The DOI matches its Crossref record; 95 of the 96 references it cites were found in a registry or an index.
A model of empathic understanding and adherence to treatment regimens in practitioner-patient relationships
Abstract
Empathic understanding in practitioner relationships is postulated as necessary for adherence to therapeutic regimens. It is considered to be one of the most important practitioner relationship skills leading ultimately to patient health benefit. Research literature from a wide-range of health disciplines including personality theory, social psychology, psychotherapy, psycho-analysis, and practitioner-patient communication highlights the key role of empathic processes in personal health care. A model of empathic understanding is described which attempts to integrate the substantive findings in the research literature and seeks to generate new ideas for further investigation. The model addresses theoretical relationships between practitioners' empathic understanding, patients' knowledge of their illness and motivation to get better, adherence to treatment advice, and outcome. Recent work on the selection and training of medical and nursing staff in empathic skills is reviewed. A number of areas for future research are outlined including the effect of individual practitioner differences in the components of empathy, empathic compatibility in practitioner-patient dyads, fluctuations in levels of practitioner empathy during long-term care, specific practitioner behaviours which communicate empathy, and the relationship between factors of patient satisfaction and the perception of empathic understanding.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“The important determinants for compliance are mainly more information giving, more positive talk and empathy and an increased participatory style.(13,17,18,20)”
From Socio-economic status of the patient and doctor–patient communication: does it make a difference? (2005) · cites this paper as [17]
Citations
Cites
Mead, G. H., Joas, H., Huebner, D. R., & Morris, C. W. (2015) · University of Chicago Press eBooks · doi:10.7208/chicago/9780226112879.001.0001 · Cited by 12,419
Measuring individual differences in empathy: Evidence for a multidimensional approach.
Davis, M. H. (1983) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.44.1.113 · Cited by 10,272
Handbook of Psychotherapy and Behavior Change
Garfield, S. L., Bergin, A. E., & Dryden, W. (1987) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.1.4.264a · Cited by 3,998
Handbook of Psychotherapy and Behavior Change
Sanford, E. F. (1988) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.1988.42.1.153 · Cited by 2,586
A measure of emotional empathy1
Mehrabian, A., & Epstein, N. (1972) · Journal of Personality · doi:10.1111/j.1467-6494.1972.tb00078.x · Cited by 2,360
Sociobehavioral Determinants of Compliance with Health and Medical Care Recommendations
Becker, M. H., & Maiman, L. A. (1975) · Medical Care · doi:10.1097/00005650-197501000-00002 · Cited by 1,584
Development of an empathy scale.
Hogan, R. (1969) · Journal of Consulting and Clinical Psychology · doi:10.1037/h0027580 · Cited by 1,532
Empathic: An Unappreciated Way of Being
Rogers, C. R. (1975) · The Counseling Psychologist · doi:10.1177/001100007500500202 · Cited by 1,276
Doctor Patient Communication: A Review
Begum, T. (2015) · Journal of Bangladesh College of Physicians and Surgeons · doi:10.3329/jbcps.v32i2.26036 · Cited by 1,047
Gaps in Doctor-Patient Communication
Francis, V., KORSCH, B. M., & Morris, M. J. (1969) · New England Journal of Medicine · doi:10.1056/nejm196903062801004 · Cited by 1,000
Research works printed but not linked: 2
- DiMatteo, 1979, Patients' perceptions of physicians' behavior: determinants of patient commitment to the therapeutic relationship, J. Commun. Hlth, 4, 280
- Ikemi, 1984, An experimental learning course on teaching humanistic skills to medical students—Effect on empathy and regard for others, Sangyo Ika Daigaku Zasshi, 6, 265
Cited by
Sorted by citations
Items 201–300 of 307
Affective Interactions in Medical Visits
Garroutte, E. M., Sarkisian, N., & Karamnov, S. (2012) · Journal of Aging and Health · doi:10.1177/0898264312457410 · Cited by 8
Doctors’ attitudes in the situation of delivering bad news: patients’ experience and expectations
Sobczak, K., & Leoniuk, K. (2021) · Archives of Medical Science · doi:10.5114/aoms/112756 · Cited by 8
Ernstmann, N., Ommen, O., Kowalski, C., Neumann, M., Visser, A. P., Pfaff, H., & Weißbach, L. (2011) · Supportive Care in Cancer · doi:10.1007/s00520-011-1151-7 · Cited by 8
López-Flores, F., Neufeld, L. M., Sotres‐Alvarez, D., García‐Guerra, A., & Ramakrishnan, U. (2012) · Salud Pública de México · doi:10.1590/s0036-36342012000500003 · Cited by 8
Joice, A., & Mercer, S. W. (2010) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x10000012 · Cited by 8
Underwood, M., & Ronald, K. (2020) · Currents in Pharmacy Teaching and Learning · doi:10.1016/j.cptl.2020.04.020 · Cited by 8
Teaching physicians to be patient: a hospital admission experience for family practice residents.
