Empatia (parte I): contribuições para a abordagem centrada na pessoa / Empathy (part I): contributions to a person-centered approach / Empatía (parte I): contribuciones a un enfoque centrado en la persona

Introdução: Este artigo explora o tema da empatia na relação médico-paciente. Objetivo: Contribuir para o aperfeiçoamento das habilidades de comunicação clínica ao revisar o entendimento e a aplicação da empatia na prática clínica. Métodos: Trata-se de uma revisão não sistemática dos principais livros utilizados na comunicação clínica sobre o tema da empatia. O recorte metodológico compreendeu as seguintes etapas: (1) amostra intencional da literatura; (2) coleta e leitura de dados ­ i.e., extração de fragmentos dos textos; (3) análise do conteúdo, com o foco na definição, importância e instrumentalização para a aplicação prática; (4) seleção e síntese, para facilitar a compreensão e a contextualização sobre o tema; e (5) comparação e ponderação do conteúdo selecionado. Resultados: A abrangência com que a empatia foi trabalhada na literatura selecionada resultou em três níveis de densidade empática: baixa, moderada e alta. Assim, a baixa densidade empática limitou-se mais à definição e importância do tema; a densidade moderada incorporou algum exemplo de como aplicar a empatia, porém de forma fragmentada; e a alta densidade empática abordou o tema de modo mais completo, facilitando a instrumentalização na prática clínica. Há concordância na literatura analisada de que a prática da empatia reflete-se na melhoria do cuidado médico, entretanto seu exercício permanece no campo racional. Ao exemplificar a aplicação prática da empatia, os autores sugerem que o médico adote uma postura isenta de julgamentos, ao mesmo tempo que propõem um exercício imaginativo, de adivinhação dos sentimentos/emoções do paciente. Apesar de os autores de alta densidade empática compreenderem a importância das emoções e nomeá-las no processo, percebe-se a necessidade de um desdobramento e aprofundamento a partir desse ponto. Conclusões: Por se tratar de um assunto complexo, com vários matizes, a empatia é abordada de diferentes formas na literatura selecionada. Isso evidencia sua riqueza e originalidade, ao mesmo tempo que apresenta lacunas para sua aplicação na prática clínica.

Introduction: This article explores the theme of empathy in the doctor-patient relationship. Objective: To contribute to the improvement of clinical communication skills by reviewing the understanding and application of empathy in clinical practice. Methods: A non-systematic review of the main books used in clinical communication on the topic of empathy. The methodological approach consisted in the following steps: (1) An intentional sample of the literature; (2) Data collection and reading, i.e., extracting fragments from texts; (3) Content analysis, focusing on definition, importance and instrumentalization for practical application; (4) Selection and synthesis to facilitate understanding and contextualization on the topic; and (5) Comparison and ponderance of the selected content. Results: The scope within which empathy was worked on in the selected literature resulted in three levels of empathic density: low, moderate, and high. Thus, low empathic density was limited to definition and importance; moderate density incorporated some examples of how to apply empathy in a fragmented way; high empathic density addressed the topic more fully, facilitating instrumentation in clinical practice. There is agreement in the literature analyzed that the practice of empathy reflects on the improvement of medical care. However, its exercise remains in the rational field. By exemplifying the practical application of empathy, the authors suggest that the physician adopt a non-judgmental posture, while proposing an imaginative exercise of guessing the patient's feelings/emotions. Although high-density empathy authors understand the importance of emotions and name them in the process, there is a need for an unfolding and deepening from this point on. Conclusions: Empathy is a complex subject with several nuances and is approached in different ways in the selected literature. This evidences its richness and originality, at the same time that it presents gaps for the application of empathy in clinical practice.

