Athletes’ Perception of Athletic Trainer Empathy: How Important Is It?

in Journal of Sport Rehabilitation

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Shannon David
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Mary Larson
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Context: Health care practitioners face increasing expectations to provide patient-centered care. Communication skills, specifically empathy, are critical in the provision of patient-centered care. Past work correlates empathy with improved patient satisfaction, compliance, and treatment outcomes. In particular, a predictive relationship exists between clients’ ratings of their clinician’s empathy and treatment outcomes. There is a dearth of studies examining empathy using qualitative methodology and factors of empathy in athletic training. Objective: To gain an understanding of athletes’ perceptions of empathy in the patient–clinician relationship. Design: Qualitative interviews were completed using grounded-theory techniques. Setting: A quiet office. Participants: A typical, purposeful sample of 15 college-age Division I student-athletes (8 female, 7 male; 19.3 ± 1.2 y) from a variety of sports (football, wrestling, volleyball, baseball, etc) participated. Data Collection and Analysis: Researchers utilized an interview protocol designed to understand the factors of empathy related to athletic training. The interview protocol established a concept of empathy to help facilitate discussion of ideas. Data were transcribed, coded, and analyzed for themes and patterns using grounded-theory techniques. Trustworthiness of the data was ensured using an external auditor, member checks, and methods triangulation. Results: Five themes described empathy: advocacy, communication, approachability, access, and competence. Advocacy was described as the athletic trainer (AT) representing the patient. Communication was the ability to listen reflectively; approachability emerged as the comfort and personal connection the patient felt with the AT. Access and technical competence were bridges required for the development of empathy. Conclusions: Providing patient-centered care facilitated by developing good patient–clinician relationships is critical in enabling the best treatment outcomes. ATs portray empathy through advocacy, communication, and approachability. Empathy improves the patient–clinician relationship and is critical for patient-centered care delivered by ATs.

The authors are with the Dept of Health, Nutrition, and Exercise Science and the Dept of Public Health, North Dakota State University, Fargo, ND.

David (Shannon.david@ndsu.edu) is corresponding author.
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  • Expand
  • 1.

    Coulter A, Ellins J. Effectiveness of strategies for informing, educating, and involving patients. BMJ. 2007;335:2427. PubMed doi:10.1136/bmj.39246.581169.80

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Hush JM, Cameron K, Mackey M. Patient satisfaction with musculoskeletal physical therapy care: a systematic review. Phys Ther. 2011;91(1):2536. PubMed doi:10.2522/ptj.20100061

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Canales M. Clinical education: a caring approach. J Nurs Educ. 1994;33(9):417419. doi:10.3928/0148-4834-19941101-08

  • 4.

    Norfolk T, Birdi K, Walsh D. The role of empathy in establishing rapport in the consultation: a new model. Med Educ. 2007;41:690697. PubMed doi:10.1111/j.1365-2923.2007.02789.x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Wanzer MB, Booth-Butterfield M, Gruber K. Perceptions of health care providers’ communication: relationships between patient-centered communication and satisfaction. J Health Commun. 2004;16(3):363384. doi:10.1207/S15327027HC1603_6

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Moyer TB, Miller WR. Is low therapist empathy toxic? Psychol Addict Behav. 2013;27(3):878884. doi:10.1037/a0030274

  • 7.

    Rogers C. Empathic: an unappreciated way of being. Couns Psychol. 1975;5(2):210. doi:10.1177/001100007500500202

  • 8.

    Kroning M. Fostering soft skills is a must for nurse leaders. Am Nurs Today. 2015;10(2). https://www.americannursetoday.com/fostering-soft-skills-must-nurse-leaders/

    • Search Google Scholar
    • Export Citation
  • 9.

    Stiller J, Ostrowski J. Tricks of the trade: enhancing interpersonal skills. Athl Ther Today. 2007;12(6):3335. doi:10.1123/att.12.6.33

  • 10.

    Maukseh LB, Dugdale DC, Dodson S, Epstein R. Relationship, communication, and efficiency in the medical encounter: creating a model from a literature review. Arch Intern Med. 2008;168(13):13871395. doi:10.1001/archinte.168.13.1387

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Neumann M, Wirtz M, Bollschweiler E, et al. Determinants and patient-reported long-term outcomes of physician empathy in oncology: a structural equation modelling approach. Patient Educ Couns. 2007;69:6375. PubMed doi:10.1016/j.pec.2007.07.003

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Neumann M, Bensing J, Mercer S, Ernstmann N, Ommen O, Pfaff H. Analyzing the “nature” and “specific effectiveness” of clinical empathy: a theoretical overview and contribution towards a theory-based agenda. Patient Educ Couns. 2009;74:339346. doi:10.1016/j.pec.2008.11.013

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Coulehan J, Platt FW, Egener B, et al. Let me see if I have this right…: words that help build empathy. Ann Intern Med. 2001;135(3):221227. PubMed doi:10.7326/0003-4819-135-3-200108070-00022

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Price S, Mercer SW, MacPherson H. Practitioner empathy, patient enablement and health outcomes: a prospective study of acupuncture patients. Patient Educ Couns. 2006; 63(1–2); 239245. doi:10.1016/j.pec.2005.11.006

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Stewart M, Brown J, Donner A, et al. The impact of patient-centered care on outcomes. J Fam Pract. 2000;49(9):796804.

