Preventing Burnout With Cognitive Empathy

Empathy expressed by a practitioner is important to patients—but empathy is also important for the practitioner. According to researchers from University of Montreal in Canada, empathic concern and perspective taking when treating patients can help prevent physician burnout.

Empathy and sympathy are 2 different concepts, and they can lead to different outcomes, the researchers say. For instance, in hypothetical situations, sympathetic physicians who “feel” their patients’ pain have used more health care resources than empathic ones who “know” their patients’ pain. Some authors, the researchers point out, believe that sympathy can be detrimental to objectivity in decision making and lead to compassion fatigue and burnout.

In their study, the researchers aimed to identify the best balance between empathic concern for the patient and affective distance necessary to maintain clinical neutrality and the physician’s own emotional equilibrium.

They gave questionnaires to 294 general practitioners: the Maslach Burnout Inventory to measure emotional exhaustion, depersonalization, and personal accomplishment; a subscale of the Jefferson Scale of Physician Empathy (JSPE) to measure perspective taking (seeing things from the patient’s point of view); and the Toronto Empathy Questionnaire to rate emotional concern.

A high level of perspective taking was associated with lower burnout. But contrary to their expectations, the researchers found that a higher level of empathic concern was also significantly associated with a lower proportion of burnout. The odds of experiencing burnout were significantly lower when physicians scored high on perspective taking (P < .001), high on empathic concern (P < .05), and high on both (P < .001). Empathic concern had no effect when perspective taking was low. The researchers speculate that when physicians are good at adopting the point of view of their patients, their emotional reaction and prosocial helping behaviors reduce the effect of exposure to stress.

Burnout was significantly associated with living alone (P < .05) and, to a certain extent, being a woman. Women had higher levels of emotional exhaustion (P < .01), lower levels of depersonalization (P < .05), and higher levels of empathic concern (P < .001) than did men. Burnout was also associated with lower scores on the JSPE measure of “standing in the patient’s shoes.”

Being sympathetic rather than empathic can lead to empathic overarousal or personal distress, the researchers say. Physicians may have trouble maintaining a sense of ownership regarding whose emotions belong to whom. According to the researchers, professionals need a high level of emotional regulation skills, that is, cognitive empathy.

But cognitive empathy takes work, the researchers suggest. According to them, it isn’t always easy to maintain emotional concern while keeping a safe distance. However, the benefits of staying engaged—just not too engaged—can be good for practitioners in several ways. Remaining open to the patients’ experience may lead to better mental health in physicians, the researchers say, and physicians have reported in other research that showing interest in the patient protected them from monotony. Moreover, good relationships with patients were reflected in patient gratitude, the researchers note, and that was another source of strength for the physician. Their findings, they say, “go a step further,” suggesting that cognitive empathy, but not affective empathy, when used independently, will lead to lower burnout and higher well-being.

Teaching emotion regulation and mindfulness should be part of the curricula for health care practitioners, the researchers say. Training physicians to keep the right amount of distance can help them help their patients—and themselves.

Source
Lamothe M, Boujut E, Zenasni F, Sultan S. BMC Family Practice. 2014;15:15.
doi: 10.1186/1471-2296-15-15.

Empathy expressed by a practitioner is important to patients—but empathy is also important for the practitioner. According to researchers from University of Montreal in Canada, empathic concern and perspective taking when treating patients can help prevent physician burnout.

Empathy and sympathy are 2 different concepts, and they can lead to different outcomes, the researchers say. For instance, in hypothetical situations, sympathetic physicians who “feel” their patients’ pain have used more health care resources than empathic ones who “know” their patients’ pain. Some authors, the researchers point out, believe that sympathy can be detrimental to objectivity in decision making and lead to compassion fatigue and burnout.

In their study, the researchers aimed to identify the best balance between empathic concern for the patient and affective distance necessary to maintain clinical neutrality and the physician’s own emotional equilibrium.

They gave questionnaires to 294 general practitioners: the Maslach Burnout Inventory to measure emotional exhaustion, depersonalization, and personal accomplishment; a subscale of the Jefferson Scale of Physician Empathy (JSPE) to measure perspective taking (seeing things from the patient’s point of view); and the Toronto Empathy Questionnaire to rate emotional concern.

A high level of perspective taking was associated with lower burnout. But contrary to their expectations, the researchers found that a higher level of empathic concern was also significantly associated with a lower proportion of burnout. The odds of experiencing burnout were significantly lower when physicians scored high on perspective taking (P < .001), high on empathic concern (P < .05), and high on both (P < .001). Empathic concern had no effect when perspective taking was low. The researchers speculate that when physicians are good at adopting the point of view of their patients, their emotional reaction and prosocial helping behaviors reduce the effect of exposure to stress.