Introducción: Este artículo explora el tema de la empatía en la relación médico-paciente. Objetivo: contribuir a la mejora de las habilidades de comunicación clínica mediante la revisión de la comprensión y aplicación de la empatía en la práctica clínica. Método: se trata de una revisión no sistemática de los principales libros utilizados en comunicación clínica sobre el tema de la empatía. El enfoque metodológico comprendió los siguientes pasos: (1) Una muestra intencional de la literatura; (2) Recopilación y lectura de datos, es decir, extracción de fragmentos de textos; (3) Análisis de contenido, centrándose en definición, importancia e instrumentalización para la aplicación práctica; (4) Selección y síntesis para facilitar la comprensión y contextualización sobre el tema; y (5) Comparación y ponderación del contenido seleccionado. Resultados: el alcance con el que se trabajó la empatía en la literatura seleccionada tuvo como resultado tres niveles de densidad empática: baja, moderada y alta. Así, la baja densidad empática se limitaba más a la definición y la importancia; densidad moderada, incorporó algún ejemplo de cómo aplicar la empatía, pero de manera fragmentada; alta densidad empática se acercó del tema de manera más completa, facilitando la instrumentación en la práctica clínica. Existe acuerdo en la literatura analizada en que la práctica de la empatía se refleja en la mejora de la atención médica. Sin embargo, su ejercicio queda en el campo racional. Al ejemplificar la aplicación práctica de la empatía, los autores sugieren que el médico adopte una postura no crítica, al tiempo que propone un ejercicio imaginativo de adivinar los sentimientos/emociones del paciente. Si bien los autores de alta densidad empática entienden la importancia de las emociones y las nombran en el proceso, existe la necesidad de un desdoblamiento y profundización a partir de este punto. Conclusiones: Por tratarse de un tema complejo y con varios matices, la empatía es abordada de diferentes maneras en la literatura seleccionada. Esto evidencia su riqueza y originalidad, al mismo tiempo que presenta vacíos para la aplicación de la empatía en la práctica clínica.

Development and effects of the PARENT (Parenting Acceptable Real Empathy Nurture Training) program for mothers who defected from North Korea.

AIM AND BACKGROUND: North Korean refugee mothers struggle with the two-fold burden of adaptation and parenting in a new environment. This study aimed to develop and examine the effects of a parenting program for North Korean refugee mothers. METHODS: This quasi-experimental study was conducted with 65 North Korean refugee mothers who were recruited through the Korea Hana Foundation Center and Sajowi. The experimental and control groups comprised 33, 32 participants respectively. A program was conducted across eight sessions, each lasting about 90-120 min. The data were analyzed using the χ2 test, independent t-test, and paired t-test. RESULTS: Significant differences were observed in the parenting efficacy (t = -10.03, p < .001) and child related stress (sub domain-parenting stress) (t = 3.24, p = .002) scores. While intergroup differences were observed for parenting efficacy (t = 5.48, p < .001), no significant differences were observed for parenting stress (parent related) (t = -0.22, p = .825) and parent-child relationship (t = 0.87, p = .387) and no intergroup differences were observed for parenting stress (t = -1.10, p = .274) and parent-child relationship (t = 1.06, p = .290). CONCLUSION: This study is significant to the field of nursing because North Korean refugee mothers who needed parenting education have high parental efficacy scores after intervention, which expresses confidence in parenting. This study proposed a parenting education intervention framework focusing on emotional empathy for North Korean refugee mothers who want to provide healthy parenting despite the challenges they encounter as immigrants, which will improve their confidence in parenting. It can serve as a source of basic data for designing parenting education intervention frameworks for refugees in the future.

Empathic Conversational Agent Platform Designs and Their Evaluation in the Context of Mental Health: Systematic Review.

