Concept Analysis in the Nursing Field



A Concept Analysis of Empathy






Running head: EMPATHY CONCEPT 2


Empathy is an essential concept in nursing, and it underlies the practice of healthcare provision. The concept of empathy can be a valuable tool for a nurse practitioner. Emotional connection on a human level can considerably enhance the patient-caregiver interaction. This can be achieved via the nurse’s ability to share the patient’s mood, show compassion, and desire to assist by providing the best care possible. Overall, empathy can improve the quality of care, most importantly in terms of mental health. This paper reviews the attributes, synonyms, and concepts related to empathy as well as constructing models, similar, and opposite cases and providing an overview of the available empirical methods for measuring and promoting empathy. The aim of the analysis is to determine the definitional range and practical value, both objective and perceived, of empathy in the healthcare setting. It is especially crucial that healthcare practitioners, such as nurses, understand and, more importantly, possess the ability to empathize.

Keywords: Empathy, Model Case, Similar Case, Opposite Case, Preoperative Nurse.

A Concept Analysis of Empathy

Purpose of the Analysis

The term empathy was coined more than a century ago by the British psychologist Edward Bradford Titchener. Despite a long history of study and scholarly debate, empathy still lacks a single universally agreed definition (Cuff, Brown, Taylor, & Howat, 2016, p. 144). The variety of its definitions contributes to misunderstandings and misconceptions regarding this term, as well as its being used interchangeably with synonymous terms. The purpose of this concept analysis of empathy is to determine the definitional range and practical value, both objective and perceived, of empathy in the healthcare setting. It is crucial that healthcare practitioners, such as nurses, understand and, more importantly, possess the ability to empathize.

Uses of the Concept

In general terms, empathy is defined as the human ability to recognize and understand the feelings of other individuals and to respond appropriately. However, its original definition was different. Titchener defined it as “a process of humanizing objects, of reading or feeling ourselves into them” (as cited in Cuff et al., 2016, p. 147). With time, this concept evolved. Empathy received its dictionary definition as a term initially applied to psychology and aesthetics. According to Oxford University Press, empathy is “The power of identifying oneself mentally with a person or object of contemplation” (Butterfield, 2015, p. 211). Rogers classified empathy as “entering the private perceptual world of the other and becoming thoroughly at home in it” (as cited in Cuff et al., 2016, p. 148). Arguably, the best field-specific healthcare definition of empathy is as follows: “A cognitive and emotional understanding of another’s experience, resulting in an emotional response that is congruent with a view that others are worthy of compassion and respect and have intrinsic worth” (Barnett & Mann as cited in Cuff et al., 2016, p. 146). Briefly, the modern interpretation of empathy is the ability to be in someone else’s shoes.

Attributes of the Concept

The three main attributes associated with the concept of empathy are understanding, relationship, and communication. The practitioner-patient relationship is rooted in communication. Being able to communicate openly with the patient is a crucial component. Aside from the verbal part, communication presupposes respecting patients’ emotions and showing understanding via adequate body language. Hence, empathy is attributed to both verbal and nonverbal communication skills (Rohani, Kesbakhi, & Mohtashami, 2018, p. 1090). Effective communication together with a dynamic relationship should also involve the distribution of essential information, such as specialized knowledge of the patient’s medical and mental condition. This helps to form a therapeutic bond between the caregiver and care recipient. Understanding the patient’s experience and its attendant implications is the principal feature of empathy and empathetic engagement (Foley & Davis, 2017, p. 72). An empathetic relationship can enhance healthcare efficiency for patients in two ways. Firstly, it can allow a caregiver to acknowledge the patient’s concerns, retrieve valuable information, establish a more accurate diagnosis, and meet the overall needs of the patient (better outcomes of care). Secondly, an empathetic relationship gives the patient a sense of being valued, listened to, and understood (better patient outcomes) (Rohani et al., 2018, p. 1090). Understanding, communication, and relationship are mutually conditioning attributes.

Empathy is often confused and used interchangeably with the related concepts of sympathy and compassion. In healthcare literature, sympathy is defined as an emotional reaction of pity towards another individual due to an unfavorable, discomforting, or hurtful situation in which they find themselves, especially towards those whose suffering is considered unfair, undeserved, or excessive. In comparison, compassion implies mentally sharing suffering and can be defined as acknowledgment of another individual’s suffering and pain complemented by a desire to help relieve them. One definition of compassion is “a virtuous response that seeks to address the suffering and needs of a person through relational understanding and action” (Sinclair et al., 2016, p. 438). Another definition suggests that compassion is sympathy plus pity (Cuff et al., 2016, p. 145). Hence, sympathy and compassion are conceptually close but not completely interchangeable. Simply put, “An initial gloss on the distinction would be that while empathy is feeling with another, sympathy is feeling for them” (Smith, 2017, p. 716). Arguably, empathy is an umbrella term combining and merging the features of sympathy and compassion.

