Thesis (Doctoral)--Göteborg Universitet, 2001. / Collection of articles, some previously published. Includes bibliographical references.

Thesis (M.S.)--University of Massachusetts Amherst, 2008. / Includes bibliographical references (p. 36-40).

Background Nursing presence is an intersubjective connection between the nurse and patient that results in improved patient outcomes. Present day task-oriented healthcare robots possess an evolving capacity to address task-based attributes of nursing care but are far less capable of addressing attributes of nursing presence. The purpose of this study was to explore adults' perception of nurse-expressed empathy, an attribute of nursing presence, as enacted by a semi-autonomous robot nurse compared to a human nurse following a discussion of the adults' health concerns or issues. Methods The design for this study employed a non-inferiority randomized comparison of two groups. The overall hypothesis was that adults' perception of nurse-expressed empathy during human-robot interactions was not inferior to the perception of nurse-expressed empathy during human-human interactions. From a broad geographic community 102 adults, age 21 to 80, were recruited and assigned to an active control or reference treatment group using stratified and blocked randomization. In each group, participants discussed the impact of health issues or concerns on their daily life. Participants in the reference treatment group interacted with a semi-autonomous robot. Participants in the control group interacted with the researcher face-to-face. Participants' perception of nurse-expressed empathy was measured using the Empathic Understanding Scale of the Barrett-Lennard Relationship Inventory. A confidence interval approach using 95%-95% method was used to assess non-inferiority. The first confidence interval was obtained from analysis of seven historical studies that measured empathy using the Empathic Understanding Scale. The second confidence interval was obtained from analyses of the difference in mean perceived empathy between the two study groups. Results Three normalized statistical methods used to evaluate non-inferiority were significant (p<.025) and contained confidence intervals less than the non-inferiority margin (δ= 3.33). This resulted in the rejection of the null hypothesis that empathy communicated by a robot was inferior to empathy communicated by a human nurse. Conclusions This study provided evidence that nurses operating semi-autonomous robots can communicate empathy to adults. Innovation and collaboration among nurses, computer scientists and engineers will ensure that successive generations of robots maintain a nursing perspective while operating at their optimal capacity.

Some research has been done on this subject, although sparsely. The purpose of this study is to determine how, why, and to what extent representation in fiction matters, in regard to socially stigmatized groups of people, focusing on mental health, sexuality, and gender roles. The main focus is on bonding with fictional characters, how it relates to representation and its importance. Eleven (cis)female participants shared their own experiences with this. Each written reply was condensed, eventually narrowed down to three main components considered central to this phenomenon; (1) a sense of isolation, (2) an inability to cope, and (3) relatability in characters. These components can all be connected to loneliness, which suggests that loneliness plays a large part in one's sense of self-worth. Thus, representation can be argued to be vital, due to its function of including and speaking for stigmatized groups of people, granting a sense of belonging and support.

