title: Nurse-expressed empathy, patient outcomes, and development of a middle-range theory.
abstract: OBJECTIVE
  To demonstrate how a middle-range theory was developed and tested through research that examined relationships between nurse-expressed empathy and two patient outcomes: patient-perceived empathy and patient distress.
  
  
  CONCLUSIONS
  Nurse-patient relationships are the basis for all nursing care and empathy is an important aspect of these relationships. Research is needed, however, to determine the patient outcomes that are related to the empathy of nurses.
  
  
  METHODS
  Orlando's (1961, 1972) nursing model.
  
  
  METHODS
  140 subjects, 70 staff RNs and 70 patients from hospital medical-surgical acute care units. Each nurse-subject completed two measures of nurse-expressed empathy and each patient-subject completed a measure of perceived empathy and two measures of distress.
  
  
  RESULTS
  Negative relationships were found between nurse-expressed empathy and patient distress (r = -.71, p < .001), and between patient-perceived empathy and patient distress (r = -.71, p < .001). A moderate positive relationship was found between nurse-expressed empathy and patient-perceived empathy (r = .35 to .47, p < .05).
  
  
  CONCLUSIONS
  A model can be tested when propositions theoretically linked to the model are empirically tested. This study's findings demonstrated support for relationships proposed in Orlando's model.
authors.affiliation: Faculty of Nursing, University of Alberta, College of Nursing, Edmonton, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Olson
authors.forename: E
authors.initials: E
authors.lastname: Hanchett
mesh_terms: D001294:Attitude to Health; D004645:Empathy; D006801:Humans; D016294:Models, Nursing; D009723:Nurse-Patient Relations; D015403:Nursing Evaluation Research; D009742:Nursing Theory; D017063:Outcome Assessment, Health Care; D015203:Reproducibility of Results; D013315:Stress, Psychological / Q000451:nursing / Q000523:psychology*