Empati och samspel : Studier ur ett sjuksköterskeperspektiv

Sammanfattning: The present study sets out to clarify the concept and phenomenon of empathy, its application in health and medical care, and in particular its significance for the nurse patient interaction.How does empathy occur and develop, and are there functional instruments which can be used to measure empathy in Swedish nurses and nursing students? How do nurses with different backgrounds view the phenomenon of empathy, and what effects do different levels of environmental factors have on nurses' interaction with patients?Addressing these issues, the employed theoretical perspective is that of symbolic interactionism. An educational interaction model is developed, showing the nurse's interaction with patients.Based on a literature study, a theory of empathy was developed. The empirical work encompassed evaluation by means of the Empathy Construct Rating Scale (ECRS, La Monica 1981) administered to 134 nursing students, interviews with 20 nurses in psychiatric and somatic care, and compilation of situational descriptions of 131 nurses and nursing students.Deducted construct descriptors were ego development, consciousness, role-taking, symbols, significant others, acts, and context. The occurrence of empathy can be described as taking place in three steps: decentring, role-taking, and showing a special quality of communicative behaviour. The ECRS instrument was easy to use, and, more importantly, had a high reliability. It cannot, however, answer the question of how a student functions in a clinical situation with a patient. The separate interviews showed that nurses themselves described empathy as including respect, insight, and understanding of others. In the context study, factors described as impediments to interaction were noticed on different levels; (i) the regional level in the form of its financial and organisational conditions, (ii) the local level in the form of its physical environment, staff co-operation, professional role, and type of environment, and (iii) the individual level as manifested in personality, nursing strategy, patient symptoms, and ability to communicate.It was concluded that the occurrence of empathy in a given situation depends on several factors, some of which are individual and some contextual. Empathy, although a very complex concept and phenomenon, is a viable factor in nurse patient interaction.