Burnout was significantly associated with living alone (P < .05) and, to a certain extent, being a woman. Women had higher levels of emotional exhaustion (P < .01), lower levels of depersonalization (P < .05), and higher levels of empathic concern (P < .001) than did men. Burnout was also associated with lower scores on the JSPE measure of “standing in the patient’s shoes.”

Being sympathetic rather than empathic can lead to empathic overarousal or personal distress, the researchers say. Physicians may have trouble maintaining a sense of ownership regarding whose emotions belong to whom. According to the researchers, professionals need a high level of emotional regulation skills, that is, cognitive empathy.

But cognitive empathy takes work, the researchers suggest. According to them, it isn’t always easy to maintain emotional concern while keeping a safe distance. However, the benefits of staying engaged—just not too engaged—can be good for practitioners in several ways. Remaining open to the patients’ experience may lead to better mental health in physicians, the researchers say, and physicians have reported in other research that showing interest in the patient protected them from monotony. Moreover, good relationships with patients were reflected in patient gratitude, the researchers note, and that was another source of strength for the physician. Their findings, they say, “go a step further,” suggesting that cognitive empathy, but not affective empathy, when used independently, will lead to lower burnout and higher well-being.

Teaching emotion regulation and mindfulness should be part of the curricula for health care practitioners, the researchers say. Training physicians to keep the right amount of distance can help them help their patients—and themselves.

Source
Lamothe M, Boujut E, Zenasni F, Sultan S. BMC Family Practice. 2014;15:15.
doi: 10.1186/1471-2296-15-15.

Empathy expressed by a practitioner is important to patients—but empathy is also important for the practitioner. According to researchers from University of Montreal in Canada, empathic concern and perspective taking when treating patients can help prevent physician burnout.

Empathy and sympathy are 2 different concepts, and they can lead to different outcomes, the researchers say. For instance, in hypothetical situations, sympathetic physicians who “feel” their patients’ pain have used more health care resources than empathic ones who “know” their patients’ pain. Some authors, the researchers point out, believe that sympathy can be detrimental to objectivity in decision making and lead to compassion fatigue and burnout.

In their study, the researchers aimed to identify the best balance between empathic concern for the patient and affective distance necessary to maintain clinical neutrality and the physician’s own emotional equilibrium.

They gave questionnaires to 294 general practitioners: the Maslach Burnout Inventory to measure emotional exhaustion, depersonalization, and personal accomplishment; a subscale of the Jefferson Scale of Physician Empathy (JSPE) to measure perspective taking (seeing things from the patient’s point of view); and the Toronto Empathy Questionnaire to rate emotional concern.

A high level of perspective taking was associated with lower burnout. But contrary to their expectations, the researchers found that a higher level of empathic concern was also significantly associated with a lower proportion of burnout. The odds of experiencing burnout were significantly lower when physicians scored high on perspective taking (P < .001), high on empathic concern (P < .05), and high on both (P < .001). Empathic concern had no effect when perspective taking was low. The researchers speculate that when physicians are good at adopting the point of view of their patients, their emotional reaction and prosocial helping behaviors reduce the effect of exposure to stress.

Burnout was significantly associated with living alone (P < .05) and, to a certain extent, being a woman. Women had higher levels of emotional exhaustion (P < .01), lower levels of depersonalization (P < .05), and higher levels of empathic concern (P < .001) than did men. Burnout was also associated with lower scores on the JSPE measure of “standing in the patient’s shoes.”

Being sympathetic rather than empathic can lead to empathic overarousal or personal distress, the researchers say. Physicians may have trouble maintaining a sense of ownership regarding whose emotions belong to whom. According to the researchers, professionals need a high level of emotional regulation skills, that is, cognitive empathy.

But cognitive empathy takes work, the researchers suggest. According to them, it isn’t always easy to maintain emotional concern while keeping a safe distance. However, the benefits of staying engaged—just not too engaged—can be good for practitioners in several ways. Remaining open to the patients’ experience may lead to better mental health in physicians, the researchers say, and physicians have reported in other research that showing interest in the patient protected them from monotony. Moreover, good relationships with patients were reflected in patient gratitude, the researchers note, and that was another source of strength for the physician. Their findings, they say, “go a step further,” suggesting that cognitive empathy, but not affective empathy, when used independently, will lead to lower burnout and higher well-being.

Teaching emotion regulation and mindfulness should be part of the curricula for health care practitioners, the researchers say. Training physicians to keep the right amount of distance can help them help their patients—and themselves.

Source
Lamothe M, Boujut E, Zenasni F, Sultan S. BMC Family Practice. 2014;15:15.
doi: 10.1186/1471-2296-15-15.