The association between empathy and the nurse–patient therapeutic relationship in mental health units: a cross‐sectional study

• Published in: Journal of psychiatric and mental health nursing Vol. 28; no. 3; pp. 335 - 343
• Main Authors: Moreno‐Poyato, Antonio R., Rodríguez‐Nogueira, Óscar
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-06-2021
• Subjects: acute care; acute mental health; Cross-sectional studies; Empathy; Inpatient care; Mental disorders; Mental health; Mental institutions; Nurse patient relationships; Nurses; Nursing; Psychiatric-mental health nursing; therapeutic relationships; empathy; acute mental health; therapeutic relationships; acute care
• ISSN: 1351-0126; 1365-2850
• DOI: 10.1111/jpm.12675

Accessible summary
What is known on the subject?
Empathy is one of the main attributes for establishing the nurse–patient therapeutic relationship. Davis (1983) identified four components on an empathic response: perspective taking, fantasy, empathetic concern and personal distress.
It is essential to deepen our knowledge on the influence of the dimensions of empathy for the construction and development of the therapeutic alliance during the different phases of the therapeutic relationship.
What the paper adds to existing knowledge?
A significant association exists between the dimensions of empathy and the construction and development of the therapeutic alliance during the different phases of the therapeutic relationship between nurses and patients in mental health units.
This study shows that the nurses' perspective on the patient's situation improves the bond, and therefore, this skill is especially useful in the first phase or orientation phase of the therapeutic relationship. However, for the second phase or working phase of the therapeutic relationship, a greater empathic concern among nurses, together with less personal distress, improves collaborative goal setting with patients.
What are the implications for practice?
It is important for mental health nurses to be aware of the importance of personal self‐awareness and the emotional management of empathy for the construction and development of therapeutic relationships of quality with patients.
Knowledge of the relationship between each of the dimensions of empathy in the different stages of the therapeutic relationship is useful for the design of educational programmes, by including training on empathic strategies.
Introduction
Empathy and its dimensions (perspective taking, empathic concern, personal distress and fantasy) are essential for establishing the nurse–patient therapeutic relationship. It is important to know how this influences the construction and development of the therapeutic alliance during the different phases of the therapeutic relationship.
Aim
To examine whether the dimensions of empathy influence the nurse–patient therapeutic relationship within mental health units.
Method
A cross‐sectional design was used to collect data to measure the therapeutic alliance and the different dimensions of empathy via an online form completed by nurses working at 18 mental health units. Linear regressions were used in the analysis.
Results
A total of 198 participants completed the questionnaires. Nurses established a greater therapeutic alliance with patients when they were able to adopt their patient's perspective and experience concern.
Discussion
Nurses’ perspective taking is an influential factor impacting the nurse–patient bond in the orientation phase, whereas experiencing greater concern and decreased emotional distress were associated with improved therapeutic alliance in the working phase.
Implications for practice
These findings may help gain awareness among nurses of the importance of empathy in the nurse–patient relationships, as well as inform educational programmes, by including training in empathic strategies and emotional management.