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Social emotion and patient safety: an important and understudied intersection
  1. Jane Heyhoe1,
  2. Rebecca Lawton1,2
  1. 1 Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, UK
  2. 2 School of Psychology, University of Leeds, Leeds, UK
  1. Correspondence to Dr Jane Heyhoe, Quality and Safety Research Group, Bradford Institute for Health Research, Bradford BD9 6RJ, UK; jane.heyhoe{at}

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Until the late 1990s, models of decision making and behaviour in the psychological literature largely ignored the role of emotion. With the work of influential authors,1–3 among others, came the recognition and evidence that our decisions are not always rational. We rely on heuristics or rules of thumb that can accumulate with experience and exposure and that help us to be more efficient (most of the time) but also prone to bias.4 At the same time, social psychologists seeking to understand what drives our behaviour were also beginning to recognise that, while the costs and benefits of adopting a particular behaviour (eg, smoking or running) were important motivators, the anticipated and actual feelings associated with engaging in these behaviours were often more important predictors of future behaviours.5 For example, people who felt miserable and embarrassed when running were less likely to run again, despite the knowledge that it was good for them. What was also becoming obvious was that people are not all that good at understanding how powerful emotions can be in driving their behaviour. Insightful work by Sayette and colleagues,6 for example, demonstrated that if we ask smokers who were not currently craving a cigarette (cold emotional state) if they could give up, they often said they could, but when craving a cigarette (in a hot emotional state), they were much more likely to be accurate about their inability to give up. There is also evidence that a hot–cold empathy gap is relevant in medical decision making.7 This last point has important implications for the study of emotions, highlighting that we may need to be cautious about interpreting findings from studies that ask people to recall or imagine how emotion may or may not have influenced their judgements or behaviour or indeed how …

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