• Marsha Campbell-Yeo, Margot Latimer, and Céleste Johnston.
• Neonatal Intensive Care, IWK Health Centre, Halifax, Nova Scotia, Canada. marsha.campbellyeo@iwk.nshealth.ca
• J Adv Nurs. 2008 Mar 1; 61 (6): 711-9.

AimThis paper is a report of a concept analysis of empathy.BackgroundIt is widely accepted that an empathetic response is necessary for nurses to deliver adequate pain relief and therapeutic care. Previous work suggests that empathy is a learned behaviour, and thus can be blocked if necessary to diminish personal distress.MethodsA computerized search of the CINAHL, MEDLINE, PsycINFO, and Web of Science databases from 1980 to 2007 was conducted, using the keywords pain and empathy, both alone and in combination. Similar concepts such as sympathy, caring and compathy were included if the database distinguished between these concepts. Twenty-five relevant articles were reviewed and Rodgers evolutionary concept analysis process was used to clarify the concept.FindingsThe recent observation that a mirror-like neural response occurs in the brain of a person witnessing another in pain provides compelling evidence that empathetic arousal may occur independent of the previously described attributes of prior experience or learned cognitive appraisal.ConclusionWhile the empathetic response of care providers plays a central role in the recognition and treatment of pain, nurses are taught that regulation of this response is important to protect themselves against the traumatic effects of seeing patients in pain. However, there is emerging evidence that some elements of empathetic arousal are autonomic and therefore unable to be fully controlled; this may have important implications for nurses' vulnerability.

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