Artigo Revisado por pares

“Let Me See If I Have This Right …”: Words That Help Build Empathy

2001; American College of Physicians; Volume: 135; Issue: 3 Linguagem: Inglês

10.7326/0003-4819-135-3-200108070-00022

ISSN

1539-3704

Autores

John L. Coulehan, Frederic W. Platt, Barry Egener, Richard M. Frankel, Chen‐Tan Lin, Beth A. Lown, William Salazar,

Tópico(s)

Innovations in Medical Education

Resumo

Medical Writings7 August 2001"Let Me See If I Have This Right …": Words That Help Build EmpathyJohn L. Coulehan, MD, Frederic W. Platt, MD, Barry Egener, MD, Richard Frankel, PhD, Chen-Tan Lin, MD, Beth Lown, MD, and William H. Salazar, MDJohn L. Coulehan, MDDr. Coulehan: State University of New York at Stony Brook; Stony Brook, NY 11794-8036Dr. Platt: University of Colorado Health Sciences Center; Denver, CO 80222Dr. Egener: American Academy on Physician and Patient; Portland, OR 97210Dr. Frankel: Highland Hospital; Rochester, NY 14620Dr. Lin: University of Colorado Health Sciences Center; Denver, CO 80222Dr. Lown: Mount Auburn Hospital; Cambridge, MA 02238Dr. Salazar: Medical College of Georgia; Augusta, GA 30902, Frederic W. Platt, MDDr. Coulehan: State University of New York at Stony Brook; Stony Brook, NY 11794-8036Dr. Platt: University of Colorado Health Sciences Center; Denver, CO 80222Dr. Egener: American Academy on Physician and Patient; Portland, OR 97210Dr. Frankel: Highland Hospital; Rochester, NY 14620Dr. Lin: University of Colorado Health Sciences Center; Denver, CO 80222Dr. Lown: Mount Auburn Hospital; Cambridge, MA 02238Dr. Salazar: Medical College of Georgia; Augusta, GA 30902, Barry Egener, MDDr. Coulehan: State University of New York at Stony Brook; Stony Brook, NY 11794-8036Dr. Platt: University of Colorado Health Sciences Center; Denver, CO 80222Dr. Egener: American Academy on Physician and Patient; Portland, OR 97210Dr. Frankel: Highland Hospital; Rochester, NY 14620Dr. Lin: University of Colorado Health Sciences Center; Denver, CO 80222Dr. Lown: Mount Auburn Hospital; Cambridge, MA 02238Dr. Salazar: Medical College of Georgia; Augusta, GA 30902, Richard Frankel, PhDDr. Coulehan: State University of New York at Stony Brook; Stony Brook, NY 11794-8036Dr. Platt: University of Colorado Health Sciences Center; Denver, CO 80222Dr. Egener: American Academy on Physician and Patient; Portland, OR 97210Dr. Frankel: Highland Hospital; Rochester, NY 14620Dr. Lin: University of Colorado Health Sciences Center; Denver, CO 80222Dr. Lown: Mount Auburn Hospital; Cambridge, MA 02238Dr. Salazar: Medical College of Georgia; Augusta, GA 30902, Chen-Tan Lin, MDDr. Coulehan: State University of New York at Stony Brook; Stony Brook, NY 11794-8036Dr. Platt: University of Colorado Health Sciences Center; Denver, CO 80222Dr. Egener: American Academy on Physician and Patient; Portland, OR 97210Dr. Frankel: Highland Hospital; Rochester, NY 14620Dr. Lin: University of Colorado Health Sciences Center; Denver, CO 80222Dr. Lown: Mount Auburn Hospital; Cambridge, MA 02238Dr. Salazar: Medical College of Georgia; Augusta, GA 30902, Beth Lown, MDDr. Coulehan: State University of New York at Stony Brook; Stony Brook, NY 11794-8036Dr. Platt: University of Colorado Health Sciences Center; Denver, CO 80222Dr. Egener: American Academy on Physician and Patient; Portland, OR 97210Dr. Frankel: Highland Hospital; Rochester, NY 14620Dr. Lin: University of Colorado Health Sciences Center; Denver, CO 80222Dr. Lown: Mount Auburn Hospital; Cambridge, MA 02238Dr. Salazar: Medical College of Georgia; Augusta, GA 30902, and William H. Salazar, MDDr. Coulehan: State University of New York at Stony Brook; Stony Brook, NY 11794-8036Dr. Platt: University of Colorado Health Sciences Center; Denver, CO 80222Dr. Egener: American Academy on Physician and Patient; Portland, OR 97210Dr. Frankel: Highland