  • 16.

    Levinson W, Gorawara-Bhat R, Lamb J. A study of patient clues and physician responses in primary care and surgical settings. JAMA. 2000;284(8):10211027. PubMed doi:10.1001/jama.284.8.1021

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Pedersen R. Empirical research on empathy in medicine–a critical review. Patient Educ Couns. 2008;76(3):307322. doi:10.1016/j.pec.2009.06.012

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Mercer SW, Reynolds WJ. Empathy and quality of care. Br J Gen Pract. 2002;52:913. PubMed

  • 19.

    Ogle J, Bushnell J, Caputi P. Empathy is related to clinical competence in medical care. Med Educ. 2013;47(8):824831. PubMed doi:10.1111/medu.12232

  • 20.

    Ridd M, Shaw A, Lewis G, Salisbury C. The patient-Doctor relationship: a synthesis of the qualitative literature on patients’ perspectives. Br J Gen Pract. 2009;59(561):116133. PubMed doi:10.3399/bjgp09X420248

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Grandquist MD, Podlog L, Engel JR, Newland A. Certified athletic trainers’ perspectives on rehabilitation adherence in collegiate athletic training settings. J Sport Rehabil. 2014;23:123133. doi:10.1123/JSR.2013-0009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Patton M. Qualitative Research and Evaluation Methods. 3rd ed. Thousand Oaks, CA: Sage; 2002.

  • 23.

    Mason M. Sample size and saturation in PhD studies using qualitative interviews. Forum: Qualitative Social Research. Updated 2010. http://www.qualitative-research.net/index.php/fqs/article/viewarticle/1428/3027#g12. Accessed November 29, 2011.

    • Search Google Scholar
    • Export Citation
  • 24.

    Guest G, Bunce A, Johnson L. How many interview are enough? An experiment with data saturation and variability. Field Method. 2006;18(1):5982. doi:10.1177/1525822X05279903

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Brantlinger E, Jimenez R, Klingner J, Pugach M, Richardson V. (2005). Qualitative studies in special education. Except Child. 71, 195207. doi:10.1177/001440290507100205

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Glaser BG, Strauss AL. The Discovery of Grounded Theory: Strategies for Qualitative Research. Chicago, IL: Aldine; 1967.

  • 27.

    Strauss A. Qualitative Analysis for Social Scientists. Cambridge, UK: University of Cambridge Press; 1987.

  • 28.

    Hall MA, Dugan E, Zheng B, Mishra AK. Trust in physicians and medical institutions: What is it, can it be measured, and does it matter? Milbank Q. 2001;79(4), 613639.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Miller WR, Rollnick S. Motivational Interviewing: Helping People Change. 3rd ed. London, UK: The Guilford Press; 2012.

  • 30.

    Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA. 2002;287(2):226235. PubMed doi:10.1001/jama.287.2.226

  • 31.

    Mu L, Shroff F, Dharamsi S. Inspiring health advocacy in family medicine: a qualitative study. Educ Health (Abingdon). 2011;24(1):534.

  • 32.

    Baldwin MA. Patient advocacy: a concept analysis. Nurs Stand. 2003;17(21):3339. PubMed doi:10.7748/ns.17.21.33.s55

  • 33.

    Copp LA. The nurse as advocate for vulnerable persons. J Adv Nurs. 1986;11(3);255263. PubMed doi:10.1111/j.1365-2648.1986.tb01246.x

  • 34.

    Ngu L, Florsheim P. The development of relational competence among young high-risk fathers across the transition to parenthood. Fam Process. 2011;50:184202. PubMed doi:10.1111/j.1545-5300.2011.01354.x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Spitzberg BH. Communication competence as knowledge, skill, and impression. Commun Educ. 1983;32(3):323329. doi:10.1080/03634528309378550

  • 36.

    Hancock RE, Bonner G, Holingdale R, Madden AM. If you listen to me properly, I feel good: a good qualitative examination of patient experiences of dietetic consultations. J Hum Nutr Diet. 2012;25(3):275284. PubMed doi:10.1111/j.1365-277X.2012.01244.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 37.

    Shapiro J. Walking a mile in their patients’ shoes: empathy and othering in medical students’ education. Philos Ethics Humanit Med. 2008;3(10):111. doi:10.1186/1747-5341-3-10

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 38.

    Institute of Medicine; Board of Health Care Services; Committee on the Health Professions Education Summit. The core competencies needed for health care professionals. In: Greiner AC, Knebel E, eds. Health Professions Education: A Bridge to Quality. Washington, DC: National Academies Press (US); 2003:4574. https://www.ncbi.nlm.nih.gov/books/NBK221519/

    • Search Google Scholar
    • Export Citation
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