Brunton, S., & Radecki, S. E. (1992) · PubMed · Cited by 8
Vellakkal, S., Juyal, S., & Mehdi, A. (2012) · SSRN Electronic Journal · doi:10.2139/ssrn.2049307 · Cited by 8
Ørnes, K., Finset, A., Storøy, H.-L. E., & Pedersen, R. (2021) · Patient Education and Counseling · doi:10.1016/j.pec.2021.03.042 · Cited by 7
The Social Side of Pain: What Does it Mean to Feel Another’s Pain?
Giummarra, M. J., Tracy, L. M., Young, K. A., & Fitzgibbon, B. M. (2016) · Springer eBooks · doi:10.1007/978-3-319-49022-9_21 · Cited by 7
Exploring empathy in genetic counseling students and new genetic counselors
Richards, J. L., Petty, E. M., & Zelenski, A. B. (2020) · Journal of Genetic Counseling · doi:10.1002/jgc4.1321 · Cited by 7
Improving compliance among hypertensive patients: a reflection on the role of patient education
Ehiri, B. I. (2000) · International Journal of Health Promotion and Education · doi:10.1080/14635240.2000.10806158 · Cited by 7
Patients’ and Doctors’ Beliefs about Treatment and Long-Term Adherence in Rheumatic Diseases
Yfantopoulos, J., Protopapa, M., Mantalias, K., Chantzaras, A. E., Koutsogianni, K., Yfantopoulos, P., & Vassilopoulos, D. (2020) · Mediterranean Journal of Rheumatology · doi:10.31138/mjr.31.1.152 · Cited by 7
Jechna, Z. (2024) · Patient Education and Counseling · doi:10.1016/j.pec.2024.108426 · Cited by 6
Using the Skill of Noticing to Support Empathy for Third-Year Medical Students in Family Medicine
Blalock, A. E., Tluczek, M., & Pylman, S. (2024) · Family Medicine · doi:10.22454/fammed.2024.190695 · Cited by 6
Patient compliance, physician empathy and financial incentives within a principal-agent framework
Mealem, Y., Siniver, E., & Yaniv, G. (2012) · The Journal of Socio-Economics · doi:10.1016/j.socec.2012.08.004 · Cited by 6
The Concept of Communication Between Nurse and Patient in the Catheterization Laboratory
Klisiari, A., & Gaki, A. (2012) · Hospital chronicles/Hospital Chronicles · Cited by 6
Lazarewicz, M. A., Włodarczyk, D., Chylińska, J., Jaworski, M., Rzadkiewicz, M., Adamus, M. M., Haugan, G., Lillefjell, M., & Espnes, G. A. (2018) · Scandinavian Journal of Public Health · doi:10.1177/1403494818780855 · Cited by 6
Do empathic osteopaths achieve better clinical results? An observational feasibility study
Acquati, A., Uberti, S., Aquino, A., Cerasetti, E., Castagna, C., Rovere, P. Q., & Pisa, V. (2019) · International journal of osteopathic medicine · doi:10.1016/j.ijosm.2019.02.002 · Cited by 6
The analysis of the empathy factor in students of medical sciences
Sobczak, K., & Popowicz, B. (2019) · Polish Annals of Medicine · doi:10.29089/2019.19.00079 · Cited by 6
Enhancing Patient-Physician Communication: A Community and Culturally Based Approach
Martin, M. Y., Keys, W., Person, S. D., Kim, Y., Ashford, R. S., Kohler, C. L., & Norton, P. (2005) · Journal of Cancer Education · doi:10.1207/s15430154jce2003_8 · Cited by 6
Two Collaborating Artists Produce a Work of Art
Platt, F. W., & Platt, C. M. (2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.10.1131 · Cited by 6
Banovic, I., Gilibert, D., Olivier, M., & Cosnes, J. (2009) · Pratiques Psychologiques · doi:10.1016/j.prps.2009.03.003 · Cited by 5
The rapport management model: how physicians build relationships with patients
Campbell, K. S. (2005) · IEEE International Professional Communication Conference (ProComm) · doi:10.1109/ipcc.2005.1494206 · Cited by 5
Erdman, S. A., Scherer, R. W., Sierra-Irizarry, B., & Formby, C. (2019) · American Journal of Audiology · doi:10.1044/2019_aja-18-0068 · Cited by 6
Tam, L., Burns, K., & Barnes, K. (2020) · Health Expectations · doi:10.1111/hex.13155 · Cited by 5
Clinician-patient communication to enhance health outcomes.
