few. The UK’s National Health Service has also established a protocol on how to deal with the needs of patients with limited English and cope with certain difficult situations. However, there are other countries which have not established communication protocols in the healthcare setting, disregarding the globalised patient profile and its needs.

Some early research suggested that the absence of empathy and emotions in patient care appears to be a predisposing factor of malpractices and patient dissatisfaction (Beckman et al. 1994). Lack of empathy and emotions has led to the general belief in the dehumanisation of medical care. Empathy and compassion in the patient-clinician communication process, when used correctly, can work as a relieving placebo for patients and relatives.

The expression of emotion is often evident through non-verbal features, which are particularly relevant when the participants in the communicative event are not proficient language speakers (clinicians and/or patients), when a healthcare setting is multicultural or when participants are limited language patients (LLP).

Occasionally, depending on institutional resources, national policy and other financial issues, the intervention of an interpreter or cultural mediator is possible. When this occurs, the following question arises: are non-verbal emotions translatable? That is, how can the interpreter or cultural mediator translate empathic or emotional communication features into meaningful language? In these cases some training is also needed. Interpreting emotion in the healthcare setting is extremely important; therefore the improvement of the communicative competence of future health professionals should be a priority in their training curricula at universities and medical institutions (Bellés-Fortuño et al. 2012).

To deepen our understanding we have carried out research into the issues surrounding emotion and empathic communication. This has been done by generating surveys and by interviewing practitioners and other healthcare staff in order to find out to what extent they are aware of the use of empathy in their clinical practices, and whether or not they have been trained in the use of tools and techniques to develop empathy in the clinical setting. The concluding results are yet to come. However, regardless of the findings, the purpose is to make clinicians and healthcare staff aware of the importance of empathic communication and the treatment of emotion in their working environment.

Begoña Bellés FortuñoBegoña Bellés Fortuño holds a PhD, is a senior lecturer in the Department of English Studies and is currently the Director of the Interuniversity Institute of Modern Applied Languages (IULMA) at Universitat Jaume I, Spain

 


References:

Beckman, H. B., Markakis, K. M., Suchman A. L. et al. (1994). The doctor patient relationship malpractice: Lessons for plaintiff depositions. Arch. Intentional Medicine, 154: 1365-1370.

Bellés-Fortuño, B. & Kozlova I. (2012). Designing a syllabus: English for medicine in the EHEA, employability in mind. In À. Llanes Baró et al. (eds.) Applied Linguistics in the Age of Globalization. XXX AESLA Conference Proceedings. Lérida: Publicaciones de la Universidad de Lérida: 154-159.

Steen, G. (1999). From linguistic to conceptual metaphor in five steps. In R. W. Gibbs Jr. and G. Steen (Eds.) Metaphor in Cognitive Linguistics. Amsterdam: John Benjamins, 55-77.