BACKGROUND: The demand for mental health (MH) services in the community continues to exceed supply. At the same time, technological developments make the use of artificial intelligence-empowered conversational agents (CAs) a real possibility to help fill this gap. OBJECTIVE: The objective of this review was to identify existing empathic CA design architectures within the MH care sector and to assess their technical performance in detecting and responding to user emotions in terms of classification accuracy. In addition, the approaches used to evaluate empathic CAs within the MH care sector in terms of their acceptability to users were considered. Finally, this review aimed to identify limitations and future directions for empathic CAs in MH care. METHODS: A systematic literature search was conducted across 6 academic databases to identify journal articles and conference proceedings using search terms covering 3 topics: "conversational agents," "mental health," and "empathy." Only studies discussing CA interventions for the MH care domain were eligible for this review, with both textual and vocal characteristics considered as possible data inputs. Quality was assessed using appropriate risk of bias and quality tools. RESULTS: A total of 19 articles met all inclusion criteria. Most (12/19, 63%) of these empathic CA designs in MH care were machine learning (ML) based, with 26% (5/19) hybrid engines and 11% (2/19) rule-based systems. Among the ML-based CAs, 47% (9/19) used neural networks, with transformer-based architectures being well represented (7/19, 37%). The remaining 16% (3/19) of the ML models were unspecified. Technical assessments of these CAs focused on response accuracies and their ability to recognize, predict, and classify user emotions. While single-engine CAs demonstrated good accuracy, the hybrid engines achieved higher accuracy and provided more nuanced responses. Of the 19 studies, human evaluations were conducted in 16 (84%), with only 5 (26%) focusing directly on the CA's empathic features. All these papers used self-reports for measuring empathy, including single or multiple (scale) ratings or qualitative feedback from in-depth interviews. Only 1 (5%) paper included evaluations by both CA users and experts, adding more value to the process. CONCLUSIONS: The integration of CA design and its evaluation is crucial to produce empathic CAs. Future studies should focus on using a clear definition of empathy and standardized scales for empathy measurement, ideally including expert assessment. In addition, the diversity in measures used for technical assessment and evaluation poses a challenge for comparing CA performances, which future research should also address. However, CAs with good technical and empathic performance are already available to users of MH care services, showing promise for new applications, such as helpline services.

Psychological Factors Determining Prognosis of Dental Treatments.

Many psychological factors may have a significant bearing on an individual's oral health and success of dental treatments. Overall, these factors may result in the avoidance of dental visits, emergency-based dental appointments, noncompliant dental behavior, the utilization of multiple oral health care providers, and poor oral health. These factors may affect the quality of life of individuals and may lead to patient dissatisfaction, poor prognosis, and failure of dental treatment. Multiple psychological factors may affect the dentist and the patient. Those factors may alter the prognosis for successful dental treatment. Physician empathy is fundamental in developing long-term physician-patient trust.

Patient-Centered Nursing for the Christ-Centered Nurse.

ABSTRACT: Patient-centered care (PCC), a term coined decades ago, is a key but challenging focus of nursing practice. The history, development, and current dialogue about PCC along with biblical perspectives on caregiving, wisdom, and discernment help nurses who follow Christ to offer compassionate PCC. Strategies are proposed for meaningfully engaging patients and families as active participants in healthcare. The Christian nurse can best provide consistent, effective PCC by remaining Christ-centered.

Covenantal Care: Nursing with God's Love and Justice.

ABSTRACT: With resources stretched thin and the growing risk of compassion fatigue, faith beliefs can offer enriching perspectives for nurses. Covenantal care is a nursing approach rooted in theological insights about humanity's inherent purpose to engage in relationship with God and actively participate in acts of love and justice. Based upon interpretations of Judeo-Christian teachings of imago Dei and God's covenant with humankind, this approach provides guidance for the nurse to care for self, patients, and the wider community. This exploration of theology-in-practice provides an orientating ethos for nurses that reflects the loving, restorative, and dignified care that is at the heart of the Christian faith.

Challenges and recommendations in the implementation of audiovisual telemedicine communication: a systematic review.

This systematic review aims to identify the elements of doctor-patient communication in telemedicine, emerging challenges, and proposed recommendations. Four databases, including Science Direct, PubMed, Cochrane, and ProQuest, were searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The inclusion criteria consisted of original research papers, availability of free full text, and publications during the past 10 years. A total of 13 articles completed the selection process and satisfied the established criteria. The issues and recommendations of telemedicine communication were categorized into three distinct groups: pre-consultation, during-consultation, and post-consultation. Preparation encompasses the arranging of visual elements, safeguarding patient privacy and confidentiality, and addressing any technical challenges that may arise. The consultation encompasses nonverbal behavior, empathy, the doctor-patient connection, and a physical examination. Post-telemedicine consultations refer to medical appointments that occur after a telemedicine session, typically involving follow-up medical interactions. Telemedicine presents unique challenges in doctor-patient consultations that differ from face-to-face interactions. Therefore, clinicians must acquire communication skills specific to telemedicine to ensure effective consultations and achieve optimal health results.