Hospital; Rochester, NY 14620Dr. Lin: University of Colorado Health Sciences Center; Denver, CO 80222Dr. Lown: Mount Auburn Hospital; Cambridge, MA 02238Dr. Salazar: Medical College of Georgia; Augusta, GA 30902Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-3-200108070-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Consider these two physician–patient dialogues:1. Patient: You know, when you discover a lump in your breast, you kind of feel—well, kind of—(her speech tapers off; she looks down; tears form in her eyes).Dr. A: When did you actually discover the lump?Patient: (absently) I don't know. It's been a while.2. Patient: (same as above)Dr. B: That sounds frightening.Patient: Well, yeah, sort of.Dr. B: Sort of frightening?Patient: Yeah … and I guess I'm feeling like my life is over.Dr. B: I see. Worried and sad too.Patient: That's it, Doctor.Dr. A's patient ...References1. Konrad TR, Williams ES, Linzer M, McMurray J, Pathman DE, Gerrity M, et al . Measuring physician job satisfaction in a changing workplace and a challenging environment. SGIM Career Satisfaction Study Group. Society of General Internal Medicine. Med Care. 1999;37:1174-82. [PMID: 10549620] CrossrefMedlineGoogle Scholar2. Donelan K, Blendon RJ, Lundberg GD, Calkins DR, Newhouse JP, Leape LL, et al . The new medical marketplace: physicians' views. Health Aff Millwood. 1997;16:139-48. [PMID: 9314685] CrossrefMedlineGoogle Scholar3. Bates AS, Harris LE, Tierney WM, Wolinsky FD. Dimensions and correlates of physician work satisfaction in a midwestern city. Med Care. 1998;36:610-7. [PMID: 9544600] CrossrefMedlineGoogle Scholar4. McMurray JE, Williams E, Schwartz MD, Douglas J, Van Kirk J, Konrad TR, et al . Physician job satisfaction: developing a model using qualitative data. SGIM Career Satisfaction Study Group. J Gen Intern Med. 1997;12:711-4. [PMID: 9383141] CrossrefMedlineGoogle Scholar5. Beckman HB, Frankel RM. The effect of physician behavior on the collection of data. Ann Intern Med. 1984;101:692-6. [PMID: 6486600] LinkGoogle Scholar6. Marvel MK, Epstein RM, Flowers K, Beckman HB. Soliciting the patient's agenda: have we improved? JAMA. 1999;281:283-7. [PMID: 9918487] CrossrefMedlineGoogle Scholar7. Roter DL, Stewart M, Putnam SM, Lipkin M, Stiles W, Inui TS. Communication patterns of primary care physicians. JAMA. 1997;277:350-6. [PMID: 9002500] CrossrefMedlineGoogle Scholar8. White J, Levinson W, Roter D. "Oh, by the way …": the closing moments of the medical visit. J Gen Intern Med. 1994;9:24-8. [PMID: 8133347] CrossrefMedlineGoogle Scholar9. Nightingale SD, Yarnold PR, Greenberg MS. Sympathy, empathy, and physician resource utilization. J Gen Intern Med. 1991;6:420-3. [PMID: 1744756] CrossrefMedlineGoogle Scholar10. Levinson W, Stiles WB, Inui TS, Engle R. Physician frustration in communicating with patients. Med Care. 1993;31:285-95. [PMID: 8464246] CrossrefMedlineGoogle Scholar11. Levinson W, Gorawara-Bhat R, Lamb J. A study of patient clues and physician responses in primary care and surgical settings. JAMA. 2000;284:1021-7. [PMID: 10944650] CrossrefMedlineGoogle Scholar12. Suchman AL, Roter D, Green M, Lipkin M. Physician satisfaction with primary care office visits. Collaborative Study Group of the American Academy on Physician and Patient. Med Care. 1993;31:1083-92. [PMID: 8246638] CrossrefMedlineGoogle Scholar13. Cohen-Cole SA. The Medical Interview: The Three-Function Approach. St. Louis: Mosby; 1991. Google Scholar14. Coulehan JL, Block MR. The Medical Interview. Mastering Skills for Clinical Practice. 4th ed. Philadelphia: FA Davis; 2001. Google Scholar15. More ES. "Empathy" enters the profession of medicine.. In: More ES, Milligan MA, eds. The Empathic Practitioner. Empathy, Gender, and Medicine. New Brunswick, NJ: Rutgers Univ Pr; 1994:19-39. Google Scholar16. Basch MF. Empathic understanding: a review of the concept and some theoretical considerations. J Am Psychoanal Assoc. 