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Erschienen in: Supportive Care in Cancer 11/2010

01.11.2010 | Original Article

Do patient attributes predict oncologist empathic responses and patient perceptions of empathy?

verfasst von: Kathryn I. Pollak, Robert Arnold, Stewart C. Alexander, Amy S. Jeffreys, Maren K. Olsen, Amy P. Abernethy, Keri L. Rodriguez, James A. Tulsky

Erschienen in: Supportive Care in Cancer | Ausgabe 11/2010

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Abstract

Purpose

Most patients with advanced cancer experience negative emotion. When patients express emotions, oncologists rarely respond empathically. Oncologists may respond more empathically to some patients, and patients may perceive different levels of empathy and trust given past documentation of disparities in cancer care.

Methods

We audio-recorded 264 outpatient encounters between oncologists and patients with advanced cancer at three sites. We examined whether patient gender, age, race, marital status, education, economic security, and length of relationship with oncologist were related to oncologist empathic responses to patient's negative emotion and patient's perceptions of oncologist empathy and trust.

Results

Half (51%) of the patients expressed a negative emotion. Oncologists sometimes responded with empathy (29%). Oncologists were equally empathic with all patients, except they were more empathic with patients with low economic security compared with those reporting high economic security (p = .002). Patients with low economic security viewed oncologists as more empathic (p = .06) compared with those with moderate security. Married patients also viewed oncologists as more empathic (p = .04). Patients who knew their oncologist for more than a year had more trust than patients who knew their oncologists for less time (p = .02).