Nanchoff-Glatt, M. (2009) · PubMed · Cited by 5
Physicians' values and physician-value neutrality
Peppin, J. F. (1995) · Journal of Religion and Health · doi:10.1007/bf02248738 · Cited by 5
Embracing Patient-Centered Professionalism
Nahai, F. (2011) · Aesthetic Surgery Journal · doi:10.1177/1090820x11420689 · Cited by 5
Why should patients and clinicians talk about emotion?
Finset, A. (2012) · Patient Education and Counseling · doi:10.1016/j.pec.2012.09.001 · Cited by 5
Pillai, A. K. (2010) · Cited by 5
Ethical Implications for Potential Placebo Effects of Point of Care Ultrasound
Scales, D. (2019) · Perspectives in biology and medicine · doi:10.1353/pbm.2019.0042 · Cited by 4
Exploring Client Adherence Factors Related to Clinical Outcomes
Gill, L., Cassia, F., Cameron, I., Kurrle, S., Lord, S., Fairhall, N., Lockwood, K. A., & Langron, C. (2014) · Australasian Marketing Journal (AMJ) · doi:10.1016/j.ausmj.2014.08.006 · Cited by 6
Barnett, P. B. (2002) · Disease-a-Month · doi:10.1016/s0011-5029(02)90032-5 · Cited by 4
The Interpersonal Dynamics in Clinician–Patient Relationships
Hojat, M. (2016) · Springer eBooks · doi:10.1007/978-3-319-27625-0_8 · Cited by 4
Watt, M. H. (2019) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/gfk9-sc63 · Cited by 3
Patient-Centered Interviewing: Narrative Approach
Park, E. W. (2010) · Korean Journal of Family Medicine · doi:10.4082/kjfm.2010.31.1.3 · Cited by 3
Wainberg, M. L., & Cournos, F. (2000) · New Directions for Mental Health Services · doi:10.1002/yd.23320008712 · Cited by 3
The Interpersonal Dynamics in Clinician–Patient Relationships
Hojat, M. (2007) · Springer eBooks · doi:10.1007/0-387-33608-7_8 · Cited by 3
Maximizing Effectiveness of Bisphosphonate Therapy for Osteoporosis
Martens, M. G., & Shaw, H. (2008) · Southern Medical Journal · doi:10.1097/smj.0b013e31817fd436 · Cited by 3
The lived experience of taking neuroleptic medication by persons with schizophrenia
Dumas, R. (1999) · UA Campus Repository (The University of Arizona) · Cited by 3
Fennern, E. B., & Sur, M. D. (2022) · Difficult decisions in surgery: an evidence-based approach · doi:10.1007/978-3-030-84625-1_10 · Cited by 2
The Ida Institute Toolbox: Tools To Enhance Collaborative Self-Management of Hearing Problems
Gregory, M. (2013) · Perspectives on Aural Rehabilitation and Its Instrumentation · doi:10.1044/arii20.1.22 · Cited by 2
Gilibert, D., & Banovic, I. (2008) · Psychologie du Travail et des Organisations · doi:10.1016/s1420-2530(16)30218-7 · Cited by 2
Considering shared power and responsibility: Diabetic patients’ experience with the PCMH care model
Mazurenko, O., Bock, S., Prato, C., & Bondarenko, M. (2015) · Patient Experience Journal · doi:10.35680/2372-0247.1056 · Cited by 2
A study of the Consultation and Relational Empathy (CARE) measure for medical students
Alnoman, N. N. H. (2014) · Discovery Research Portal (University of Dundee) · Cited by 2
Réflexions sur la pratique des entretiens à l’adolescence
Courtois, R., Fillatre, M., Fourn, J.-Y. L., & Courtois, A. (2009) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2008.12.006 · Cited by 2
O'Toole, D. (2012) · White Rose eTheses Online (University of Leeds, The University of Sheffield, University of York) · Cited by 2
Attitude of Medical Staff Towards Victims of Violence and Assaults