1983;31:101-26. [PMID: 6681414] CrossrefMedlineGoogle Scholar17. Wispe L. History of the concept of empathy.. In: Eisenberg N, Strayer J, eds. Empathy and Its Development. Cambridge, UK: Cambridge Univ Pr; 1987:17-37. Google Scholar18. Book HE. Empathy: misconceptions and misuses in psychotherapy. Am J Psychiatry. 1988;145:420-4. [PMID: 3348445] CrossrefMedlineGoogle Scholar19. Buie DH. Empathy: its nature and limitations. J Am Psychoanal Assoc. 1981;29:281-307. [PMID: 7264177] CrossrefMedlineGoogle Scholar20. Wilmer HA. The doctor-patient relationship and the issues of pity, sympathy and empathy. Br J Med Psychol. 1968;41:243-8. [PMID: 5728595] CrossrefMedlineGoogle Scholar21. Strayer J. Affective and cognitive perspectives on empathy.. In: Eisenberg N, Strayer J, eds. Empathy and Its Development. Cambridge, UK: Cambridge Univ Pr; 1987:218-44. Google Scholar22. Brothers LA, Finch DM. Physiological evidence for an excitatory pathway from entorhinal cortex to amygdala in the rat. Brain Res. 1985;359:10-20. [PMID: 4075137] CrossrefMedlineGoogle Scholar23. Grattan LM, Eslinger PJ. Empirical study of empathy [Letter]. Am J Psychiatry. 1989;146:1521-2. [PMID: 2619825] CrossrefMedlineGoogle Scholar24. Katz RL. Empathy: Its Nature and Uses. New York: Free Press; 1963:26. Google Scholar25. Lief HI, Fox RC. Training for "detached concern" in medical students.. In: Lief HI, eds. The Psychological Basis of Medical Practice. New York: Harper & Row; 1963:12-35. Google Scholar26. Halpern J. Empathy: Using resonance emotions in the service of curiosity.. In: Spiro H, McCrea Curnen MG, Peschel E, St James D, eds. Empathy and the Practice of Medicine. New Haven, CT: Yale Univ Pr; 1993:160-73. Google Scholar27. Wispe L. The distinction between sympathy and empathy: to call forth a concept, a word is needed. Journal of Personality and Social Psychology. 1986;50:314-21. CrossrefGoogle Scholar28. Wilmer HA. The doctor-patient relationship and the issues of pity, sympathy and empathy. Br J Med Psychol. 1968;41:243-8. [PMID: 5728595] CrossrefMedlineGoogle Scholar29. Bertakis KD, Roter D, Putnam SM. The relationship of physician medical interview style to patient satisfaction. J Fam Pract. 1991;32:175-81. [PMID: 1990046] MedlineGoogle Scholar30. Roter D, Lipkin M, Korsgaard A. Sex differences in patients' and physicians' communication during primary care medical visits. Med Care. 1991;29:1083-93. [PMID: 1943269] CrossrefMedlineGoogle Scholar31. Levinson W, Roter D. Physicians' psychosocial beliefs correlate with their patient communication skills. J Gen Intern Med. 1995;10:375-9. [PMID: 7472685] CrossrefMedlineGoogle Scholar32. Spiro H. What is empathy and can it be taught? Ann Intern Med. 1992;116:843-6. [PMID: 1482433] LinkGoogle Scholar33. Brock CD, Salinsky JV. Empathy: an essential skill for understanding the physician–patient relationship in clinical practice. Fam Med. 1993;25:245-8. [PMID: 8319851] MedlineGoogle Scholar34. Platt FW, Keller VF. Empathic communication: a teachable and learnable skill. J Gen Intern Med. 1994;9:222-6. [PMID: 8014729] CrossrefMedlineGoogle Scholar35. Platt FW, Platt CM. Empathy: a miracle or nothing at all? Journal of Clinical Outcomes Management. 