Defining clinical empathy: a grounded theory approach from the perspective of healthcare workers and patients in a multicultural setting

OBJECTIVE: To define clinical empathy from the perspective of healthcare workers and patients from a multicultural setting. DESIGN: Grounded theory approach using focus group discussions. SETTING: A health cluster in Singapore consisting of an acute hospital, a community hospital, ambulatory care teams, a medical school and a nursing school. PARTICIPANTS: 69 participants including doctors, nurses, medical students, nursing students, patients and allied health workers. MAIN OUTCOME MEASURES: A robust definition of clinical empathy. RESULTS: The construct of clinical empathy is consistent across doctors, nurses, students, allied health and students. Medical empathy consists of an inner sense of empathy (imaginative, affective and cognitive), empathy behaviour (genuine concern and empathic communication) and a sense of connection (trust and rapport). This construct of clinical empathy is similar to definitions by neuroscientists but challenges a common definition of clinical empathy as a cognitive process with emotional detachment. CONCLUSIONS: This paper has defined clinical empathy as ‘a sense of connection between the healthcare worker and the patient as a result of perspective taking arising from imaginative, affective and cognitive processes, which are expressed through behaviours and good communication skills that convey genuine concern’. A clear and multidimensional definition of clinical empathy will improve future education and research efforts in the application and impact of clinical empathy.