Unfolding the empathic insights and tendencies among medical students of two gulf institutions using interpersonal reactivity index.

BACKGROUND: Empathy is an essential core competency for future doctors. Unfortunately, the medical curriculum is infamously known to burn out aspiring doctors, which may potentially lead to a decline in empathy among medical students. This research was planned to understand the evolution of empathic approaches among students across the curriculum using the Interpersonal reactivity index (IRI) as a benchmark at the Royal College of Surgeons in Ireland - Medical University of Bahrain (RCSI-MUB) and University of Sharjah (UoS). METHODS: We adopted a cross-sectional design and administered an online survey to the medical students of RCSI-MUB and UoS using a modified version of the IRI along with its three subscales of empathic concern (EC), perspective taking (PT), and personal distress (PD). To identify intra- and inter-institutional variations in empathy scores, the Analysis of Variance (ANOVA) was performed separately for each institution and with both institutions combined. A two-way ANOVA was conducted for the comparison between years and institutions. For the subscale analysis of EC, PT, and PD, we used one-way ANOVA for significant differences between years at both institutions. For the gender-effect analysis, t-test was performed to examine the differences in total IRI scores at both institutions combined and at each institution separately. Additionally, an Analysis of Covariance (ANCOVA) was done to identify the influence of gender on empathy scores. RESULTS: A total of 140 students from both institutions participated in this study. We found a fluctuating pattern of empathy scores without a clear trend across the years. The sub-scales of EC, PD, and PT across academic years at both institutions showed significant differences within the EC at RCSI-MUB (p = 0.003). No significant differences were identified across other years from both institutions. There were significant differences between empathy scores from RCSI-MUB and UoS for EC (p = 0.011). Additionally, a pronounced interaction effect between year and institution was observed for PT (p = 0.032). The gender-wise analysis showed that female students had higher empathy scores than males (p = 0.004). The ANCOVA for IRI score results revealed a p-value of 0.023, indicating that gender plays a crucial role in empathy levels among medical students. The ANCOVA results revealed a p-value of 0.022 in the EC subscale. CONCLUSION: Our study unveiled intricate patterns in empathy development among medical students across years and genders at RCSI-MUB and UoS. These congruences and dissimilarities in empathy scores signal a subjective understanding of empathy by medical students. The disparities in understanding may encourage medical educators to embed empathy in standard medical curricula for better healthcare outcomes.

Insight and empathy in schizophrenia: Impact on quality of life and symptom severity.

BACKGROUND: Quality of life has emerged as a powerful indicator of therapeutic success. However, little research has been conducted to study potential factors that influence quality of life in persons with schizophrenia, particularly in low-income developing nations. AIM: This study aimed to investigate how insight and empathy impacted the quality of life and severity of symptoms in patients. METHODS: A descriptive cross-sectional research design was conducted on 168 patients with schizophrenia using the PANSS Scale, Schizophrenia Quality of Life Scale R4, the Interpersonal Reactivity Index, and the Birchwood Insight Scale. RESULTS: Our findings show that the mean score for quality of life was (70.9 ± 9.2), whereas the mean scores for empathy and insight were (60.8 ± 15.8) and (5.8 ± 1.9), respectively. Insight and empathy have predicted effects on QoL (adjusted r square = 0.035, sig = 0.009) and (adjusted r square = 0.012, sig = 0.027), respectively. On the other hand, the regression model also showed a substantial inverse relationship between the severity of the illness and both empathy and insight. CONCLUSION: The majority of the clients had poor quality of life, low insight, and low empathy. Insight and empathy play a role in anticipating the patient's perceptions of quality of life. They might affect how severe their illness is. Our findings highlight the importance of developing empathy and insight, and therapies that do so may aid patients with low quality of life.

Level and Influencing Factors of Clinical Nurses' Caring Behaviour in Southern China.