1998;5:30-3. Google Scholar36. Suchman AL, Markakis K, Beckman HB, Frankel R. A model of empathic communication in the medical interview. JAMA. 1997;277:678-82. [PMID: 9039890] CrossrefMedlineGoogle Scholar37. Charon R. The narrative road to empathy.. In: Spiro H, McCrea Curnen MG, Peschel E, St James D, eds. Empathy and the Practice of Medicine. New Haven, CT: Yale Univ Pr; 1993:147-59. Google Scholar38. Carson RA. Beyond respect to recognition and due regard.. In: Toombs SK, Barnard D, Carson RA, eds. Chronic Illness from Experience to Policy. Bloomington, IN: Indiana Univ Pr; 1995:105-28. Google Scholar39. Hunter KM, Charon R, Coulehan JL. The study of literature in medical education. Acad Med. 1995;70:787-94. [PMID: 7669155] MedlineGoogle Scholar40. Novack DH, Suchman AL, Clark W, Epstein RM, Najberg E, Kaplan C. Calibrating the physician. Personal awareness and effective patient care. Working Group on Promoting Physician Personal Awareness, American Academy on Physician and Patient. JAMA. 1997;278:502-9. [PMID: 9256226] CrossrefMedlineGoogle Scholar41. Coulehan JL. Tenderness and steadiness: emotions in medical practice. Lit Med. 1995;14:222-36. [PMID: 8558910] CrossrefMedlineGoogle Scholar42. Connelly J. Being in the present moment: developing the capacity for mindfulness in medicine. Acad Med. 1999;74:420-4. [PMID: 10219225] CrossrefMedlineGoogle Scholar43. Epstein RM. Mindful practice. JAMA. 1999;282:833-9. [PMID: 10478689] CrossrefMedlineGoogle Scholar44. Miller SZ, Schmidt HJ. The habit of humanism: a framework for making humanistic care a reflexive clinical skill. Acad Med. 1999;74:800-3. [PMID: 10429589] CrossrefMedlineGoogle Scholar45. Barrett-Lennard GT. The phases and focus of empathy. Br J Med Psychol. 1993;66 Pt 1 3-14. [PMID: 8485075] CrossrefMedlineGoogle Scholar46. Gallop R, Lancee WJ, Garfinkel PE. The empathic process and its mediators. A heuristic model. J Nerv Ment Dis. 1990;178:649-54. [PMID: 2230750] CrossrefMedlineGoogle Scholar47. Hall JA, Roter DL, Rand CS. Communication of affect between patient and physician. J Health Soc Behav. 1981;22:18-30. [PMID: 7240703] CrossrefMedlineGoogle Scholar48. Larsen KM, Smith CK. Assessment of nonverbal communication in the patient–physician interview. J Fam Pract. 1981;12:481-8. [PMID: 7462949] MedlineGoogle Scholar49. Suchman AL, Matthews DA. What makes the patient-doctor relationship therapeutic? Exploring the connexional dimension of medical care. Ann Intern Med. 1988;108:125-30. [PMID: 3276262] LinkGoogle Scholar50. Suchman AL. Control and Relation: Two Foundational Values and Their Consequences.. In: Suchman AL, Botelho RJ, Hinton-Walker P, eds. Partnerships in Healthcare: Transforming Relational Process. Rochester, NY: Univ of Rochester Pr; 1998. Google Scholar51. Branch WT, Malik TK. Using "windows of opportunities" in brief interviews to understand patients' concerns. JAMA. 1993;269:1667-8. [PMID: 8455300] CrossrefMedlineGoogle Scholar52. Pinderhughes EB. Teaching empathy: ethnicity, race and power at the cross-cultural treatment interface. American Journal of Social Psychology. 1984;4:5-12. Google Scholar53. Kleinman A, Eisenberg L, Good B. Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Ann Intern Med. 1978;88:251-8. [PMID: 626456] LinkGoogle Scholar54. Platt FW, Gaspar DL, Coulehan JL, Fox L, Adler AJ, Weston WW, et al . "Tell me about yourself": the patient-centered interview. Ann Intern Med. 2001;134:1079-85. LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Dr. Coulehan: State University of New York at Stony Brook; Stony Brook, NY 11794-8036Dr. Platt: University of Colorado Health Sciences Center; Denver, CO 80222Dr. Egener: American Academy on Physician and Patient; Portland, OR 97210Dr. Frankel: Highland Hospital; Rochester, NY 14620Dr. Lin: University of Colorado Health Sciences Center; Denver, CO 80222Dr. Lown: Mount Auburn Hospital; Cambridge, MA 02238Dr. Salazar: Medical College of Georgia; Augusta, GA 30902Corresponding Author: John L. Coulehan, MD, Department of Preventive Medicine, HSC L3-086, State University of New York at Stony Brook, Stony Brook, NY 11794-8036; e-mail, [email protected]sunysb.edu.Current Author Addresses: Dr. Coulehan: Department of Preventive Medicine, HSC L3-086, State University of New York at Stony Brook, Stony Brook, NY 11794-8036.Drs. Platt and Lin: University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Denver, CO 80222.Dr. Egener: American Academy on Physician and Patient, Legacy Clinic Northwest, 1130 NW 22nd Avenue, Suite 220, Portland, OR 97210.Dr. Frankel: Highland Hospital, 1000 South Avenue, Rochester, NY 14620.Dr. Lown: Mount Auburn Hospital, 300 Mt. Auburn Street, Cambridge, MA 02238.Dr. Salazar: Medical College of Georgia, 1120 15th Street, HS2010, Augusta, GA 30902. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByHow does narrative medicine impact medical trainees' learning of professionalism? A qualitative studyEmpathy in nurse-patient interaction: a conversation analysisPhysician empathy according to physicians: A multi-specialty qualitative analysisCompassion FatigueDefining clinical empathy: a grounded theory approach from the perspective of healthcare workers and patients in a multicultural settingEmpathy in patient care: from 'Clinical Empathy' to 'Empathic Concern'Introducing reflective narrative for first-year medical students to promote empathy as an integral part of physiology curriculumSoft Skills: The Case for Compassionate Approaches or How Behavior Analysis Keeps Finding Its HeartBedside Manner 2020: An Inventory of Best PracticesClinical Empathy for the Surgical Patient: Lessons From W.H. Auden's Prose and PoetryCraving Empathy: Studying the Sustained Impact of Empathy Training on CliniciansThe Development of Empathy and Associated Factors during Medical Education: A Longitudinal StudyComparison of self-reported empathy levels among dental undergraduate students in Northern India: A questionnaire-based cross-sectional studyThe role of compassion in ethical frameworks and medical practiceSearching for the erosion of empathy in medical undergraduate students: a longitudinal studyImproving Interactions with Healthcare Robots: A Review of Communication Behaviours in Social and Healthcare ContextsDevelopment and piloting of a Situational Judgement Test for emotion-handling skills using the Verona Coding Definitions of Emotional Sequences (VR-CoDES)The impact of therapeutic alliance in physical therapy for chronic musculoskeletal pain: A systematic review of the literatureFeelings Behind a Face: a Medical Student Counseling Workshop in Facial Reconstructive SurgeryAchieving positive outcomes in complex cases: The Admiral Nurse Dementia Helpline (Innovative Practice)Psychological phenomena in the doctor- Elderly patient relationshipApplying a critical race lens to relationship‐centered care in pregnancy and childbirth: An antidote to structural racismHow do perceptions of verbal statements and nonverbal actions as empathetic differ by medical appointment context?Practices to Foster Physician Presence and Connection With Patients in the Clinical EncounterRapport, Empathy and Professional Identity: Some Challenges for International Medical Graduates Speaking English as a Second or Foreign LanguageUnder what circumstances can immigrant patients and healthcare professionals co-produce health? - an interpretive scoping reviewClinical sympathy: the important role of affectivity in clinical practiceEmpathy in computer-mediated interactions: A conceptual framework for research and clinical practice.Psychotherapist's empathic responses to client's troubles telling/feelings talk in psychotherapy: A conversation analysisHow does medical education affect empathy and compassion in medical students? A meta-ethnography: BEME Guide No. 57Empathy in psychotherapy: Using conversation analysis to explore the therapists' empathic interaction with clientsThe Tinnitus Retraining Therapy Trial's Standard of Care Control Condition: Rationale and Description of a Patient-Centered ProtocolMultidisciplinary Teaming: Enhancing Collaboration through Increased UnderstandingCommunication in Health CareCommunication in Surgery