Loving care for a person with dementia: from phenomenological findings to lifeworld theatre.

Abstract

Compassion and empathy are essential characteristics of healthcare providers, yet the public sees provider compassion as lacking. Physician empathy also decreases during medical training. While the traditional scientific model of objective principles predominates the medical field, more recent moves in research-informed theatre have allowed qualitative researcher/educators to use drama to make their research more significant and relevant to healthcare settings. Theatre can significantly contribute to medical education by allowing students to reflect on their own emotions and the use of an imaginative perspective to develop insight into how best to convey compassion and empathy to patients. This study explored the emotional impact of a phenomenology-based play on medical students, healthcare professionals, and the public including carers of people with dementia with a specific focus on empathy and understanding of the patient/caregiver/ physician triad. Three phases were involved in the completion of this project: 1) a phenomenological study was completed with 10 people caring for a person with dementia; 2) these findings and basic theatrical principles were used to develop a theatrical playscript about the experiences of family carers of persons with dementia; 3) the playscript was produced before an audience of healthcare professionals including physicians and medical students, informal carers and community members. The emotional impact of the play was evaluated through a reflective writing exercise. Ofthe 400 people attending the play, 255 completed the evaluation. Evaluation data was analyzed using a content analysis methodology. There was strong evidence that lifeworld phenomenology-based theatre was a stimulus for empathic understanding. Four types of empathy were identified: 1) cognitive empathyunderstanding another's thoughts/feelings; 2) affective empathy-feeling another's emotion; 3) shared empathy-finding commonalities in previous experiences/feelings; and 4) projected/imagined shared empathy-imagining having same experience/feelings in the future. Medical students spend little time understanding and processing their own emotions around patient care. Lifeworld phenomenology-based theatre is a safe and effective tool to enhance empathy and help students understand patient emotions as well as their own.