Objective Empathy and empathy education have been reviewed a number of times through systematic reviews and meta-analyses; however, the topic of ‘empathetic communication’ remains poorly understood when considering engaging in hospital-based research. Therefore, this scoping review aimed to explore the existing literature concerning empathetic communication in hospital settings and to evaluate the definitions presented. Design Scoping review. Data sources Systematic searches of the PubMed, CINAHL, Cochrane, PsycINFO, and PsycArticles databases were conducted. Study selection All English studies in which empathetic communication in hospital settings were explored. The search terms used included empathy, communication, hospital settings, providers, and consumers. Data extraction Data were assessed through the use of a pre-set analysis tool. Results After conducting the searches, 419 articles were identified, of which 26 were included in this review. No single article specifically defined the term ‘empathetic communication’; however, 33 unique definitions of ‘empathy’ were identified, of which 23 considered communication to be a component of empathy. There was a considerable lack of consistency between the empathy definitions, with some classifying communication in empathy as an ability and others classifying it as a dynamic process. Conclusion Future and contextually focused research is needed to develop a consistent and clear definition of empathetic communication and empathy within a hospital setting to better build positive healthcare cultures. Practice implications Inconsistencies between definitions of empathy in empathetic communication research could reduce the efficacy of future research gains and impact the translation of research findings into clinical practice.

Background: Obesity is a well-established risk factor for multi-morbidity and disability among older adults in the community and acute care settings. However, nursing home residents with body mass index (BMI) below 18.5 kg/m² and above 25.0 kg/m² have been understudied. We examined the prevalence of multi-morbidity and disability in activities of daily living (ADL) by BMI category and further investigated the association between BMI, multi-morbidity, and disability of ADL in a large cohort of older adults in nursing homes in New Zealand. Methods: A retrospective review of nursing home residents’ data obtained from the New Zealand International Resident Assessment Instrument national dataset from 2015 to 2018. One hundred ninety-eight thousand seven hundred ninety older adults (≥60 years) living in nursing homes were included. BMI was calculated as weight in kilograms (kg) divided by height in meters squared (m²). Multimorbidity was defined as the presence of ≥2 health conditions. The risk of disability was measured by a 4-item ADL self-performance scale. The prevalence ratio (PR) of the association between BMI and multi-morbidity and between BMI and disability in ADL was assessed using Poisson regression with robust variance. Results: Of the 198,790 residents, 10.6, 26.6, 11.3 and 5.4% were underweight, overweight, obese, and extremely obese, respectively. 26.4, 31.3 and 21.3% had one, two and three disease conditions, respectively, while 14.3% had four or more conditions. 24.1% could perform only one ADL, and 16.1% could perform none. The prevalence of multi-morbidity increased with increasing BMI, whereas mean disability in ADL decreased with increasing BMI. The risk of multi-morbidity was higher for the overweight (PR, 95%CI: 1.03, 1.02–1.03) and obese (PR, 95% CI: 1.07, 1.06–1.08) compared to normal weight after controlling for age, sex, ethnicity, and region. BMI was inversely associated with mean ADL; β, 95% CI for overweight (− 0.30, − 0.32, − 0.28) and obese − 0.43, − 0.45, − 0.40 compared to normal weight. Conclusion: Being underweight was associated with a decline in the performance of ADL in nursing home residents. In contrast, being overweight and obese positively affected functional performance, demonstrating that the obesity paradox plays an important role in this population. The observed associations highlight areas where detection and management of underweight and healthy aging initiatives may be merited.

Empathy is positively related to healthcare workers and patients’ wellbeing. There is, however, limited research on the effects of empathy education delivered in acute clinical settings and its impact on healthcare consumers. This research tests the feasibility and the potential efficacy outcomes of an immersive education programme developed by the research team in collaboration with clinical partners and a multidisciplinary advisory group. Healthcare worker participants in the intervention ward will receive an 8-week immersive empathy education. The primary outcome (feasibility) will be assessed by evaluating the acceptability of the intervention and the estimated resources. The secondary outcome (efficacy) will be assessed using a quasi-experimental study design. Non-parametric tests will be used to test healthcare worker participants’ empathy, burnout, and organisational satisfaction (within-group and across groups), and healthcare consumer participants’ satisfaction (between-group) over time. Despite growing interest in the importance of empathy in professional relationships, to our knowledge, the present pilot study is the first to explore the feasibility and efficacy of an immersive empathy education in New Zealand. Our findings will provide critical evidence to support the development of a randomised cluster trial and potentially provide preliminary evidence for the effectiveness of this type of empathy education.

Background: Empathy and compassion are integral to person‐centred care. Contemporary literature also provides evidence of the impact of empathic and compassionate care on patient outcomes, including enhanced satisfaction with care and improved patient safety. Notably, a previous scoping review identified only a limited number of studies exploring patients' experiences of empathic and compassionate care, underscoring the need for further research on patients' and their significant others' perspectives and experiences of empathic and compassionate healthcare encounters.Objective: The aim of this paper is to explore patients' and their significant others' perceptions of empathic and compassionate healthcare encounters.Methods: This qualitative descriptive international survey recruited people who were willing to report on a personal experience with a healthcare professional that demonstrated positive or negative examples of empathic and/or compassionate care. Data were analysed using Framework Analysis.Results: A total of 84 participants from the Pacific region, the United States of America, and Europe reported encounters with nurses, doctors, allied health professionals, and multidisciplinary teams. Analysis revealed four overarching themes: (1) Verbal and non‐verbal communication; (2) Clinician attitudes and attributes; (3) The power of small, thoughtful gestures; and (4) Enduring impact of empathic care.Conclusions: To promote empathic and compassionate care, there needs to be a holistic focus on practitioner communication across the bio‐psycho‐social‐spiritual domains. When these elements are included in interactions with patients and their significant others, healthcare providers can have a powerful and long‐lasting impact on people's experiences and health outcomes.

Humour: A purposeful and therapeutic tool in surgical nursing practice

Little is known about the level of service demand and preparedness of Aotearoa New Zealand’s aged residential care facilities to care for older adults with extreme obesity. The aim of this study was to assess the current state of bariatric (extreme obesity) services within aged residential care. An environmental scan was conducted to identify bariatric resident needs and gaps in service provision to inform the development of policy and service provision. Observational and interview data from three facilities in Aotearoa New Zealand was collected along with a retrospective review of national resident admissions over a three-year period. Poor environmental design that included infrastructure deficiencies and financial barriers impacted on the ability to deliver safe and equitable care for this population. Specifically, equipment procurement and safe staffing ratios were of concern to the sector. There is an increasing need for bariatric level support within aged care, necessitating more equipment and staff, adaptation of physical care environments, and enhanced funding. Significant investment is required to address care concerns of older adults with extreme obesity at government and organisational levels.