A group of researchers is working to systematically pinpoint and catalogue compassionate words and actions in doctor-patient conversations. By breaking down the dialogue and studying the context, they hope to create a behavioral taxonomy that will guide medical training and education.

“In health care, we believe in being compassionate but the reality is that many of us have a preference for technical and biomedical issues over establishing emotional ties,” said senior investigator Ronald Epstein, M.D., professor of Family Medicine, Psychiatry, Oncology, and Nursing and director of the University of Rochester Center for Communication and Disparities Research.

Epstein’s team recruited 23 oncologists from a variety of private and hospital-based oncology clinics in the Rochester, New York, area, according to a university press release. The doctors and their stage III or stage IV cancer patients volunteered to be recorded during routine visits. Researchers then analyzed the 49 audio-recorded encounters that took place between November 2011 and June 2012, and looked for key observable markers of compassion.

In contrast to empathy, compassion involves a deeper and more active imagination of the patient’s condition. An important part of this study, therefore, was to identify examples of the three main elements of compassion:

• Recognition of suffering

• Emotional resonance; and

• Movement toward addressing suffering.

Researchers also observed non-verbal communication, such as pauses or sighs at appropriate times, as well as speech features and voice quality (tone, pitch, loudness) and other metaphorical language that conveyed certain attitudes and meaning.

Compassion unfolds over time, the researchers concluded. “During the process, physicians must challenge themselves to stay with a difficult discussion, which opens the door for the patient to admit uncertainty and grieve the loss of normalcy in life,” the press release noted.

“It became apparent that compassion is not a quality of a single utterance but rather is made up of presence and engagement that suffuses and entire conversation,” the study said.

Related article: “Compassion Can Be Learned”

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