Renck, B. (1993) · Scandinavian Journal of Caring Sciences · doi:10.1111/j.1471-6712.1993.tb00208.x · Cited by 2
Harinarain, E. (2008) · University of the Witwatersrand, Johannesburg Institutional Repository on DSpace (University of the Witwatersrand, Johannesburg) · Cited by 2
Kim, S. (2025) · Patient Education and Counseling · doi:10.1016/j.pec.2025.109230 · Cited by 1
Alhaidari, B., Mulhall, C. M., Condron, C. M., Shpigelman, J., Jain, D., & Daly, M. J. (2025) · BMC Medical Education · doi:10.1186/s12909-025-08264-7 · Cited by 1
Carrilho, M., Pinto, D. C., Shuqair, S., Herter, M. M., & Mattila, A. S. (2026) · Psychology and Marketing · doi:10.1002/mar.70167 · Cited by 1
Foo, M., Chua, J. C., Toh, C. K., & Ng, J. (2012) · IEEE International Conference on e-Health Networking, Applications and Services (Healthcom) · doi:10.1109/healthcom.2012.6379381 · Cited by 1
van Nes, K. A., Bonifácio, C. C., van Hunnik, M. M., van Loveren, C., & Aartman, I. H. A. (2023) · European Archives of Paediatric Dentistry · doi:10.1007/s40368-023-00823-0 · Cited by 1
Changes in the Affective Empathy of Osteopathic Students: a Longitudinal Study
Newton, B. W., & Vaskalis, Z. T. (2024) · Medical Science Educator · doi:10.1007/s40670-024-02139-0 · Cited by 1
컴퓨터 에이전트와 관계 맺기: 공감을 표현하는 컴퓨터 에이전트를 통한 동류의식 형성과 사회적 지지의 획득
Rheu, M., Kim, J. H., & 진전은영 (2017) · Korean Journal of Journalism & Communication Studies · doi:10.20879/kjjcs.2017.61.2.004 · Cited by 1
Humanism and Medical Treatment: Clinicians and Patients Finding Common Ground
Weissmann, P. F., Fornari, A. B., & Branch, W. T. (2019) · Springer eBooks · doi:10.1007/978-3-030-12665-0_8 · Cited by 1
Facial Emotional Perception Training for Medical Students
Campo, M. V., Vidal, L., Torres, Á., Mateos, R., Olivares, J. M., García-Lado, I., & García-Caballero, A. A. (2019) · Creative Education · doi:10.4236/ce.2019.108128 · Cited by 1
Health Services Management and Health Behavior
Daugherty, R. H. (1997) · Springer eBooks · doi:10.1007/978-1-4899-0484-3_10 · Cited by 1
A Database to Describe the Practice Component of the CNS Role
Dabbs, A. D. V., Curran, C. R., & Lenz, E. R. (2000) · Clinical Nurse Specialist · doi:10.1097/00002800-200007000-00011 · Cited by 1
Nursing. Treatment adherence and the role of trust, trauma and social connectedness.
Bieberly, J. (2009) · PubMed · Cited by 1
Towards Elucidating the Operationalization and Measurement of Empathy in Clinical Outcome Research
Sharp, K. L. (2016) · KU ScholarWorks (University of Kansas) · Cited by 1
Clinicians: enabled by empathy?
Ogle, J. (2012) · Research Online (University of Wollongong)
Harris, J. M. (2015) · ThinkTech (Texas Tech University)
MEDICAL AND LAY KNOWLEDGE OF THE SPREAD OF HEPATITIS C
Perzynski, A. T. (2008)
Hollett, S. (2015) · Memorial University Research Repository (Memorial University)
Chapter 11. Supportive Communication
Berger, B. A. (2009) · The American Pharmacists Association eBooks · doi:10.21019/9781582121321.ch11
Chapter 4. Listening and Empathic Responding
Berger, B. A. (2009) · The American Pharmacists Association eBooks · doi:10.21019/9781582121321.ch4
Chapter 4 Communications in Pharmacy Practice
Berger, B. A. (2009) · The American Pharmacists Association eBooks · doi:10.21019/9781582120935.ch4
Melamed, G. M. (2000) · Nelson Mandela University Research Repository
Ageing today: a new challenge for tomorrow.