A importância da empatia como um elemento indispensável para o desenvolvimento infantil saudável tem sido apontada em diversos estudos. Contudo, são muito poucos os registros de pesquisas nacionais sobre programas desenvolvidos com o objetivo de promovê-la, ou de potencializar o seu desenvolvimento. Embora parta de uma base biológica inata, a empatia depende da estimulação social, das práticas educativas e do contexto em que as crianças crescem, para desabrochar plenamente. Ao lado dos pais, a escola, onde as crianças passam grande parte do seu dia, ocupa um lugar de destaque na educação infantil. Considerando a importância da empatia para o desenvolvimento infantil saudável, e a influência que a educação escolar pode ter sobre ela, propôs-se a realização de um programa com o objetivo de potencializar o seu desenvolvimento, na escola. O objetivo geral deste estudo foi desenvolver o programa e testar a sua eficácia. Os objetivos específicos foram os seguintes: a) Elaborar e descrever os procedimentos utilizados na intervenção; b) Verificar se, após a conclusão do programa, os participantes apresentariam níveis significativamente mais elevados nas medidas de empatia, em comparação à linha de base; c) Verificar se, após a conclusão do programa, os participantes do grupo experimental apresentariam níveis significativamente mais elevados nas medidas de empatia em comparação às crianças do grupo controle; d) Adicionalmente, continuar a normatizar o Teste de Empatia em Ceninhas (TEC: Motta, 2005). Para a avaliação da empatia, usamos: uma medida de auto-relato a Escala de Empatia para Crianças e Adolescentes (EECA: Bryant, 1982); uma medida de empatia acurada o TEC (Motta, 2005); a avaliação do professor o Teachers Rating of Empathy (Barnett & cols., 1982); e a avaliação dos alunos o Empatia do Coleguinha, adaptado do Peers Rating of Empathy (Barnett & cols., 1982). Participaram do programa 43 alunos, da segunda e terceira série do ensino fundamental, de uma escola municipal do Rio de Janeiro. Cada turma foi dividida, aleatoriamente, em dois grupos, um deles experimental/placebo (EP experimental no primeiro segmento da pesquisa, placebo, no segundo) e o outro, placebo/experimental (PE placebo no primeiro segmento da pesquisa, experimental, no segundo). Seguimos o modelo longitudinal pré e pós-teste. Na primeira fase da pesquisa, os grupos EP participaram de 11 encontros de uma hora de duração, com atividades orientadas para o desenvolvimento da empatia, enquanto os grupos PE participaram de atividades de recreação infantil. Na segunda fase, os grupos PE receberam o mesmo tratamento oferecido aos grupos EP, na primeira fase, vice-versa. Os resultados indicaram que o treinamento beneficiou a empatia dos participantes da pesquisa. Sugere-se que a implementação de programas para o desenvolvimento da empatia pode contribuir para a promoção e o aperfeiçoamento desta habilidade nas escolas. / The importance of empathy as an indispensable element for healthy child development has been identified in several studies. However, there are very few records of national researches regarding programs developed aiming to promote it, or to enhance its development. Although empathy has an innate biological base, in order to fully blossom, it depends on social stimulation, educational practices and the environment in which children are raised. Alongside parents, the school, where children spend much of their day, occupies a prominent place in early childhood education. Considering the importance of empathy for healthy child development, and the influence that school education can have on it, a program with the goal of improving its development in school was proposed. The general objective of this study was to develop the program and test its efficacy. The specific objectives were the following: a) Elaborate and describe the procedures utilized in intervention; b) Verify whether, upon completion of the program, the experimental group participants would exhibit significantly higher levels on empathy measures when compared to the baseline; c) Verify whether, upon completion of the program, the experimental group participants would exhibit significantly higher levels on empathy measures when compared to children of the control group; d) Additionally, standardize the Empathy Test in Short Scenes (TEC: Motta, 2005). For the assessment of empathy, we use: a measure of self-report the Empathy Scale for Children and Adolescents (EECA: Bryant, 1982); an accurate measure of empathy the TEC (Motta, 2005); the teachers evaluation the Teacher's Rating of Empathy (Barnett & cols., 1982); and the students assessment the Classmates Empathy, adapted from the Peer's Rating of Empathy (Barnett & cols., 1982). Forty Three students participated in the program, from second and third grades of a public school in Rio de Janeiro. Each class was randomly split in two groups, one experimental/placebo (EP experimental in the first segment of the research, placebo, in the second segment) and the other placebo/experimental (PE placebo in the first segment of the research, experimental in the second segment). The longitudinal model was followed in the pre-test and post-test. In the first phase of the research, the EP groups participated in 11 meetings of an hour each, with activities oriented towards the development of empathy, while the PE groups participated in recreational activities for children. In the second phase, the PE groups received the same treatment offered in the first phase to the EP groups, vice versa. The results indicated that the training benefited the empathy of the research participants. It is suggested that the implementation of programs for the development of empathy can contribute to the promotion and improvement of this skill in schools. Keywords: empathy, development, child.

