A systematic review of research on empathy in health care

• Published in: Health services research Vol. 58; no. 2; pp. 250 - 263
• Main Authors: Nembhard, Ingrid M., David, Guy, Ezzeddine, Iman, Betts, David, Radin, Jennifer
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.04.2023; Health Research and Educational Trust
• Subjects: Analysis; Assessors; Care and treatment; Citations; Clinical outcomes; Cross-Sectional Studies; Data collection; Data search; Delivery of Health Care; Educational programs; Emotions; Empathy; Empirical analysis; Exceptions; Extraction; Health care; Health care reform; Health education; Health Personnel; Health status; Humans; impact; Influence; Information processing; Intervention; Literature reviews; Medical personnel; Medical research; Medical screening; Medicine, Experimental; Meta-analysis; Organizational aspects; Outcome and process assessment (Health Care); Outcome and process assessment (Medical care); Patient care; Patient compliance; Patient Experience; Patients; Personnel; Psychological aspects; Services; Statistical analysis; Systematic review; Trainees; United States; empathy; intervention; systematic review; patient experience; impact; health personnel
• ISSN: 0017-9124; 1475-6773
• DOI: 10.1111/1475-6773.14016

Objective To summarize the predictors and outcomes of empathy by health care personnel, methods used to study their empathy, and the effectiveness of interventions targeting their empathy, in order to advance understanding of the role of empathy in health care and facilitate additional research aimed at increasing positive patient care experiences and outcomes. Data Source We searched MEDLINE, MEDLINE In‐Process, PsycInfo, and Business Source Complete to identify empirical studies of empathy involving health care personnel in English‐language publications up until April 20, 2021, covering the first five decades of research on empathy in health care (1971–2021). Study Design We performed a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines. Data Collection/Extraction Methods Title and screening for study eligibility was followed by full‐text screening of relevant citations to extract study information (e.g., study design, sample size, empathy measure used, empathy assessor, intervention type if applicable, other variables evaluated, results, and significance). We classified study predictors and outcomes into categories, calculated descriptive statistics, and produced tables to summarize findings. Principal Findings Of the 2270 articles screened, 455 reporting on 470 analyses satisfied the inclusion criteria. We found that most studies have been survey‐based, cross‐sectional examinations; greater empathy is associated with better clinical outcomes and patient care experiences; and empathy predictors are many and fall into five categories (provider demographics, provider characteristics, provider behavior during interactions, target characteristics, and organizational context). Of the 128 intervention studies, 103 (80%) found a positive and significant effect. With four exceptions, interventions were educational programs focused on individual clinicians or trainees. No organizational‐level interventions (e.g., empathy‐specific processes or roles) were identified. Conclusions Empirical research provides evidence of the importance of empathy to health care outcomes and identifies multiple changeable predictors of empathy. Training can improve individuals' empathy; organizational‐level interventions for systematic improvement are lacking.