Development and Sustainability of Empathy Among Nurses in Kenya

Abstract

Background: Empathy is a crucial competence in nursing care that involves cognitive-social-professional responses to human need for affection, understanding and help. Empathy is highly associated with altruistic nursing character or caring behaviours observed during nurse-patient transactions. The benefits of empathy include expedited and improved health outcomes for patients and professional wellbeing for nurses. Training nurses on empathy has been associated with positive social and clinical outcomes. Regardless of the benefits of empathy, training for nurses has consistently shown inadequate and inconsistent resources and strategies for development and sustainability of empathy in nursing practice. Aim: The study aimed at conducting a needs analysis, develop and implement an intervention intended to promote development and sustainability of empathy among nurses in Kenya. Methodology: A multi-stage mixed method design was adopted in this research: first phase involved three stage needs analysis while the intervention phase involved three stages. The empathy training needs analysis had exploratory – explanatory sequential approach, quasi experimental design and participant observation were applied included 154 nurses whose information provided basis and rationale for the intervention. The intervention population involved a stratified sample of 384 nurses selected from the four hospital that were participating. A training intervention was developed, implemented, and the pre/post scores compared. The pre-post training questionnaire assessed nurses’ knowledge on observable characteristics related to empathy, factors that favoured development of empathy, factors that favoured sustainability of empathy and factors that hindered both development and sustainability of empathy among nurses. The study variables were statistically compared using a paired samples t-test and variable effect size estimation. Findings: Needs analysis showed gaps in knowledge and skill in integrating empathy in nursing practice. The need to intervene using a constructivist approach by locally developed empathy training tool formed the basis of the training intervention. Factor analysis showed that dependent variables had positive influences on empathy development. Knowledge on observable characteristics related to developing and sustaining empathy was reportedly low during baseline analysis but a significant increase was achieved following the intervention. The knowledge scores on the factors that favoured development of empathy improved significantly following training (Mb=0.50, Me=0.87), t(384), =-12.80, p<0.05. Similarly. significant improvements in empathy development skill was observed (Mb=0.48, Me=0.88), t(384), =-14.13, p<0.05; and sustainability in nursing practice (Mb=0.66, Me=0.83), t(384), =-6.23, p<0.05. Significant change in awareness on sustainability of empathy among nurses (Mb=0.34, Me=0.66), t(384), =-9.75, p<0.05 was achieved. Hypothesis tests showed significant relationship between the intervention and empathy knowledge/skill achievement (0.4 - 0.8 ± 0.07; p=0.001). Conclusion: empathy development and sustainability among nurses in Kenya was to be achieved through training on empathy knowledge and skill. The contextualised need analysis strategy for developing and sustaining empathy established that a training need existed. Baseline study showed that knowledge was ranging from low to average. Substantial gains in knowledge and observable empathy behaviours was achieved; this gain is attributable to empathy training intervention. Recommendations: Empathy training module should be implemented to all nurses in Kenya Key Words: Emotional intelligence, Empathy - development, Sustainability, Self-determinism