for Patient SafetyAgents of empathy: How medical interpreters bridge sociocultural gaps in genomic sequencing disclosures with Spanish-speaking familiesThe development and psychometric validation of a Chinese empathy motivation scaleEmpathic and compassionate healthcare as a Christian spiritual practiceObesity bias among preclinical and clinical chiropractic students and faculty at an integrative health care institution: A cross-sectional studyEmpathy: From Attribute to RelationshipInfluences on students' empathy in medical education: an exploratory interview study with medical students in their third and last yearTeaching future doctors to communicate: a communication intervention for medical students in their clinical yearEmpathy in general practice: its meaning for patients and doctorsEmpathically designed responses as a gateway to advice in Dutch counseling callsAnnotating and modeling empathy in spoken conversationsEmpathy can make the difference. How?The Effect of Patient Participation through Physician's Resources on Experience and WellbeingDepression/AnxietySuffering, Hope, and HealingA Review of Empathy, Its Importance, and Its Teaching in Surgical TrainingAthletes' Perception of Athletic Trainer Empathy: How Important Is It?Empathy from the perspective of oncology nursesPatients' Trust in Physician, Patient Enablement, and Health-Related Quality of Life During Colon Cancer TreatmentMeasuring Medical Students' EmpathyEmpathy in the Clinician–Patient RelationshipComparing two types of perspective taking as strategies for detecting distress amongst parents of children with cancer: A randomised trialIf You Could Read My Mind: The Role of Healthcare Providers' Empathic and Communicative Competencies in Clients' Satisfaction with ConsultationsPatients who are anxious or fearfulFatigue: Has It Affected Your Compassion?Study on Empathy among Undergraduate Students of the Medical Profession in NepalPower Relations and Health Care Communication in Older Adulthood: Educating Recipients and ProvidersBreast Biopsies are Minimally Painful, Exceed Patient Expectations, and Do Not Represent a Genuine Lasting Harm for Most WomenSpirituality and Ubuntu as the foundation for building African institutions, organizations and leadersShowing you care: An empathetic approach to doctor–patient communicationEmpathy and affect: what can empathied bodies do?Computational Analysis and Simulation of Empathic Behaviors: a Survey of Empathy Modeling with Behavioral Signal Processing FrameworkPsychosocial burden in medical students and specific prevention strategiesClinician empathy is associated with differences in patient–clinician communication behaviors and higher medication self-efficacy in HIV careClarifying empathy: the first step to more humane clinical careGiving End-of-Life Spiritual CareRisks, Benefits, and Patients' Treatment Decisions at the End of LifeThe Social Side of Pain: What Does it Mean to Feel Another's Pain?Effects of changing practitioner empathy and patient expectations in healthcare consultationsRelationship BuildingResponding to EmotionsNonpharmacologic Options for Treating Acute and Chronic PainEnhancing international medical graduates' communication: the contribution of applied linguisticsCare Management by Oncology Nurses To Address Palliative Care Needs: A Pilot Trial To Assess Feasibility, Acceptability, and Perceived Effectiveness of the CONNECT InterventionMindfulness-Based Supportive Therapy (MBST)Empathetic attitudes of undergraduate paramedic and nursing students towards four medical conditions: A three-year longitudinal studyEmpathy: what does it mean for GPs? A qualitative studyEnd-of-Life Issues: SpiritualityRoutine, empathic and compassionate patient care: definitions, development, obstacles, education and beneficiariesApproach to the Patient with