Giustini, M., Longo, E., Beggiato, M., & Cozzolino, M. (2009) · Rapporti ISTISAN - Istituto Superiore di Sanità
Elements that Establish a Healthy Doctor Patient Relationship
Near, K. (2019) · TEXILA INTERNATIONAL JOURNAL OF BASIC MEDICAL SCIENCES · doi:10.21522/tijbms.2016.04.01.art002
Management of canine atopic dermatitis
Lipscomb, H., & Bellis, F. D. (2020) · Companion animal · doi:10.12968/coan.2020.0007
Janowski, M., Dahlgren, O., Taylor, K.-A., Kaza, I., Alam, A., Papadimos, T. J., Pellegrino, A. N., & Stawicki, S. P. (2021) · IntechOpen eBooks · doi:10.5772/intechopen.94969
Naturopathic Physical Medicine Approaches to General Health Enhancement and Specific Conditions
Chaitow, L., Brown, H. N., Buratovich, N., Isbell, B., Maeckel, L., Neary, D. E., Russ, D., & Turner, R. N. (2008) · Elsevier eBooks · doi:10.1016/b978-044310390-2.50015-8
GHİASEE, A. (2021) · Tıbbi Sosyal Hizmet Dergisi · doi:10.46218/tshd.1010481
(2012) · Wiley eBooks · doi:10.1002/9781119977452.refs
Gottschlich, M. (1998) · Springer eBooks · doi:10.1007/978-3-7091-9477-5_8
Chapter 4: Communications in Pharmacy Practice
Berger, B. A. (2016) · The American Pharmacists Association eBooks · doi:10.21019/9781582122779.ch4
(2019) · The American Pharmacists Association eBooks · doi:10.21019/9781582123219.ch7
(2011) · Elsevier eBooks · doi:10.1016/b978-0-7295-3908-1.10001-6
(2013) · The American Pharmacists Association eBooks · doi:10.21019/9781582121802.ch6
On Prudent Love and Imprudent Lovelessness
Marcum, J. A. (2011) · Philosophy and medicine · doi:10.1007/978-94-007-2706-9_5
Empathische Kommunikation will gelernt sein
Haak, R. (2020) · Oralprophylaxe & Kinderzahnheilkunde · doi:10.3238/bf03651603
Ethical Deliberation on AI-Based Medicine
Behrouzieh, S., Keshavarz-Fathi, M., Vellido, A., Seyedpour, S., Afkham, S. A., Vahed, A., Dorigo, T., & Rezaei, N. (2022) · Integrated science · doi:10.1007/978-3-030-96814-4_25
Hypertoniás betegek telemedicinális gondozásával kapcsolatos teendők és kommunikáció
Simon, A., & Tiringer, I. (2023) · Hypertonia és Nephrologia · doi:10.33668/hn.27.012
Karnesis, G., Rama Sai, P., Parsa, C., & Prasad, C. (2023) · Medical Journal of Southern California Clinicians · doi:10.38206/160101
From Bedside Manner to Surgical Excellence
Suhaiba, A., Choubey, A. S., Drake, B. A., Kerns, J. M., & Gonzalez, M. H. (2024) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.23.00992
Role of doctor-patient communication in rheumatology
Грехов, Р. А., Александров, А. В., & Zborovskaya, I. A. (2025) · Russian Journal of Preventive Medicine · doi:10.17116/profmed202528041156
Assessing dental students’ empathy through experimental economics: a complementary approachPreprint
NDOYE, M., Rafaï, I., Ventelou, B., & Lupi, L. (2025) · Research Square · doi:10.21203/rs.3.rs-6735083/v1
The Satir Model in Developing Empathy in Nursing Communication
Chee, C. K., Shariff, S. F. M., & Yusooff, F. (2025) · International Journal of Research and Innovation in Social Science · doi:10.47772/ijriss.2025.910000148
MacArthur, K. R. (2008) · OhioLink ETD Center (Ohio Library and Information Network)
Selinger, E. M., & Cahn, A. F. (2026) · Cambridge University Press eBooks · doi:10.1017/9781009466592.012
Assessing self-reported empathy among chiropractic students at a South African university
Ismail, F., & Simoes, M. (2026) · Journal of Chiropractic Education · doi:10.7899/jce-25-6
Metadata
- Authors
- Squier, R. W.
- Corresponding author
- Squier, Roger W.
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 1990-01
- Volume
- 30
- Issue
- 3
- Pages
- 325-339
- ISSN
- 0277-9536 (ISSN-L)
- OpenAlex
- W2087743410
- Cited by
- 305
- References
- 96
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 5 · 2023: 3 · 2022: 5 · 2021: 12 · 2020: 15 · 2019: 14 · 2018: 8 · 2017: 9 · 2016: 14 · 2015: 9 · 2014: 9 · 2013: 12 · 2012: 21
- FWCI
- 0.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Keywords
- empathic understanding, medication adherence, practitioner-patient relationship, empathy, disease knowledge, empathy training, patient satisfaction, therapeutic relationship, health care outcomes
- MeSH terms
- Communication, Education, Medical, Education, Nursing, Empathy, Helping Behavior, Humans, Patient Compliance, Physician-Patient Relations, Psychoanalytic Theory
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review