Page 181 - Encyclopedia of Nursing Research

148 n END-OF-LiFE PLANNiNG AND CHOiCES

engagement in learning about empathy. The research and growth in our understanding of
investigator assigned subjects to intervention empathy, the art of nursing can be enhanced
E and control groups. The intervention group and improved outcomes for clients will be
received empathy exercises involving the use achieved.
of a reproduction of Edvard Munch’s paint-
ing, The Sick Girl, to stimulate discussion and Dianna Hutto Douglas
account making regarding interpretations of
empathy depicted in the painting. There was
a significant improvement in the intervention
group members’ levels of empathy as com- EnD-of-lifE planning
pared with the matched control group. The
research findings supported the use of art anD choicEs
as a complementary strategy to theoretical
knowledge on empathy to stimulate nurses’
basic empathy. The decision to choose or appoint another to
Continued research into the biological make health care and end-of-life (EOL) treat-
basis for empathy is certainly on the horizon. ment decisions for one in the event of tem-
Development of tools that more accurately porary or permanent loss of decision-making
measure empathy is required. Simulation capacity is less risky and requires less cogni-
laboratories in nursing education are a fitting tive capacity than the creation of a list of treat-
venue for continued investigation. Research ments desired and not desired at some point
into the development of scenarios that have in the future. There is no “gold standard”
been shown to enhance empathy is neces- to assess decisional capacity; mental status
sary. Research focused on interventions that assessment tests cannot be the sole criterion.
facilitate emotional development and allow Decision making is retained in early demen-
students and caregivers to develop empathic tia, especially insofar as appointing a trusted
capability and self-awareness is needed. other to make health care decisions for one’s
More research is indicated in the areas of cli- self (Kim & Karlawish, 2002). Using the tech-
ents’ perception of empathy. nique of paraphrased recall and reflection,
Over the past 40 years, empathy has Mezey, Tersei, Ramsey, Mitty, and Bobrowitz
been conceptually and empirically advanced (2002) developed a set of guidelines to deter-
in the nursing literature. Studies have raised mine if nursing home (NH) residents had the
critical questions about the nature of empathy capacity sufficient to create a Durable Power
and how empathy may or may not be teach- of Attorney for Health Care (i.e., a Health
able using various educational and experien- Care Proxy [HCP]). Analysis indicated that
tial strategies. Research findings suggest that many mild cognitively impaired residents
baseline measurements of empathy in nurses had this capacity. Mezey et al. suggest that
and nursing students can be a starting point the guidelines are more predictive than the
for developing strategies to enhance empathic Mini Mental State Examination in identi-
response to clients. Nursing as a profession fying such residents and could be used for
needs more replication of studies to identify determining decision-making capacity suffi-
basic empathy skills and to discern the dif- cient to create an HCP.
ferential impact of empathy education versus Nurses lack confidence in assisting peo-
empathy education combined with experi- ple make decisions about care preferences at
ential exercises in empathic understanding the EOL (Jezewski et al., 2005). Education of
such as simulation, reflective insight, art, health care professionals can make a differ-
film, music, and literature. With continued ence in advance direction (AD) completion