Multiple Somatic SymptomsClinical Examiners, Simulated Patients, and Student Self-assessed Empathy in Medical Students During a Psychiatry Objective Structured Clinical ExaminationResidents' and standardized patients' perspectives on empathy: Issues of agreementDiagnosis and treatment of narcotic bowel syndromeInterdisciplinary Approaches to the Phenomenology of Auditory Verbal HallucinationsDevelopment and Evaluation of a 4-year Communication Curriculum in Motivational Interviewing Techniques for Behavioral ChangeThe REDE Model of Healthcare Communication: Optimizing Relationship as a Therapeutic AgentHow do primary care physicians respond when patients cry during routine ambulatory visits?Validity and reliability of the Japanese version of the CARE Measure in a general medicine outpatient settingUnderstanding Patient Satisfaction Ratings for Radiology Services"In the Beginning . . . "The Experiences of Suffering of Palliative Care Informal Caregivers in MalaysiaThe final goodbyeConsidering the development of doctor-patient relationships: a call and a cautionCompassionate care: Enhancing physician–patient communication and education in dermatologyThe Psychophysics of Transition to Long Term CareSuffering, Hope, and HealingStructureEffectiveness of empathy in general practice: a systematic reviewStudents Meeting with Caregivers of Cancer Patient: Results of an Experience-Based Learning ProjectAn exploration of empathy and correlates among Taiwanese nursesThree types of ambiguity in coding empathic interactions in primary care visits: Implications for research and practiceUser interactions with an affective nutritional coachProviding support to patients in emotional encounters: A new perspective on missed empathic opportunitiesBuoyancy: A Model for Self-Reflection about Stress and Burnout in Oncology ProvidersA longitudinal study of changes in provider–patient interaction in treatment of localized prostate cancerCharacterizing changes in student empathy throughout medical schoolThe role of poetry and prose in medical education: the pen as mighty as the scalpel?A Steinian approach to an empathic understanding of hope among patients and clinicians in the culture of palliative careTo Suffer With: The Poetry of CompassionThe Role of Empathy in Therapy and the Physician-Patient RelationshipDeveloping New Dental Communication Skills Assessment Tools by Including Patients and Other StakeholdersEthics Consultation and EmpathyEmpathy Decline and Its Reasons: A Systematic Review of Studies With Medical Students and ResidentsEmpathyExploring the nature of value in the word-of-mouth referral equation for health careUnderstanding and Managing the Fearful Dental PatientWhat does care mean? Perceptions of people approaching the end of lifeThe benefit of meeting a stranger: Experiences with emotional support provided by nurses among Danish-born and migrant cancer patientsClinical Application of ASCEND: A Pathway to Higher Ground for CommunicationExploring and overcoming barriers to clinical empathic communicationComparing a Self-Administered Measure of Empathy with Observed Behavior Among Medical StudentsDoctor–Patient Communication in Glaucoma CareCaring in medicine: missed opportunity for healing?Patient-Centered Communication to Assess and Enhance Patient Adherence to Glaucoma MedicationSymptom Burden, Depression, and Spiritual Well-Being: A Comparison of Heart Failure and Advanced Cancer PatientsAnalyzing the "nature" and "specific effectiveness" of clinical empathy: A theoretical overview and contribution towards a theory-based research agendaCritical elements of culturally competent communication in the medical encounter: A review and modelExpanding Clinical Empathy: An Activist PerspectiveThe Interviewer's Questions"Enough about Me, Let's Get Back to You": Physician Self-disclosure