Empathy towards the older person in paramedic-led out-of-hospital healthcare: A scoping review.

Most patients attended to by emergency ambulance service paramedics in Australia are aged greater than 65 years. Empathy-based interventions have been reported to improve attitudes toward the older person and enhance patient outcomes, yet empathy is reported as an understudied area of paramedic practice and little is known about paramedics' level of empathy, or the impact of empathic care, for the older person. The aim of this study was to identify what is known about the provision of empathic care toward the older person by paramedics and paramedic students, in out-of-hospital healthcare. Following the JBI methodology for scoping reviews, six papers were identified and thematically analysed. Four elements of empathic and non-empathic care were jointly identified by paramedics and the older person: 1) communication, 2) individualised care, 3) time and 4) professionalism. One additional theme identified by paramedics and students was concern for their own wellbeing when providing empathic care. Empathic care of the older person in the paramedic-led out-of-hospital context enhances patient outcomes, strengthens the person-paramedic relationship, and enhances the provision of holistic person-centred care. Programs for student and registered paramedics must include evidence-based education on practicing empathy towards the older person, along with strategies to address barriers to providing empathic care.