A cross-sectional descriptive study was conducted to assess the level of caring behaviour among clinical nurses in Southern China and explore its influencing factors. The study was carried out in the Sixth Affiliated Hospital, South China University of Technology, Guangdong, China, from December 2022 to February 2023. A total of 537 nurses participated, and the mean scores for caring behaviour, responsibility perception, and inclusive leadership were examined. The mean score for caring behaviour among clinical nurses was 125.25 ± 18.31. The mean responsibility perception score was 21.38 ± 3.36, while the mean inclusive leadership score was 38.04 ± 6.56. Notably, the inclusive leadership questionnaire and responsibility perception showed significant positive correlations with caring behaviour (p <0.01). Furthermore, regression analysis indicated that inclusive leadership and responsibility perception exerted significant influences on nurses' caring behaviour (p <0.01). These findings underscore the importance of creating an inclusive leadership environment that enhances nurses' sense of responsibility perception in order to promote and improve nursing caring behaviour. Key Words: Caring behaviour, Inclusive leadership, Responsibility perception, Influence factor, Clinic nurses.

Reserving the human touch in nursing education while integrating virtual reality and simulation.

In the ever-evolving landscape of nursing education, the integration of virtual reality (VR) and simulation technologies presents both promise and challenges. Although these innovative tools offer unparalleled opportunities for skill acquisition and clinical reasoning, concerns have arisen regarding the potential erosion of compassionate care at the core of nursing practice. The article explores the balance between technical proficiency and compassionate care in nursing education. The importance of comprehensive educator training in utilizing VR and simulation to instill humanistic values, along with the need for curriculum development that seamlessly integrates compassionate care throughout nursing programs, is underscored. By emphasizing the integration of empathy, emotional intelligence, and reflection into VR and simulation experiences, nursing education can ensure that graduates possess the skill sets and values essential for patient-centered practice. The preservation of human touch remains a priority and a cornerstone in the preparation of nursing professionals equipped to deliver holistic and empathetic care in an increasingly technology-driven healthcare landscape.

Using Caring Theory to Guide Application of Psychological PPE to Support Graduate Nurse Wellbeing in a Pandemic and Beyond.

The COVID-19 pandemic disrupted lives worldwide, including students pursuing secondary education. This disruption caused increased worry, anxiety, and overall stress in students. Graduate-level nursing students also not only experienced stress related to educational disruptions but also due to work and home life upheaval as well. Faculty were challenged to support students in reducing educational stress and anxiety. While the Institute for Healthcare Improvement introduced the concept of 'Psychological Personal Protective Equipment' (PPE) to support the mental well-being of healthcare workers, this article explores how faculty implemented psychological PPE in graduate-level education using Swanson's Theory of Caring as the theoretical framework during the pandemic and how these constructs can continue to support student wellbeing in today's challenging environment.

Virtual Reality Combined With Psychoeducation to Improve Emotional Well-Being in Informal Caregivers of Alzheimer's Disease Patients: Rationale and Study Design of a Randomized Controlled Trial.

OBJECTIVES: Care for community-dwelling people with dementia is frequently delegated to relatives, who find themselves in the role of informal caregivers with no practical management knowledge. This situation exposes caregivers to increased risk for emotional wellbeing. The current study aims to test whether the integration of the efficacy of an immersive virtual reality (VR) experience into an online psychoeducational program impacts caregiver empathy and therefore emotional wellbeing. METHODS: One-hundred informal caregivers of mild-to-moderate Alzheimer's disease (AD) patients will be enrolled and randomly assigned to (i) an online psychoeducational program (control arm); or (ii) an online psychoeducational program integrated with VR (experimental arm). VR will consist of 360-degree videos involving the caregivers to an immersive experience of dementia symptoms from the patient's perspective. Before, after the intervention and after 2 months, all participants will complete validated clinical scales for caregiver burden and anxiety (primary outcomes) and sense of competence and dispositional empathy (secondary outcomes). A subsample of 50 participants will also undergo MRI exam, including structural and functional (resting-state and task-functional MRI [fMRI]) sequences. The fMRI task paradigm will use emotional stimuli to evaluate the neural correlate of empathy, by stressing its cognitive and affective components. The main outcome will be the change in the clinical assessment; the secondary outcome will be the change in brain connectivity of networks subserving the empathic and emotional functioning. RESULTS: We expect that the psychoeducational program will decrease anxiety and stress, enabling caregivers to perceive themselves capable of managing AD patients at home, educating them on symptom handling and boosting their cognitive empathy. In the experimental intervention, the VR-based experience will act as an add-on to psychoeducation, leading to greater improvement in the assessed clinical dimensions. VR should, in fact, enable a deeper understanding of disease symptoms and improve caregivers' cognitive empathy. We expect that the experimental intervention will result in deeper comprehension of disease symptoms and further strengthen caregivers' cognitive empathy. At the neural level, we expect to observe increased activation in circuits subserving cognitive empathy and decreased activation in circuits underlying affective empathy. CONCLUSIONS: To the best of our knowledge, this will be the first randomized controlled trial assessing the effect of combining psychoeducational interventions with VR-based experience in caregivers, and assessing both clinical and imaging outcomes. TRIAL REGISTRATION: Registered in ClinicalTrials.gov (NCT05780476).