A importância da empatia como um elemento indispensável para o desenvolvimento infantil saudável tem sido apontada em diversos estudos. Contudo, são muito poucos os registros de pesquisas nacionais sobre programas desenvolvidos com o objetivo de promovê-la, ou de potencializar o seu desenvolvimento. Embora parta de uma base biológica inata, a empatia depende da estimulação social, das práticas educativas e do contexto em que as crianças crescem, para desabrochar plenamente. Ao lado dos pais, a escola, onde as crianças passam grande parte do seu dia, ocupa um lugar de destaque na educação infantil. Considerando a importância da empatia para o desenvolvimento infantil saudável, e a influência que a educação escolar pode ter sobre ela, propôs-se a realização de um programa com o objetivo de potencializar o seu desenvolvimento, na escola. O objetivo geral deste estudo foi desenvolver o programa e testar a sua eficácia. Os objetivos específicos foram os seguintes: a) Elaborar e descrever os procedimentos utilizados na intervenção; b) Verificar se, após a conclusão do programa, os participantes apresentariam níveis significativamente mais elevados nas medidas de empatia, em comparação à linha de base; c) Verificar se, após a conclusão do programa, os participantes do grupo experimental apresentariam níveis significativamente mais elevados nas medidas de empatia em comparação às crianças do grupo controle; d) Adicionalmente, continuar a normatizar o Teste de Empatia em Ceninhas (TEC: Motta, 2005). Para a avaliação da empatia, usamos: uma medida de auto-relato a Escala de Empatia para Crianças e Adolescentes (EECA: Bryant, 1982); uma medida de empatia acurada o TEC (Motta, 2005); a avaliação do professor o Teachers Rating of Empathy (Barnett & cols., 1982); e a avaliação dos alunos o Empatia do Coleguinha, adaptado do Peers Rating of Empathy (Barnett & cols., 1982). Participaram do programa 43 alunos, da segunda e terceira série do ensino fundamental, de uma escola municipal do Rio de Janeiro. Cada turma foi dividida, aleatoriamente, em dois grupos, um deles experimental/placebo (EP experimental no primeiro segmento da pesquisa, placebo, no segundo) e o outro, placebo/experimental (PE placebo no primeiro segmento da pesquisa, experimental, no segundo). Seguimos o modelo longitudinal pré e pós-teste. Na primeira fase da pesquisa, os grupos EP participaram de 11 encontros de uma hora de duração, com atividades orientadas para o desenvolvimento da empatia, enquanto os grupos PE participaram de atividades de recreação infantil. Na segunda fase, os grupos PE receberam o mesmo tratamento oferecido aos grupos EP, na primeira fase, vice-versa. Os resultados indicaram que o treinamento beneficiou a empatia dos participantes da pesquisa. Sugere-se que a implementação de programas para o desenvolvimento da empatia pode contribuir para a promoção e o aperfeiçoamento desta habilidade nas escolas. / The importance of empathy as an indispensable element for healthy child development has been identified in several studies. However, there are very few records of national researches regarding programs developed aiming to promote it, or to enhance its development. Although empathy has an innate biological base, in order to fully blossom, it depends on social stimulation, educational practices and the environment in which children are raised. Alongside parents, the school, where children spend much of their day, occupies a prominent place in early childhood education. Considering the importance of empathy for healthy child development, and the influence that school education can have on it, a program with the goal of improving its development in school was proposed. The general objective of this study was to develop the program and test its efficacy. The specific objectives were the following: a) Elaborate and describe the procedures utilized in intervention; b) Verify whether, upon completion of the program, the experimental group participants would exhibit significantly higher levels on empathy measures when compared to the baseline; c) Verify whether, upon completion of the program, the experimental group participants would exhibit significantly higher levels on empathy measures when compared to children of the control group; d) Additionally, standardize the Empathy Test in Short Scenes (TEC: Motta, 2005). For the assessment of empathy, we use: a measure of self-report the Empathy Scale for Children and Adolescents (EECA: Bryant, 1982); an accurate measure of empathy the TEC (Motta, 2005); the teachers evaluation the Teacher's Rating of Empathy (Barnett & cols., 1982); and the students assessment the Classmates Empathy, adapted from the Peer's Rating of Empathy (Barnett & cols., 1982). Forty Three students participated in the program, from second and third grades of a public school in Rio de Janeiro. Each class was randomly split in two groups, one experimental/placebo (EP experimental in the first segment of the research, placebo, in the second segment) and the other placebo/experimental (PE placebo in the first segment of the research, experimental in the second segment). The longitudinal model was followed in the pre-test and post-test. In the first phase of the research, the EP groups participated in 11 meetings of an hour each, with activities oriented towards the development of empathy, while the PE groups participated in recreational activities for children. In the second phase, the PE groups received the same treatment offered in the first phase to the EP groups, vice versa. The results indicated that the training benefited the empathy of the research participants. It is suggested that the implementation of programs for the development of empathy can contribute to the promotion and improvement of this skill in schools. Keywords: empathy, development, child.

