"Genuine and fundamentally human": a qualitative study into Dutch humanist chaplains' conceptualizations of empathy.

Empathy has been highlighted as a key concept in chaplaincy care, but its meaning has hardly been explored in depth within this field. This study aims to help develop stronger conceptual clarity by investigating humanist chaplains' conceptualizations of empathy. Data were collected through semi-structured interviews with twenty humanist chaplains working in health care, military, and prisons. A qualitative design was employed to clarify which components and features constitute empathy in humanist chaplaincy care. Empathy emerges as a multidimensional concept that is "fundamentally human." Chaplains distinguish between true and pseudo empathy based on different features including authenticity and concern. This article provides a conceptual model that combines the different components and features of empathy in humanist chaplaincy care and the relationship between them in light of empathy's humanizing quality. It may be used for educational purposes and could function as a conceptual framework for future research efforts.

Engaging otherness: care ethics radical perspectives on empathy.

Throughout the years, care ethicists have raised concerns that prevalent definitions of empathy fail to adequately address the problem of otherness. They have proposed alternative conceptualizations of empathy that aim to acknowledge individual differences, help to extend care beyond one's inner circle, and develop a critical awareness of biases and prejudices. We explore three such alternatives: Noddings' concept of engrossment, Meyers' account of broad empathy, and Baart's concept of perspective-shifting. Based on these accounts, we explain that care ethics promotes a conceptualization of empathy that is radical in its commitment to engage otherness and that is characterized by being: (1) receptive and open, (2) broad and deep in scope, (3) relational and interactive, (4) mature and multifaceted, (5) critical and reflective, (6) disruptive and transformative. This type of empathy is both demanding and rewarding, as it may inspire health professionals to rethink empathy, its challenges, and its contribution to good care and as it may enrich empathy education and professional empathy practices in health care.

"We Need to Talk About Empathy": Dutch Humanist Chaplains' Perspectives on Empathy's Functions, Downsides, and Limitations in Chaplaincy Care.

This paper investigates the functions, downsides, and limitations of empathy in chaplaincy care. Data were collected from 20 humanist chaplains working in health care, prison, and military settings using semi-structured interviews. According to the participants, empathy is at the heart of their profession but has disadvantages as well. The analysis yields seven major functions of empathy with corresponding downsides and limitations: (1) to connect, (2) to understand, (3) to guide, (4) to acknowledge, (5) to motivate, (6) to inspire, and (7) to humanize. We argue for a need to "talk about empathy" since despite its importance and challenges, there is little professional and academic discussion about empathy in chaplaincy care. We hope that the findings of this study can function as starting points for the discussion and thus contribute to the ongoing professionalization of chaplaincy care. To that end, we propose three topics for further reflection and conversation.

Towards a relational conceptualization of empathy.

Empathy is a fundamental concept in health care and nursing. In academic literature, it has been primarily defined as a personal ability, act or experience. The relational dimensions of empathy have received far less attention. In our view, individualistic conceptualizations are restricted and do not adequately reflect the practice of empathy in daily care. We argue that a relational conceptualization of empathy contributes to a more realistic, nuanced and deeper understanding of the functions and limitations of empathy in professional care practices. In this article, we explore the relational aspects of empathy, drawing on sources that offer a relational approach, such as the field of care ethics, the phenomenology of Edith Stein and qualitative research into interpersonal and interactive empathy. We analyse the relational aspects of three prevalent components of empathy definitions: the underlying ability or act (i.e. the cognitive, affective and perception abilities that enable empathy); the resulting experience (i.e. empathic understanding and affective responsivity) and the expression of this experience (i.e. empathic expression). Ultimately, we propose four inter-related understandings of empathy: (a) A co-creative practice based on the abilities and activities of both the empathizer and the empathee; (b) A fundamentally other-oriented experience; (c) A dynamic, interactive process in which empathizer and empathee influence each other's experiences; (d) A quality of relationships.

Care ethics: An ethics of empathy?

BACKGROUND: Empathy is a contested concept in the field of care ethics. According to its proponents, empathy is a unique way to connect with others, to understand what is at stake for them, and to help guide moral deliberation. According to its critics, empathy is biased, inaccurate or a form of projection that does not truly grasp and respect the otherness of the other, and that may be distorted by prejudices. OBJECTIVES: We aim to contribute to a better understanding of the significance of empathy in care ethics by reviewing both the functions and limitations of empathy in this field. RESEARCH DESIGN: Drawing on literature from care ethics and closely related fields, we identify the relevant functions and limitations of empathy from the relational, epistemic, normative, and political perspectives. These perspectives are drawn from four main characteristics of care ethics, which serve as a concise framework for understanding the significance of empathy. PARTICIPANTS AND RESEARCH CONTEXT: This article is written as part of an empirical and theoretical research project that aims to better understand the functions and limitations of empathy in care practices, from the perspective of care ethics. ETHICAL CONSIDERATIONS: We try to do justice to both the appraisal and critique of empathy in the care ethics literature. FINDINGS: Our findings stress that the relationship between care ethics and empathy is complicated and rife with opposing views. Therefore, we conclude that care ethics is not an ethics of empathy. DISCUSSION AND CONCLUSION: Based on our findings, we formulate pathways that may guide the further analysis of empathy in care practices and care ethics.

Self-report questionnaire for measuring presence: development and initial validation.

BACKGROUND: The concept of 'presence' appears frequently in the literature and seems to be a highly relevant concept in discussing and evaluating quality of relations in healthcare practices. However, no existing self-report measure of presence for health professionals was found. PURPOSE: The purpose of this study was (i) to develop a self-report questionnaire for measuring presence and (ii) to conduct initial psychometric testing of the questionnaire. METHOD: The process followed two steps. Phase 1 consisted of the development of 64 items that were derived from the 'theory of presence' (ToP) as developed by Andries Baart in the Netherlands in 2001. Face and content validity were completed by a panel of experts in ToP. A pilot study to test understandability was done (N = 22). During Phase 2, 48 remaining items of the Presence Questionnaire for Caregivers (PQ-C) were tested among 723 healthcare professionals. Exploratory principal component analysis was conducted, and reliability coefficients and known-group validity were assessed. RESULTS: Principal component analysis showed three new components that were labelled 'dedicated attitude', 'openness in perception' and 'reciprocal humaneness'. Thirty-one items were retained which explain 25.4% of the variance. An initial psychometric assessment of the shortened scale showed a Cronbach's alpha of 0.82 and a Spearman-Brown coefficient (for equal length) of 0.63. There were significant differences in sum scores between groups based on age, years of experience and familiarity with ToP. CONCLUSION: It appeared possible to develop a self-report questionnaire for measuring presence and establish face and content validity. In initial exploratory factor analysis, the eight theoretical principles of ToP used to develop the questionnaire were not reflected, and three new components appeared. Further research is needed to examine the value of the three new dimensions, and investigation into the construct validity and reliability of the three new components is recommended.