Empathy at the core: a qualitative study of patient experience in an urban and rural emergency department setting

Emergency-department patients interviewed at an urban academic center and a rural community hospital identified staff empathy as the most impactful part of their visits, even when circumstances were unfavorable. The qualitative study included 56 participants and found one unifying theme—empathy—encompassing five major aspects of patient experience: staff attitudes, showing concern, patient-centered communication, frequent updates and discrimination. Patients associated the most positive experiences with empathetic attitudes, regular information during their visit, communication centered on the patient, and enough time to ask questions without feeling rushed.

Researchers used semi-structured individual interviews with emergency-department patients at the two hospitals. The study adopted a constructivist approach and analyzed the interview material with inductive thematic analysis, allowing themes to emerge from the accounts rather than testing predetermined categories. The design examined the factors shaping patient experience in two distinct clinical settings. Because the study was qualitative, its results describe reported experiences and recurring themes; they do not estimate how common those experiences were across all emergency-department patients, establish causes and effects, or demonstrate that empathy improves clinical outcomes.

The interviews showed that communication was not experienced as a single interaction. It included staff attitudes, demonstrations of concern, frequent updates throughout the emergency-department visit and patient-centered communication, especially during discharge. Being able to ask questions without feeling rushed was another feature associated with positive experiences. Patients also identified differences between the two departments in their confidence in the care received and in the physical environment, including crowdedness and the use of hallway beds. The reported contrasts were distinguishing features of the two settings rather than evidence of a trend over time or proof that one hospital provided systematically better care.

Discrimination was the fifth major theme connected to the broader experience of empathy. Its presence indicates that patients’ accounts of empathy encompassed not only concern and communication but also whether they perceived discrimination during the visit. Across both hospitals, however, empathy remained the central influence patients attributed to their emergency-department experience. The authors said future studies should explore perceptions of empathy across cultural differences and examine interpersonal and systemic interventions intended to improve it. The present study provides the qualitative foundation for that work but does not test whether particular interventions are effective. It also focuses on two emergency departments, one urban and one rural, so the findings describe experiences within those settings rather than the full range of emergency care.

Subject of Research: Patient perceptions of empathy in urban and rural emergency departments

Article Title: Empathy at the core: a qualitative study of patient experience in an urban and rural emergency department setting

Article References: Carmel, M., Kaur, N., Strachan, C. C., & Alexander, A. B. (2026). Empathy at the core: a qualitative study of patient experience in an urban and rural emergency department setting. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15237-z

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15237-z

Keywords: patient experience, empathy, emergency department, qualitative interviews, patient-centered communication, health communication, urban health, rural health, inductive thematic analysis, discrimination, core, qualitative