Palliative Medicine Reports (Jun 2020)

Patients' and Clinicians' Perceptions of Clinician-Expressed Empathy in Advanced Cancer Consultations and Associations with Patient Outcomes

  • Hinke Hoffst?dt,
  • Jacqueline Stouthard,
  • Maartje C. Meijers,
  • Janine Westendorp,
  • Inge Henselmans,
  • Peter Spreeuwenberg,
  • Paul de Jong,
  • Sandra van Dulmen,
  • Liesbeth M. van Vliet

DOI
https://doi.org/10.1089/PMR.2020.0052
Journal volume & issue
Vol. 1, no. 1
pp. 76 – 83

Abstract

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Background: Empathy is a cornerstone of effective communication. However, clinicians' and patients' perceptions of clinician-expressed empathy might differ. The independent perceptions of patients and clinicians on clinician-expressed empathy in advanced cancer consultations and the associations of these perceptions with patient outcomes are unknown. Objective: We assessed (1) patients' and clinicians' independent perceptions of clinician-(self-)expressed empathy in advanced cancer consultations and (2) the associations between these perceptions and affective patient outcomes. Methods: This observational study included data from 41 consultations in the advanced breast cancer setting. Postconsultation, patients' and clinicians' perceptions of clinician-expressed empathy were assessed, as well as patients' (1) pre?post anxiety, (2) post-anxiety, (3) emotional well-being, and (4) satisfaction. Multilevel regression analyses were run to draw conclusions. Results: Patients perceived higher levels of empathy than clinicians, without a significant relationship between the two (mean [M]?=?85.47, standard deviation [SD]?=?14.00 vs. M?=?61.88, SD?=?15.30, 0?100 scale; ??=?0.14, p?<?0.138, 95% confidence interval [CI]?=??0.04 to 0.32). Higher patient-perceived empathy was associated with decreased anxiety [(1) ??=??0.67, p?=?0.039, 95% CI?=??1.30 to ?0.03; (2) ??=??0.15, p?=?0.042, 95% CI?=??0.30 to ?0.01], higher satisfaction (??=?0.05, p?<?0.001, 95% CI?=?0.03 to 0.08), and lower emotional distress (??=??0.32, p?<?0.001, 95% CI?=??0.48 to ?0.16). There were no associations with clinicians' perceptions [(1) ??=??0.34, p?=?0.307, 95% CI?=??1.00 to 0.31; (2) ??=??0.02, p?=?0.824, 95% CI?=??0.17 to 0.14; (3) ? < 0.01, p?=?0.918, 95% CI?=??0.03 to 0.02; (4) ??=?0.08, p?=?0.335, 95% CI?=??0.08 to 0.25]. Conclusions: Patients' and clinicians' empathy perceptions differed. In improving patient outcomes, the focus should be on patients' perceptions of clinician-expressed empathy. Future research could focus on ways to elicit patients' perceptions of empathy with the higher aim of improving patient outcomes.

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