Martina Kelly1, Clark Svrcek1, Nigel King2, Albert Scherpbier3, Tim Dornan4. 1. Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. 2. Department of Applied Psychology, University of Huddersfield, Huddersfield, UK. 3. Faculty of Health, Medicine and Life Sciences, School of Health Professions Education, Maastricht University, Maastricht, the Netherlands. 4. Centre for Medical Education, Queen's University Belfast, Belfast, UK.
Abstract
CONTEXT: Empathic physician behaviour is associated with improved patient outcomes. One way to demonstrate empathy is through the use of non-verbal communication (NVC) including touch. To date, research on NVC, and specifically touch, has been relatively limited in medicine, which is surprising given the central role it plays in conveying affective and empathic messages. To inform curriculum development on NVC, this study aimed to examine physicians' experiences of communicating by touch. METHODS: We conducted an interpretative phenomenological study. A total of 15 physicians (seven women and eight men) from different specialties, including both recent graduates and experienced doctors, described in detail specific instances of touch drawn from their clinical practices. Interview prompts encouraged participants to recall exact details such as the context, their relationship with the patient they touched and their physical experience of touching. Interviews (45-100 minutes) were analysed with template analysis, followed by a process of dialectic questioning, moving back and forth between the data and researchers' personal reflections on them, drawing on phenomenological literature to synthesise a final interpretation. RESULTS: Participants described two dimensions of the experience of touch: 'choosing and inviting touch' and 'expressing empathy.' Touch was a personal and fragile process. Participants interpreted non-verbal patient cues in order to determine whether or not touch was appropriate. They interpreted facial expressions and body language in the present to make meaning of patients' experiences. They used touch to share emotions, and to demonstrate empathy and presence. Participants' experiences of touch framed it as a form of embodied empathic communication. CONCLUSIONS: Touch is a powerful form of NVC that can establish human connection. Phenomenological accounts of empathy, which emphasise its embodied intersubjective nature, can be used to theoretically enrich pedagogical approaches to touch in medical education and to deepen our understanding of empathy.
CONTEXT: Empathic physician behaviour is associated with improved patient outcomes. One way to demonstrate empathy is through the use of non-verbal communication (NVC) including touch. To date, research on NVC, and specifically touch, has been relatively limited in medicine, which is surprising given the central role it plays in conveying affective and empathic messages. To inform curriculum development on NVC, this study aimed to examine physicians' experiences of communicating by touch. METHODS: We conducted an interpretative phenomenological study. A total of 15 physicians (seven women and eight men) from different specialties, including both recent graduates and experienced doctors, described in detail specific instances of touch drawn from their clinical practices. Interview prompts encouraged participants to recall exact details such as the context, their relationship with the patient they touched and their physical experience of touching. Interviews (45-100 minutes) were analysed with template analysis, followed by a process of dialectic questioning, moving back and forth between the data and researchers' personal reflections on them, drawing on phenomenological literature to synthesise a final interpretation. RESULTS:Participants described two dimensions of the experience of touch: 'choosing and inviting touch' and 'expressing empathy.' Touch was a personal and fragile process. Participants interpreted non-verbal patient cues in order to determine whether or not touch was appropriate. They interpreted facial expressions and body language in the present to make meaning of patients' experiences. They used touch to share emotions, and to demonstrate empathy and presence. Participants' experiences of touch framed it as a form of embodied empathic communication. CONCLUSIONS: Touch is a powerful form of NVC that can establish human connection. Phenomenological accounts of empathy, which emphasise its embodied intersubjective nature, can be used to theoretically enrich pedagogical approaches to touch in medical education and to deepen our understanding of empathy.
Authors: Mathias Schlögl; Katrin Singler; Nicolas Martinez-Velilla; Schildmann Jan; Heike A Bischoff-Ferrari; Regina Elisabeth Roller-Wirnsberger; Jadwiga Attier-Zmudka; Christopher A Jones; Stéphanie Miot; Adam L Gordon Journal: Eur Geriatr Med Date: 2021-07-01 Impact factor: 1.710