Using Emotional Empathy to Reduce Workplace Stress and Horizontal Workplace Violence in Healthcare Professionals

Patricia Littlejohn

    Research output: ThesisDoctoral Thesis

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    Growing evidence from the social sciences suggests that focusing on the empathic self could assist in reducing the workplace stress of health professionals; and in decreasing levels of horizontal violence in health-related workplace settings. The purpose of this research was to test
    the possibility of, firstly, increasing awareness of emotional empathy in a healthcare setting; secondly, increasing levels of emotion empathy in health professionals, with a view to reducing instances of workplace violence; and thirdly, increasing emotional empathy, with a view to decreasing levels of workplace stress.

    The ethics approved study was conducted utilizing a mixed-methods design that incorporated both quantitative (‘Survey’) and qualitative (‘Qualitative Description’) approaches to collecting data. Participants were recruited from inpatient surgical staff and ambulatory surgical staff located within a perioperative health setting located in the United States of America. Participants located in the inpatient surgical setting received interventions that included education, focus group discussions, and one-to-one interviews. Participants located in the ambulatory surgical setting received no interventions and thereby formed a ‘control’ group. Data were collected using both quantitative and qualitative approaches, with the participants in the control group participating in the quantitative data collection alone.

    Quantitative data were obtained through three validated instruments: Balanced Emotional Empathy Scale, Perceived Workplace Stress Scale and Horizontal Workplace Violence Survey. These questionnaires were tested at three individual time intervals (beginning, middle and end of
    the data collection period). Analyses of data generated by the three questionnaires included time (survey event) and group influences, both of which were tested for statistical significance. The initial quantitative results (beginning of data collection period) revealed real time knowledge of
    the actual workplace violence, stress and empathy levels of staff, across the three survey times. These results were collated, at the three different intervals, and used by the researcher to guide the development of the educational and focus group intervention sessions.

    The qualitative approach used questions adapted from the three survey instruments, and preliminary findings, to guide focus group discussions and one-to-one interviews. This permitted a deeper understanding of the issues being studied and also provided a means by which participants could reflect upon their learning and support development of empathy awareness and/or emotional empathy in staff.

    Results from the statistical analysis of the surveys were not definitive. For example, despite the use of an educational intervention to raise awareness of develop emotional empathy, the empathy and perceived horizontal workplace violence raw scores were different for the two groups. Interestingly, perceived workplace stress, overall, was not statistically different – although the control group demonstrated higher levels of empathy. Also, there was a significant difference in conflict scores – with the intervention group scoring higher. Likewise, the intervention group showed no statistically significant changes in levels or emotional empathy nor perceived workplace stress, despite the interventions received.

    The study revealed significant differences in the groups themselves. For example, the control group – that is, those who worked in the ambulatory surgical setting – demonstrated higher levels of empathy. Though the study did not attempt to understand this result in and of itself, the results did suggest two things. Firstly, awareness raising and education alone is not the answer to the challengs of workplace violence nor in increasing levels of emotional empathy. Secondly, there is a need for further study on how to increase empathy levels and reduce WPV
    for staff working in a highly stressful inpatient surgery area with more critically ill patients.

    Findings from the qualitative findings were valuable as they provided additional insights into the factors that generate high levels of empathy in perioperative staff. Participants were provided with an opportunity to consider the issues involved and suggest how changes could be made, in the future.

    The exegesis concludes with a discussion of the possible causative factors for the results. It also identifies the practice change that was effected by the study. For example, many researchers suggest ‘more education’ as the answer to a range of issues. This study found that education did not make a different – and suggests a different way forward, for managers of the
    future. Also of note was the cultural change that was effected for participants by virtue of their involvement. Many clinicians see research as an activity that ‘someone else’ undertakes or participates in. Involvement in this research enabled the research participants to see how they can be part of an evidence-based practice solution.

    Following this discussion, recommendations are provided for practice change. Additional recommendations are also made in relation to the future research that is needed, to more closely consider the difference in these conflict and empathy scores between the intervention and control
    groups located in the perioperative settings.

    Original languageEnglish
    QualificationDoctor of Health Science
    Awarding Institution
    • Charles Sturt University
    • Crowther, Andrew, Principal Supervisor
    • Kemp, Michael, Co-Supervisor
    Award date07 Nov 2018
    Publication statusPublished - 2018


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