A Model Case

The following model case provides a clear example of empathy. A preoperative nurse enters a patient room to obtain consent and start preparing the patient for surgery. The nurse sees the patient crying and asks, “What is wrong? How can I help?” The patient states that he is very nervous about the surgery because he has never had surgery before, and he does not know why it is necessary. Empathy permits the nurse to remember being faced with an unknown situation and to recall feelings of uncertainty and fear. The preoperative nurse empathizes with the patient even though the nurse has not experienced this type of surgery. Empathy allows the preoperative nurse to understand why a patient would be nervous, and the nurse has the prerequisite knowledge to understand the reason for the surgery. The nurse responds by consoling the patient and stating, “I understand why you would be nervous. It is normal to feel nervous and anxious when dealing with a new situation.” The preoperative nurse then explains the procedure and the reason why the patient must undergo surgery. The preoperative nurse has demonstrated empathy through communication with the patient, acknowledging and understanding the patient’s emotions, and understanding his experience.

A Similar Case

A similar case that clearly illustrates empathy and its role in the patient-practitioner relationship is a patient diagnosed with late-stage cancer who was previously unaware of his condition. The chances of conquering the disease are low, but remission is possible. The patient hears the news from a doctor and, naturally, sees the most pessimistic scenario as the only possible one. A nurse feels empathy towards the patient. Even though the nurse has not personally experienced this disease, she tries to put herself in the patient’s shoes and imagine how he feels. This empathic act helps the nurse to find words of encouragement that sound sincere, letting the patient know he is cared for, understood, and supported. Since treatment depends mainly on the psychological state and determination of the patient, the patient must be optimistic and ready to endure the necessary procedures. Even though a positive result is not guaranteed, the focus is now on the patient.

An Opposite Case

A preoperative nurse enters a patient room to obtain consent and start preparing the patient for surgery. The nurse sees the patient crying and asks, “What is wrong?” The patient states that he is very nervous about the surgery because he has never had surgery before, and he does not know why the surgery is needed. The preoperative nurse responds to the patient, “I can imagine how anxious you must be, but the surgeon should be here soon, and you should ask the surgeon that question. I am not supposed to explain that to you.” The nurse then leaves the patient’s room. In such a case, a sympathetic nurse would feel and, perhaps, express pity towards the patient, but the components of being in his shoes, associating with him, and acting to reassure the patient are all absent.

Antecedents and Consequences

The significant antecedents of empathy are the intention to help and awareness of the sufferer’s state and needs. Here, the intention to help means readiness to be open to someone’s suffering. This is a need to serve people in distress or pain as an intrinsic, consistent, and unconditional quality or feeling existing in a potential care provider. Everyone who becomes a healthcare practitioner should be motivated by the personal intention to help people. Awareness is the ability to monitor the patient’s condition and know their habits to determine when they need help, assistance, or emotional support (Foley & Davis, 2017, p. 72). Awareness is closely related to attention, but it also includes a component of personal involvement with the patient in terms of intuitively feeling and not only medically determining their state.

A far-reaching, long-term positive consequence of empathy is patient-centered quality healthcare, where the attitudes of the care practitioner translate into patient satisfaction with the care provided (Foley & Davis, 2017, p. 73). It is especially important that the patient feels satisfied. Mental well-being is as important as physical well-being as a component of health. The nurse’s desire to help results in quality care and an increase in the patient’s mental satisfaction, coupled with a positive physiological reaction to adequate, targeted, thoughtful care.

Empirical Methods for Measuring Empathy

Empathy is a necessary constituent in the new patient-centered care delivery. The importance and positive effects of empathy as a nursing tool are best evidenced by research on the role of empathy in severe, fatal, or potentially incurable conditions, such as cancer. Researchers generally agree that empathy is an essential communication skill in healthcare, especially in such settings (Alkan, 2017; Rohani et al., 2018). In the context of oncology-related care, empathy is especially needed. The nurse’s mastery of empathy results in more effective patient-centered consultations as a part of intervention programs (Rohani et al., 2018, p. 1089). These and other studies suggest that nurses need to be capable of empathy, since this facilitates the treatment process in healthcare practices in general and particularly in cases with seriously ill patients.

Recent studies investigating empathy as an integral part of the healthcare framework have identified a trend of erosion of empathy in healthcare education and clinical practice (Sinclair et al., 2016, p. 438). This is disturbing, since empathy can be a valuable tool for nurses, without which modern healthcare is unimaginable. This finding establishes two requirements: adequate measurement strategies and strategies to promote empathy. The available methods for measuring empathy levels include 1) self-report measures through written questionnaires; 2) behavioral measures (tests aimed at evaluating experimental stimuli and performance), and 3) neuroscientific measures with brain imaging tests (Neumann, Chan, Boyle, Wang, & Westbury, 2015, p. 259). Strategies for promoting empathy and ensuring that this component is present in the healthcare framework include, but are not limited to, incorporating empathy parameters in job interviews; empathy education and training within healthcare organizations via courses and workshops; talking about empathy and automating its use by including it in all communications within the setting, such as emails, phone conversations, and educational modules; an organized advisory board of patients and caregivers; and surveying patients to receive feedback on care provided and improve care based on data retrieved (Nelson, 2017). These strategies, selected and combined in optimal ways, can help build and promote a culture of empathy.


It is vitally important that healthcare practitioners, such as nurses, understand and, more importantly, possess the ability to empathize. The concept of empathy, which has multiple definitions, is a complex interpersonal construct revolving around awareness and uniting the features of compassion and sympathy. Empathy lies at the core of modern healthcare together with patient-practitioner relationships. The ability to empathize is a nurse practitioner’s tool in enhancing care provision and patient satisfaction. Some researchers have demonstrated that additional research is needed to determine the levels of nurse understanding, inherent empathy, and training needed to foster a culture of empathy among healthcare practitioners.


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