Abstract
Background: Any caring relationship needs empathy, but it's especially important for providing high-quality nursing care. However, previous health and social care reports have revealed severe failings in patient care in the NHS and called for a culture change to include more empathetic care. Also, nursing studies show that empathy declines throughout nursing students’ studies. Therefore, the primary aim of this PhD study was to develop a novel digital stories intervention and then test its effects on nursing students’ empathy. It is hoped that this understanding will lead to the integration of digital stories in nursing education and, consequently, to improvements in patient care. The study was conducted during the pandemic, and considerable attention was given to the challenges of demonstrating empathy during this time.Methods: This study utilises the Medical Research Council (MRC) framework for developing and evaluating complex interventions. In line with this framework, this study has three phases. Before starting the phases, a pre-clinical stage was conducted, which involved a thorough review of the evidence base to determine an intervention method and design. In Phase I (development phase), the intervention was developed using stories from NHS staff members. These stories were about the experiences of NHS staff members who demonstrated empathy to patients during the COVID-19 pandemic. In phase II (feasibility phase), the intervention was tested for feasibility and practicality among part-time Nursing and Psychology students at USW (n = 9). The findings revealed that the intervention was positively perceived to elicit emotions and helped demonstrate empathy. In Phase III (evaluation phase), the empathy intervention developed was tested among 197 nursing students in a Quasi-experimental cluster trial. The empathy levels of nursing students were assessed pre-test, post-test, and at 4-6 weeks follow-up using the Jefferson Scale of Empathy, Healthcare Professional students’ version.
Results: In phase III (evaluation phase), it was found that there was a significant increase in nursing students’ empathy in the intervention group, from pre-test to post-test (p = 0.029). However, this difference was no longer significant at post-test and follow-up (p = 0.69), suggesting that the improvement in empathy scores did not sustain over time. In addition, there was a marginally significant improvement (p = 0.09) in nursing students’ empathy scores in the control group between the pre-test and follow-up, suggesting that nursing students’ empathy improved regardless of whether they received the intervention. However, this improvement in the control group was not evident at the follow-up test (p = 0.88).
Discussion: The findings of the evaluation phase suggested that empathy interventions using stories lead to a short-term increase in empathy among nursing students. However, empathy scores did not sustain after 4-6 weeks. To maintain improvement in empathy over time, additional research into efficient intervention delivery methods and a fundamental redesign of the intervention itself are required.
Conclusion: Nurse educators must ensure that the importance of empathy and how to display it to patients is taught to enhance and sustain empathy in nursing students throughout their future practice.
| Date of Award | 2025 |
|---|---|
| Original language | English |
| Sponsors | KESS 2 PhD Student, University of South Wales & Aneurin Bevan University Health Board |
| Supervisor | Juping Yu (Supervisor), Deborah Lancastle (Supervisor) & Gareth Parsons (Supervisor) |