Conclusions

Oncologists, in general, did not respond empathically to patient's negative emotion, and did this equally for most patients. Oncologists responded more empathically to patients who were less economically advantaged. In turn, patients with lower economic security perceived more empathy. Although oncologists need more education in responding empathically, they may not need to correct many biases in care.
Literatur
1.
Zurück zum Zitat Anderson LA, Dedrick RF (1990) Development of the Trust in Physician scale: a measure to assess interpersonal trust in patient-physician relationships. Psychol Rep 67:1091–1100PubMed Anderson LA, Dedrick RF (1990) Development of the Trust in Physician scale: a measure to assess interpersonal trust in patient-physician relationships. Psychol Rep 67:1091–1100PubMed
2.
Zurück zum Zitat Armstrong K, Ravenell K, McMurphy S, Putt M (2007) Racial/Ethnic differences in physician distrust in the United States. Res Prac 97:1283–1289 Armstrong K, Ravenell K, McMurphy S, Putt M (2007) Racial/Ethnic differences in physician distrust in the United States. Res Prac 97:1283–1289
3.
Zurück zum Zitat Badger TA, Braden CJ, Mishel MH (2001) Depression burden, self-help interventions, and side effect experience in women receiving treatment for breast cancer. Oncol Nurs Forum 28:567–574PubMed Badger TA, Braden CJ, Mishel MH (2001) Depression burden, self-help interventions, and side effect experience in women receiving treatment for breast cancer. Oncol Nurs Forum 28:567–574PubMed
4.
Zurück zum Zitat Badger TA, Braden CJ, Mishel MH, Longman A (2004) Depression burden, psychological adjustment, and quality of life in women with breast cancer: patterns over time. Res Nurs Health 27:19–28CrossRefPubMed Badger TA, Braden CJ, Mishel MH, Longman A (2004) Depression burden, psychological adjustment, and quality of life in women with breast cancer: patterns over time. Res Nurs Health 27:19–28CrossRefPubMed
5.
Zurück zum Zitat Butow P, Cockburn J, Girgis A, Bowman D, Schofield P, D'Este C, Stojanovski E, Tattersall MH (2008) Increasing oncologists' skills in eliciting and responding to emotional cues: evaluation of a communication skills training program. Psychooncology 17:209–218CrossRefPubMed Butow P, Cockburn J, Girgis A, Bowman D, Schofield P, D'Este C, Stojanovski E, Tattersall MH (2008) Increasing oncologists' skills in eliciting and responding to emotional cues: evaluation of a communication skills training program. Psychooncology 17:209–218CrossRefPubMed
6.
Zurück zum Zitat Collins TC, Clark JA, Petersen LA, Kressin NR (2002) Racial differences in how patients perceive physician communication regarding cardiac testing. Med Care 40:I27–I34PubMed Collins TC, Clark JA, Petersen LA, Kressin NR (2002) Racial differences in how patients perceive physician communication regarding cardiac testing. Med Care 40:I27–I34PubMed
7.
Zurück zum Zitat Corbie-Smith G, Thomas SB, St George DM (2002) Distrust, race, and research. Arch Intern Med 162:2458–2463CrossRefPubMed Corbie-Smith G, Thomas SB, St George DM (2002) Distrust, race, and research. Arch Intern Med 162:2458–2463CrossRefPubMed
8.
Zurück zum Zitat Diggle PJ, Liang K-Y, Zeger SL (1994) Analysis of longitudinal data. Oxford Science Publications, NY Diggle PJ, Liang K-Y, Zeger SL (1994) Analysis of longitudinal data. Oxford Science Publications, NY
9.
Zurück zum Zitat Fallowfield L, Jenkins V, Farewell V, Saul J, Duffy A, Eves R (2002) Efficacy of a Cancer Research UK communication skills training model for oncologists: a randomised controlled trial. Lancet 359:650–656CrossRefPubMed Fallowfield L, Jenkins V, Farewell V, Saul J, Duffy A, Eves R (2002) Efficacy of a Cancer Research UK communication skills training model for oncologists: a randomised controlled trial. Lancet 359:650–656CrossRefPubMed
10.
Zurück zum Zitat Fischer G, Tulsky J, Arnold R (2000) Communicating a poor prognosis. In: Portenoy R, Bruera E (eds) Topics in palliative care. Oxford University Press, New York Fischer G, Tulsky J, Arnold R (2000) Communicating a poor prognosis. In: Portenoy R, Bruera E (eds) Topics in palliative care. Oxford University Press, New York
11.
Zurück zum Zitat Fogarty LA, Curbow BA, Wingard JR, McDonnell K, Somerfield MR (1999) Can 40 seconds of compassion reduce patient anxiety? J Clin Oncol 17:371–379PubMed Fogarty LA, Curbow BA, Wingard JR, McDonnell K, Somerfield MR (1999) Can 40 seconds of compassion reduce patient anxiety? J Clin Oncol 17:371–379PubMed
12.
Zurück zum Zitat Gordon HS, Street RL Jr, Sharf BF, Kelly PA, Souchek J (2006) Racial differences in trust and lung cancer patients' perceptions of physician communication. J Clin Oncol 24:904–909CrossRefPubMed Gordon HS, Street RL Jr, Sharf BF, Kelly PA, Souchek J (2006) Racial differences in trust and lung cancer patients' perceptions of physician communication. J Clin Oncol 24:904–909CrossRefPubMed
13.
Zurück zum Zitat Grabsch B, Clarke DM, Love A, McKenzie DP, Snyder RD, Bloch S, Smith G, Kissane DW (2006) Psychological morbidity and quality of life in women with advanced breast cancer: a cross-sectional survey. Palliat Support Care 4:47–56CrossRefPubMed Grabsch B, Clarke DM, Love A, McKenzie DP, Snyder RD, Bloch S, Smith G, Kissane DW (2006) Psychological morbidity and quality of life in women with advanced breast cancer: a cross-sectional survey. Palliat Support Care 4:47–56CrossRefPubMed
14.
Zurück zum Zitat Kennifer SL, Alexander SC, Pollak KI, Jeffreys AS, Olsen MK, Rodriguez KL, Arnold RM, Tulsky JA (2009) Negative emotions in cancer care: do oncologists' responses depend on severity and type of emotion? Patient Educ Couns 76:51–56CrossRefPubMed Kennifer SL, Alexander SC, Pollak KI, Jeffreys AS, Olsen MK, Rodriguez KL, Arnold RM, Tulsky JA (2009) Negative emotions in cancer care: do oncologists' responses depend on severity and type of emotion? Patient Educ Couns 76:51–56CrossRefPubMed
15.