From childhood emotional abuse to adolescent loneliness: The roles of self-compassion and rejection sensitivity.

BACKGROUND: Emotional abuse is one of the important risk factors for adolescent loneliness. However, there is a shortage of information regarding protective factors and potential mediating mechanisms between emotional abuse and adolescent loneliness, which require further investigation. OBJECTIVES: The present study explored the chain mediating role of self-compassion and rejection sensitivity on the pathway from childhood emotional abuse to adolescent loneliness, based on attachment theory and a stress process model. PARTICIPANTS AND SETTING: Five hundred sixty-seven Chinese adolescents aged 12 to 17 years participated in this study. METHODS: An online questionnaire was utilized to assess a variety of variables including childhood emotional abuse, physical abuse, sexual abuse, self-compassion, rejection sensitivity, and loneliness. To increase the validity of the results, physical and sexual abuse were included as covariates since emotional abuse may co-occur with these types of abuse. RESULTS: Emotional abuse in childhood is significantly positively correlated with adolescent loneliness. Emotional abuse in childhood can affect adolescent loneliness not only directly, but also indirectly through self-compassion (including its components of self-warmth and self-coldness) and rejection sensitivity. CONCLUSIONS: This study sheds further light on the chain mediating role of self-compassion and rejection sensitivity in the relationship between emotional abuse in childhood and loneliness in adolescence, suggesting that intervention programs targeting increased self-compassion and decreased rejection sensitivity may be effective to reduce loneliness in adolescents.

Proactive Personality and Caring Behavior of Clinical Nurses: A Moderated Mediation Model of Emotional Intelligence and Disgust Sensitivity.

The aims of the research were to investigate the mediating effect of emotional intelligence and the moderating effect of disgust sensitivity on the relationship between proactive personality and caring behavior among clinical nurses. A cross-sectional design while adhering to STROBE guidelines was used for this study. Three hundred ninety-three purposely selected nurses from three tertiary general hospitals completed an online survey. Measures included proactive personality, emotional intelligence, disgust sensitivity, and caring behavior. The findings showed that proactive personality positively predicted nurses' caring behavior, and that emotional intelligence played a mediating role in the relationship between proactive personality and caring behavior. Disgust sensitivity indirectly and negatively moderated the impact of proactive personality on nurses' caring behavior mainly in the second half of this moderated relationship. The findings underscore that the nursing managers may consider incorporating emotional intelligence topic in practical nursing skills training and improving nurses' ability to control their disgust sensitivity can improve their professional behavior, thus to provide patients with high-quality nursing services.

Positive Deviance Theory: Leveraging Compliments Data to Guide Strategic Planning for Patient Experience Improvement in a Large Rural Health Care System.

