Carma L Bylund1, Greenberry Taylor2, Emily Mroz3, Diana J Wilkie4, Yingwei Yao4, Linda Emanuel5, George Fitchett6, George Handzo7, Harvey Max Chochinov8, Susan Bluck9. 1. Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL. 2. Department of Communication, Flagler College, St. Augustine, FL. 3. Department of Internal Medicine, Yale University, New Haven, CT. 4. Biobehavioral Nursing Science, University of Florida, Gainesville, FL. 5. The Mongan Institute, Massachusetts General Hospital, Boston, MA. 6. Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, IL. 7. Health Services Research and Quality, Healthcare Chaplaincy Network, New York, NY. 8. Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada. 9. Department of Psychology, University of Florida, Gainesville, FL.
Abstract
OBJECTIVE: Dignity therapy (DT) is a guided process conducted by a health professional for reviewing one's life to promote dignity through the illness process. Empathic communication has been shown to be important in clinical interactions but has yet to be examined in the DT interview session. The Empathic Communication Coding System (ECCS) is a validated, reliable coding system used in clinical interactions. The aims of this study were (1) to assess the feasibility of the ECCS in DT sessions and (2) to describe the process of empathic communication during DT sessions. METHODS: We conducted a secondary analysis of 25 transcripts of DT sessions with older cancer patients. These DT sessions were collected as part of larger randomized controlled trial. We revised the ECCS and then coded the transcripts using the new ECCS-DT. Two coders achieved inter-rater reliability (κ = 0.84) on 20% of the transcripts and then independently coded the remaining transcripts. RESULTS: Participants were individuals with cancer between the ages of 55 and 75. We developed the ECCS-DT with four empathic response categories: acknowledgment, reflection, validation, and shared experience. We found that of the 235 idea units, 198 had at least one of the four empathic responses present. Of the total 25 DT sessions, 17 had at least one empathic response present in all idea units. SIGNIFICANCE OF RESULTS: This feasibility study is an essential first step in our larger program of research to understand how empathic communication may play a role in DT outcomes. We aim to replicate findings in a larger sample and also investigate the linkage empathic communication may have in the DT session to positive patient outcomes. These findings, in turn, may lead to further refinement of training for dignity therapists, development of research into empathy as a mediator of outcomes, and generation of new interventions.
OBJECTIVE: Dignity therapy (DT) is a guided process conducted by a health professional for reviewing one's life to promote dignity through the illness process. Empathic communication has been shown to be important in clinical interactions but has yet to be examined in the DT interview session. The Empathic Communication Coding System (ECCS) is a validated, reliable coding system used in clinical interactions. The aims of this study were (1) to assess the feasibility of the ECCS in DT sessions and (2) to describe the process of empathic communication during DT sessions. METHODS: We conducted a secondary analysis of 25 transcripts of DT sessions with older cancer patients. These DT sessions were collected as part of larger randomized controlled trial. We revised the ECCS and then coded the transcripts using the new ECCS-DT. Two coders achieved inter-rater reliability (κ = 0.84) on 20% of the transcripts and then independently coded the remaining transcripts. RESULTS: Participants were individuals with cancer between the ages of 55 and 75. We developed the ECCS-DT with four empathic response categories: acknowledgment, reflection, validation, and shared experience. We found that of the 235 idea units, 198 had at least one of the four empathic responses present. Of the total 25 DT sessions, 17 had at least one empathic response present in all idea units. SIGNIFICANCE OF RESULTS: This feasibility study is an essential first step in our larger program of research to understand how empathic communication may play a role in DT outcomes. We aim to replicate findings in a larger sample and also investigate the linkage empathic communication may have in the DT session to positive patient outcomes. These findings, in turn, may lead to further refinement of training for dignity therapists, development of research into empathy as a mediator of outcomes, and generation of new interventions.
Authors: Harvey Max Chochinov; Wendy Johnston; Susan E McClement; Thomas F Hack; Brenden Dufault; Murray Enns; Genevieve Thompson; Mike Harlos; Ronald W Damant; Clare D Ramsey; Sara Davison; James Zacharias; Doris Milke; David Strang; Heather J Campbell-Enns; Maia S Kredentser Journal: PLoS One Date: 2016-01-25 Impact factor: 3.240
Authors: Marina Martínez; María Arantzamendi; Alazne Belar; José Miguel Carrasco; Ana Carvajal; María Rullán; Carlos Centeno Journal: Palliat Med Date: 2016-08-26 Impact factor: 4.762