Exploration of empathy-enhancing interventions and the prevalence of mentalization within the field of nursing

Abstract

BACKGROUND: Empathy is considered an important component of Person Centred Care (PCC), as is the process of mentalization in the successful application of sensitive care -giving. Both concepts can overlap, with empathy underpinning mentalization. Nurses tend to work within emotionally-charged environments, which can cause excess pressure and negatively impact both empathy, and the ability to mentalize. Nurses, however, require resilient empathy and mentalizing skills to be able to adequately cope with such levels of pressure.

METHODS: This thesis systematically reviewed research which promoted empathy-enhancing interventions, particularly those aimed at nurses. An empirical study was conducted to investigate the mentalizing ability of registered mental health nurses (RMNs) by means of a self-reported measure, and a narration of a critical incident. Additionally, a wellbeing outcome measure was completed by participants to investigate whether mentalizing ability could predict wellbeing.

RESULTS: Empathy-enhancing interventions were perceived to be successful, with thirteen studies finding significant improvements to empathy levels of nurses. The sustained treatment effect of the interventions is, however, unknown. The empirical study showed that self-reported high mentalizing ability was a significant predictor of compassion satisfaction (wellbeing measure). By contrast, inferred mentalizing ability from participant narratives had no association with self-reported ability and was not a predictor of wellbeing.

CONCLUSION: Empathy levels of nurses can be enhanced to some extent, an important factor in the successful delivery of PCC. However, future research with standardised interventions and more rigorous study designs are required in order to understand whether the enhanced empathy levels can be sustained over time. The results from the empirical study suggested effective mentalizing skills predicted positive wellbeing, a potential protective factor for mental health. The study however was underpowered, therefore the results may only be considered preliminary. Future research is required with an adequately powered sample.