BACKGROUND: Patient-centered care (PCC) has been called for as a solution to improving care quality and patient outcomes. Patient experience, termed care experience, is a measurable aspect of PCC and aligns with coproduction. Identifying patterns of positivity and high performers is a Positive Deviance approach that can inform strategic improvement of the care experience. OBJECTIVE: To identify the characteristics of positive deviances from voluntary, unsolicited compliments from patients and family members about their care experiences. METHODS: The authors conducted a mixed-method analysis, including content and a thematic analysis of unsolicited comments from patients and families, submitted between January 2021 and January 2022. After removing duplicates and miscategorized comments, 213 compliments were included in the analysis using a single, blinded inductive coding to synthesize thematic statements. RESULTS: The main campus received the most compliments by location (89%); the most widely used patient sentiment was thankful (36.8%). Compassionate (26.8%), together with six others: competent (11.6%), communication (10.6%), cared for (8.5%), care team (8.0%), and supportive (8.0%), made up approximately 80% of drivers of care quality. Physicians (37.3%) and nurses (34.2%) were the most complimented personnel, although surgery (17.0%) were the most complimented services team. Similar characteristics were reported for exemplary individuals and their associated care teams. CONCLUSION: The results align with previously reported work by the Beryl Institute and CMS 5-star rating on key drivers of patient experience. This approach provides a method by which exemplars can be identified within health systems, and that information is used to guide improvement and organizational planning.

Introducing patient stories in health sciences education: the learning experiences of students.

BACKGROUND: It has been advocated that the development of medical school curricula must be informed by students, doctors in training, educators, employers, other health and social care professionals and patients, families and carers. Patients are widely employed to teach clinical and interpersonal skills, and while recognised as crucial in health education, they have mostly been offered a passive role. We assessed the impact of patients contributing personal illness narratives in the master curriculum of allied health care professionals on students' learning experiences. METHODS: We designed a module (Patient and Society) for a master's degree programme in Health Sciences at the University of Southern Denmark in collaboration with six patients. The patients contributed to the teaching by sharing and discussing their personal illness narrative. At the end of the module, as part of the exam, we asked the students to reflect on the patients' contribution to the module and how this affected their learning experiences. The 500-word exam responses of 29 students were analysed, in collaboration with six patients, using thematic analysis. RESULTS: Including patients' illness narratives lifted students' academic learning, and their personal and professional development. The stories brought theoretical concepts to life; it helped the students to obtain, retain, and apply academic knowledge. Actively and uninterrupted listening to patients' illness experiences promoted empathy and critical reflection on clinical practice. Faced with the impact of a disease on a person's life, seeing the healthcare system through a patient's lens made students reflect critically on the medical positivist model ruling the health care system focused on just fixing the medical problem with very little room for the illness experience. CONCLUSION: Our analyses support previous findings indicating that patient narratives are a powerful tool to achieve academic and professional development. Working with patients in health education has the potential to work towards a more inclusive epistemological stance in the health care system and health research.

Kindness or Intelligence? Angry Men are Perceived as Less Intelligent by Their Female Romantic Partners.

We were interested in how people in a romantic relationship would perceive the intelligence of their partners who have high or low trait anger. Specifically, we referred to the tension between compassion (low anger) and competence (high intelligence) in mate choice. Some evolutionary theories suggest that mating might be considered a bargaining process between these two higher-order attributes. Our study involved 148 heterosexual couples in romantic relationships. We measured the relationship between relationship satisfaction, trait anger, objective intelligence, self-assessed intelligence, and subjectively assessed partners' intelligence. We found that angrier men were less satisfied in their romantic relationship than those men who were less angry, and their partners were also less satisfied in the relationship. Additionally, women perceived angrier men as less intelligent, an effect that remained after controlling for men's objective intelligence. Lastly, we found that women's perception of their partner's intelligence mediated the link between men's anger and relationship satisfaction for both sexes. Our findings suggest that both anger and intelligence play important roles in romantic relationship functioning, consistent with evolutionary theories that emphasize the value of competence (i.e., intelligence) and compassion (i.e., low anger) in romantic partners. Furthermore, our study highlights the importance of women's perception of their partner's intelligence in determining the quality of the relationship.

Cultivating Disability Humility: Opportunities for Course Correction in Healthcare Education.

Healthcare education programs often engage in learning activities that attempt to simulate the lived experiences of persons with disabilities (PWD). While well-intentioned, these activities can often result in negative consequences, counteracting the stated goals of the activity, including increased empathy and respect for disabled individuals. Health educators have an opportunity to shift attitudes about individuals with disabilities through mindful framing of learning activities that center lived experiences of individuals and promote anti-ableism.