. IMPLICATIONS FOR PRACTICE
Empathy and its dimensions are generally related with the establishment of the TR among nurses and patients in mental health units. According to the phase of the therapeutic relationship, certain dimensions influence empathy more than others, therefore nurses must be aware of this and adapt to this in their daily clinical practice. Perspective-taking skills are one of the components which most strongly influence the nurse-patient bond, which is an essential starting point in the orientation phase of a therapeutic relationship. Also, knowing that empathic concern and personal distress are more influential than other dimensions of empathy in the working phase of the therapeutic relationship could be especially important for mental health nurses to become aware of the importance of personal self-awareness and emotional management in the establishment of therapeutic relationships of quality with patients. This specific finding is both relevant and striking, considering the tendencies of current mental health care which are centered on the paradigm of autonomy and the model of recovery. Thus, according to this model, to facilitate patient empowerment, health professionals should constantly generate spaces for shared decision making (Newman, O’Reilly, Lee, & Kennedy, 2015; Smith & Williams, 2016). This may help gain awareness among nurses of these factors, as well as inform educational programs, by including the training of empathic strategies and emotional management. Likewise, these findings, together with the existing literature, indicate the need for further research on the factors which predict the establishment of therapeutic relationships, in order to improve the quality of care provided at mental health hospitalization units.
RELEVANCE STATEMENT
This article features the results of a study analyzing the association between the dimensions of empathy and the therapeutic relationship of nurses in mental health units. After controlling the influence of nurses’ social and professional characteristics, we found that the changes that occurred in the therapeutic relationship were significantly related with certain dimensions of empathy in nurses. Perspective taking is the factor which most strongly influences the bond between the patient and nurse, constituting an essential starting point in the orientation phase of a therapeutic relationship. Also, the fact that empathic concern and personal distress are more influential than other dimensions of empathy in the work phase of the therapeutic relationship is important, as mental health nurses must be aware of the importance of personal self-awareness and emotional management in the establishment of greater quality in the nurse-patient therapeutic relationships. These factors are directly related with shared decision making, and the basic practice of person-centered care, which, in turn is recognized as being an essential component of recovery-oriented care.