abstract: Engineering ethics is preoccupied with technical failure. To ameliorate the risk that engineering works might either blow up or fall down, the engineering code of ethics provides guidance of how engineers should conduct themselves. For example, the Fundamental Canons in the National Society of Professional Engineers code of ethics states that engineers should hold paramount the health, safety and welfare of the public. As a result, engineering designs meet basic human needs such as food, water and shelter -- at risks that are generally considered acceptable. However, even safe designs fail to meet our needs ranked higher in Maslow's hierarchy -- such as belonging, esteem and self-actualization. While these have historically not been ethical priorities, increasing expectations in developed countries now include more complex ethical concepts such as sustainability and social justice. We can expect these trends toward higher and more complex human needs to continue -- although the profession seems ill-prepared. We argue that an empathic approach to engineering design is necessary to meet these higher needs of developed and developing societies. To guide engineers towards this approach, we propose a pluralistic interpretation of empathy grounded in an understanding of the three parts of the mind: cognitive, affective, and conative. In fact, product designers already use empathy in their design processes. However, an exemplar of an empathic design is harder to find in civil engineering disciplines. This paper discusses an example of the Hoover Dam Bypass, which resulted in an award-winning design and construction that improved traffic flow, reduced vulnerability to terrorist attack, and accounted for historical factors and environmental impacts. However, this technical success is an empathic failure. Although project leaders commissioned ethnographic studies to understand the impact the bridge would have on the local Native American populations and their cultural sites, the eventual design showed little consideration of the concerns that were revealed. For engineering designs such as bridges, other infrastructure and systems to meet the needs of the various populations in which they serve, engineers need to incorporate empathy into their designs. / Dissertation/Thesis / Masters Thesis Civil Engineering 2016

I would like to thank my thesis advisor, Professor Bowman, for providing valuable input as I pursued this important topic. I would also like to thank Professor Krauss, my unofficial Psychology advisor. I would like to thank my parents who raised me to value empathy. Our family-dinner conversations weren’t always pretty, but they served me well as I made the trek from Cincinnati, Ohio to Claremont, California. As we were encouraged to speak, we were required to listen and to try to understand different viewpoints. We didn’t always agree, but the confinements of our home forced us to understand not only other beliefs, but the reasons behind those beliefs. Finally, this thesis and my experience at Claremont McKenna College taught me that empathy for most humans is a choice. This choice can mean the world to both the recipient and the provider.

Empathy is a central concern in the counselling process. Though much researched, and broadly commented upon, empathy is still largely understood through the words within a client-counsellor interaction. This semantic focus continues despite converging lines of evidence that suggest other elements of an interaction – for example body language – may be involved in the communication of empathy. In this thesis, the foundations of empathy are examined, focusing on empathy’s professional instantiation. These foundations are then related to the idea that the face, and its ability to express emotion, are an important part of the empathic process. What follows is an experiment testing 60 participants. This was a between groups design, with participants assigned to two even groups; one group receiving training in how emotion appears on the face: using the training program eMETT; the other reading a passage on empathy. Following the intervention, hypothesised group differences were assessed using the following analyses. Firstly, an Independent sample T-test, compared group means on the Ickes Empathic Accuracy paradigm, the measure of empathy used. Secondly, a further Independent sample T-test assessed the effect of eMETT training. Thirdly, an ANCOVA, evaluated whether the obtained results may have been confounded by age difference between the experimental groups. Finally a correlational analyse tested for any relationship between baseline and outcome measures. The hypothesis tested stated: training in facial expressions of emotion will enhance counsellors’ empathic accuracy; a hypothesis for which positive evidence was shown. The implications of this evidence suggest efficacy of the eMETT training to enhance empathic accuracy, though this is qualified through critical examination of the experimental method. Suggestions for refinement of this method are discussed.

This study investigated the effects of empathy training on medical students' responses to emotionally intense situations. It also explored the interaction between empathy and stress. Thirteen volunteers from a second-year medical class completed the study which utilized a two-factor crossover design. In the first of three testing situations, each subject participated in a 15-minute videotaped interview with an actor who portrayed an angry, fearful, or grieving patient. Each medical student then completed measures of empathic understanding and perceived stress regarding the encounter, as well as scales of coping and hardiness. Each simulated patient rated the medical student's level of empathic understanding. Two raters, blind to the experimental design, analyzed the tapes and rated the medical students' degree of communicated empathy. Subjects were then randomly assigned to one of two groups: training with follow-up, or control with delayed training. The first group received four 3-hour weekly sessions in empathy training while the second group served as a wait-list control. All subjects then participated in a second taped interview and completed all measures again. The subjects in group two received the training while the first group received no further treatment. All subjects were tested a third time which concluded the experimental procedure. The principal statistical analyses comprised a series of 2 x 2 ANOVAS tested at the .05 level of significance. Results revealed that, following the training, subjects learned to interact in a more empathic manner; effect sizes ranged from 1.08 to 18.32. Also, subjects' stress levels regarding the emotionally intense encounters were reduced; the effect size was -1.95. As hypothesized, these changes in empathy and stress were not observed for the wait-list control group, while training effects were maintained for subjects in the follow-up group. Changes in hardiness and coping were not statistically significant. An outline is presented which illustrates the mediating function of empathic responding in stressful interactions. Also addressed are implications for empathy training in medical education and for communication in the physician-patient relationship. / Graduate and Postdoctoral Studies / Graduate