Zurück zum Zitat Koropchak C, Pollak K, Arnold R, Alexander S, Skinner C, Olsen M, Jeffreys A, Rodriguez K, Abernethy A, Tulsky J (2006) Studying communication in oncologist-patient encounters: the SCOPE Trial. Palliat Med 20:813–819CrossRefPubMed Koropchak C, Pollak K, Arnold R, Alexander S, Skinner C, Olsen M, Jeffreys A, Rodriguez K, Abernethy A, Tulsky J (2006) Studying communication in oncologist-patient encounters: the SCOPE Trial. Palliat Med 20:813–819CrossRefPubMed
16.
Zurück zum Zitat Mager WM, Andrykowski MA (2002) Communication in the cancer 'bad news' consultation: patient perceptions and psychological adjustment. Psychooncology 11:35–46CrossRefPubMed Mager WM, Andrykowski MA (2002) Communication in the cancer 'bad news' consultation: patient perceptions and psychological adjustment. Psychooncology 11:35–46CrossRefPubMed
17.
Zurück zum Zitat Mercer SW, Reynolds WJ (2002) Empathy and quality of care. Br J Gen Pract 52(Suppl):S9–S12PubMed Mercer SW, Reynolds WJ (2002) Empathy and quality of care. Br J Gen Pract 52(Suppl):S9–S12PubMed
18.
Zurück zum Zitat Morse DS, Edwardsen EA, Gordon HS (2008) Missed opportunities for interval empathy in lung cancer communication. Arch Intern Med 168:1853–1858CrossRefPubMed Morse DS, Edwardsen EA, Gordon HS (2008) Missed opportunities for interval empathy in lung cancer communication. Arch Intern Med 168:1853–1858CrossRefPubMed
19.
Zurück zum Zitat Pollak KI, Alexander SC, Grambow SC, Tulsky JA (2009) Race and socioeconomic differences in oncologist patient-centered communication with patients with advanced cancer. Palliat Med (in press) Pollak KI, Alexander SC, Grambow SC, Tulsky JA (2009) Race and socioeconomic differences in oncologist patient-centered communication with patients with advanced cancer. Palliat Med (in press)
20.
Zurück zum Zitat Pollak KI, Arnold RM, Jeffreys AS, Alexander SC, Olsen MK, Abernethy AP, Sugg SC, Rodriguez KL, Tulsky JA (2007) Oncologist communication about emotion during visits with patients with advanced cancer. J Clin Oncol 25:5748–5752CrossRefPubMed Pollak KI, Arnold RM, Jeffreys AS, Alexander SC, Olsen MK, Abernethy AP, Sugg SC, Rodriguez KL, Tulsky JA (2007) Oncologist communication about emotion during visits with patients with advanced cancer. J Clin Oncol 25:5748–5752CrossRefPubMed
21.
Zurück zum Zitat Rimer BK, Halabi S, Skinner CS, Lipkus IM, Strigo TS, Kaplan EB, Samsa GP (2002) Effects of a mammography decision-making intervention at 12 and 24 months. Am J Prev Med 22:247–257CrossRefPubMed Rimer BK, Halabi S, Skinner CS, Lipkus IM, Strigo TS, Kaplan EB, Samsa GP (2002) Effects of a mammography decision-making intervention at 12 and 24 months. Am J Prev Med 22:247–257CrossRefPubMed
22.
Zurück zum Zitat Siminoff LA, Graham GC, Gordon NH (2006) Cancer communication patterns and the influence of patient characteristics: disparities in information-giving and affective behaviors. Patient Educ Couns 62:355–360CrossRefPubMed Siminoff LA, Graham GC, Gordon NH (2006) Cancer communication patterns and the influence of patient characteristics: disparities in information-giving and affective behaviors. Patient Educ Couns 62:355–360CrossRefPubMed
23.
Zurück zum Zitat Skinner CW, Pollak KI, Farrell D, Olsen MK, Jeffreys AS, Tulsky JA (2009) Use of and reactions to a tailored CD-ROM designed to enhance oncologist-patient communication: the SCOPE Trial intervention. Patient Educ Couns 77:90–96CrossRefPubMed Skinner CW, Pollak KI, Farrell D, Olsen MK, Jeffreys AS, Tulsky JA (2009) Use of and reactions to a tailored CD-ROM designed to enhance oncologist-patient communication: the SCOPE Trial intervention. Patient Educ Couns 77:90–96CrossRefPubMed
24.
Zurück zum Zitat Smith R, Hoppe R (1991) The patient's story: integrating the patient- and physician-centered approaches to interviewing. Ann Intern Med 115:470–477PubMed Smith R, Hoppe R (1991) The patient's story: integrating the patient- and physician-centered approaches to interviewing. Ann Intern Med 115:470–477PubMed
25.
Zurück zum Zitat Stark D, Kiely M, Smith A, Velikova G, House A, Selby P (2002) Anxiety disorders in cancer patients: their nature, associations, and relation to quality of life. J Clin Oncol 20:3137–3148CrossRefPubMed Stark D, Kiely M, Smith A, Velikova G, House A, Selby P (2002) Anxiety disorders in cancer patients: their nature, associations, and relation to quality of life. J Clin Oncol 20:3137–3148CrossRefPubMed
26.
Zurück zum Zitat Suchman A, Markakis K, Beckman H, Frankel R (1997) A model of empathic communication in the medical interview. JAMA 277:678–682CrossRefPubMed Suchman A, Markakis K, Beckman H, Frankel R (1997) A model of empathic communication in the medical interview. JAMA 277:678–682CrossRefPubMed
27.
Zurück zum Zitat Tulsky J et al (2004) Doctor-patient communication issues. In: Cassel C, Leipzig R, Cohen H (eds) Geriatric medicine. Springer, New York, NY Tulsky J et al (2004) Doctor-patient communication issues. In: Cassel C, Leipzig R, Cohen H (eds) Geriatric medicine. Springer, New York, NY
28.
Zurück zum Zitat Tulsky JA, Alexander SC, Olsen MK et al (2008) Can Oncologists be taught to respond to patients' negative emotions? Results of the SCOPE Trial Tulsky JA, Alexander SC, Olsen MK et al (2008) Can Oncologists be taught to respond to patients' negative emotions? Results of the SCOPE Trial
29.
Zurück zum Zitat Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S (2001) The prevalence of psychological distress by cancer site. Psychooncology 10:19–28CrossRefPubMed Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S (2001) The prevalence of psychological distress by cancer site. Psychooncology 10:19–28CrossRefPubMed
Metadaten
Titel
Do patient attributes predict oncologist empathic responses and patient perceptions of empathy?
verfasst von
Kathryn I. Pollak
Robert Arnold
Stewart C. Alexander
Amy S. Jeffreys
Maren K. Olsen
Amy P. Abernethy
Keri L. Rodriguez
James A. Tulsky
Publikationsdatum
01.11.2010
Verlag
Springer-Verlag
Erschienen in
Supportive Care in Cancer / Ausgabe 11/2010
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-009-0762-8

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