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.
NorfolkT, BirdiK, WalshD. The role of empathy in establishing rapport in the consultation: a new model. . 2007;41:690–697. PubMed doi:10.1111/j.1365-2923.2007.02789.x10.1111/j.1365-2923.2007.02789.x17614890)| false
WanzerMBBooth-ButterfieldMGruberK. Perceptions of health care providers’ communication: relationships between patient-centered communication and satisfaction. J Health Commun. 2004;16(3):363–384. doi:10.1207/S15327027HC1603_6
WanzerMB, Booth-ButterfieldM, GruberK. Perceptions of health care providers’ communication: relationships between patient-centered communication and satisfaction. . 2004;16(3):363–384. doi:10.1207/S15327027HC1603_610.1207/S15327027HC1603_6)| false
MauksehLBDugdaleDCDodsonSEpsteinR. Relationship, communication, and efficiency in the medical encounter: creating a model from a literature review. Arch Intern Med. 2008;168(13):1387–1395. doi:10.1001/archinte.168.13.1387
MauksehLB, DugdaleDC, DodsonS, EpsteinR. Relationship, communication, and efficiency in the medical encounter: creating a model from a literature review. . 2008;168(13):1387–1395. doi:10.1001/archinte.168.13.138710.1001/archinte.168.13.1387)| false
NeumannM, WirtzM, BollschweilerE, et al. Determinants and patient-reported long-term outcomes of physician empathy in oncology: a structural equation modelling approach. . 2007;69:63–75. PubMed doi:10.1016/j.pec.2007.07.0031785101610.1016/j.pec.2007.07.003)| false
NeumannMBensingJMercerSErnstmannNOmmenOPfaffH. Analyzing the “nature” and “specific effectiveness” of clinical empathy: a theoretical overview and contribution towards a theory-based agenda. Patient Educ Couns. 2009;74:339–346. doi:10.1016/j.pec.2008.11.013
NeumannM, BensingJ, MercerS, ErnstmannN, OmmenO, PfaffH. Analyzing the “nature” and “specific effectiveness” of clinical empathy: a theoretical overview and contribution towards a theory-based agenda. . 2009;74:339–346. doi:10.1016/j.pec.2008.11.01310.1016/j.pec.2008.11.013)| false
CoulehanJ, PlattFW, EgenerB, et al. Let me see if I have this right…: words that help build empathy. . 2001;135(3):221–227. PubMed doi:10.7326/0003-4819-135-3-200108070-0002210.7326/0003-4819-135-3-200108070-00022)| false
PriceSMercerSWMacPhersonH. Practitioner empathy, patient enablement and health outcomes: a prospective study of acupuncture patients. Patient Educ Couns. 2006; 63(1–2); 239–245. doi:10.1016/j.pec.2005.11.006
PriceS, MercerSW, MacPhersonH. Practitioner empathy, patient enablement and health outcomes: a prospective study of acupuncture patients. . 2006; 63(1–2); 239–245. doi:10.1016/j.pec.2005.11.00610.1016/j.pec.2005.11.00616455221)| false
LevinsonW, Gorawara-BhatR, LambJ. A study of patient clues and physician responses in primary care and surgical settings. . 2000;284(8):1021–1027. PubMed doi:10.1001/jama.284.8.10211094465010.1001/jama.284.8.1021)| false
RiddM, ShawA, LewisG, SalisburyC. The patient-Doctor relationship: a synthesis of the qualitative literature on patients’ perspectives. . 2009;59(561):116–133. PubMed doi:10.3399/bjgp09X42024810.3399/bjgp09X420248)| false
GrandquistMDPodlogLEngelJRNewlandA. Certified athletic trainers’ perspectives on rehabilitation adherence in collegiate athletic training settings. J Sport Rehabil. 2014;23:123–133. doi:10.1123/JSR.2013-0009
MasonM. 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.
MasonM. Sample size and saturation in PhD studies using qualitative interviews. . Updated 2010. http://www.qualitative-research.net/index.php/fqs/article/viewarticle/1428/3027#g12. Accessed November 29, 2011.)| false
NguL, FlorsheimP. The development of relational competence among young high-risk fathers across the transition to parenthood. . 2011;50:184–202. PubMed doi:10.1111/j.1545-5300.2011.01354.x2156406010.1111/j.1545-5300.2011.01354.x)| false
HancockREBonnerGHolingdaleRMaddenAM. 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):275–284. PubMed doi:10.1111/j.1365-277X.2012.01244.x
HancockRE, BonnerG, HolingdaleR, MaddenAM. If you listen to me properly, I feel good: a good qualitative examination of patient experiences of dietetic consultations. . 2012;25(3):275–284. PubMed doi:10.1111/j.1365-277X.2012.01244.x10.1111/j.1365-277X.2012.01244.x)| false
ShapiroJ. Walking a mile in their patients’ shoes: empathy and othering in medical students’ education. Philos Ethics Humanit Med. 2008;3(10):1–11. doi:10.1186/1747-5341-3-1010.1186/1747-5341-3-10)| false
Institute of Medicine; Board of Health Care Services; Committee on the Health Professions Education Summit. The core competencies needed for health care professionals. In: GreinerACKnebelE eds. Health Professions Education: A Bridge to Quality. Washington, DC: National Academies Press (US); 2003:45–74. https://www.ncbi.nlm.nih.gov/books/NBK221519/
Institute of Medicine; Board of Health Care Services; Committee on the Health Professions Education Summit. The core competencies needed for health care professionals. In: GreinerAC, KnebelE, eds. . Washington, DC: National Academies Press (US); 2003:45–74. https://www.ncbi.nlm.nih.gov/books/NBK221519/)| false