during Primary Care EncountersDiane S. Morse, MD, Susan H. McDaniel, PhD, Lucy M. Candib, MD, and Mary Catherine Beach, MDRecognition, reflection, and role models: Critical elements in education about care in medicineCore Competencies in Palliative Care for Surgeons: Interpersonal and Communication SkillsPalliative symptom management in patients with heart failureEducational Perspectives: Difficult Conversations in the Neonatal Intensive Care UnitBreaking Bad News: Use of Cancer Survivors in Role-Playing ExercisesBeneficial Effects of Hypnosis and Adverse Effects of Empathic Attention during Percutaneous Tumor Treatment: When Being Nice Does Not SufficeAn empathy learning problem for HSI: To be empathic, self-improving and ambientEmpathy: Necessary for effective pain management?Defining the role of palliative care in older adults with heart failureCommunication and Decision-Making About Prognosis in Heart Failure CareEmpathy: improving the quality of the genitourinary medicine consultationThe Optomedical HistoryDeterminants and patient-reported long-term outcomes of physician empathy in oncology: A structural equation modelling approachA focus group study of veterinarians' and pet owners' perceptions of the monetary aspects of veterinary careA Cross-sectional Measurement of Medical Student EmpathyWithdrawing Life-Sustaining Treatment: Ethical ConsiderationsThe role of empathy in establishing rapport in the consultation: a new modelEmpathy, Emotion, and Ekstasis in the Patient–Physician RelationshipToward a Biopsychosocial Understanding of the Patient–Physician Relationship: An Emerging DialogueThe Anxious or Fearful Dental PatientDiscussing Prognosis: "How Much Do You Want to Know?" Talking to Patients Who Do Not Want Information or Who Are AmbivalentDiscussing resuscitation preferences with patients: Challenges and rewards"Nobody Understands": On a Cardinal Phenomenon of Palliative CareEvaluation of the nutrition counselling component of a fitness programme for children with disabilitiesRelationship-centered Care. A Constructive ReframingPhysician contributions to disparities in HIV/AIDS care: The role of provider perceptions regarding adherenceWithdrawing Life-Sustaining Treatment: Ethical ConsiderationsSystolic Hypertension in Older Persons: Complexities in Clinical Decision MakingClinical Decision Making during Public Health Emergencies: Ethical ConsiderationsBernard Lo, MD and Mitchell H. Katz, MDTo Feed or Not to Feed: Is That the Right Question?Doing empathy and sympathy: caring responses to troubles tellings on a peer support lineDiscussing health care costs with patientsHow to make the "difficult" patient encounter less difficultTalking About the Unthinkable: Perinatal/Neonatal Communication Issues and ProceduresDealing With Difficult Patients in Your Pain Practice5 Medicine as a moral epistemologyReview of The Renewal of Generosity: Illness, Medicine, and How to Live.Invite, Listen, and Summarize: A Patient-Centered Communication TechniquePersonal Illness Narratives: Using Reflective Writing to Teach EmpathyImproving Communication Among Attending Physicians, Long-Term Care Facilities, Residents, and Residents' FamiliesMeasuring Social Aspects in the Physician/Patient RelationshipThe office approach to the obese patientSome Words That Matter"I Wish Things Were Different": Expressing Wishes in Response to Loss, Futility, and Unrealistic HopesTimothy E. Quill, MD, Robert M. Arnold, MD, and Frederic Platt, MDYou Say Self-Interest, I Say AltruismMedical Student Burnout 7 August 2001Volume 135, Issue 3Page: 221-227KeywordsEmotionsFearHearingHeartPatient advocacyPostural controlPreventive medicineTemperatureTouchTreatment guidelines ePublished: 7 August 2001 Issue Published: 7 August 2001 CopyrightCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...

Referência(s)