How physician affective communication skills are related to patient characteristics and outcomes: empathy and self-awareness in the spotlight

Empathy is a central element of patient centered-care and therefore believed to improve patient outcomes. Empathy consists of multiple components (cognitive, affective, and behavioral), which play together in an interaction between the physician and a patient. Physician and patient characteristics affect empathy in the specific interaction. Empirical results on the effects of empathy on patient outcomes are ambiguous and incomparable, because studies mostly measure only one component of empathy in relation to patient outcomes or physician and patient characteristics. <br>Study 1 addresses the research question whether different components of empathy are related patient outcomes and patient characteristics. To do we videotaped general practitioners with a maximum of 5 of their patients in their medical practices. We assessed different physician empathic components (cognitive, affective, and behavioral) using different measures for each component as well patient outcomes (satisfaction, trust) and characteristics (general health status) through self-evaluation. Results indicate that different components of empathy are related differently to patient outcomes and that using different measures influences our study results. Patient characteristics are related to all empathic components. <br>Self-awareness, as the physician’s skill to be aware of one’s own emotional experience, is believed to be a beneficial antecedent of empathy and therefore an important affective physician communication skill. However, research on the relationship between self-awareness and empathy is extremely scarce. <br>Study 2 investigates the relationship between self-awareness and empathic behavior when considering patient communication style. Simulated patients served as targets for medical students whose task was to lead a medical consultation with the simulated patients. We manipulated patient communication style as either demanding or neutral to see whether physician self-awareness was related to empathy depending on patient communication style. Physician self-awareness and empathy (cognitive, affective, and behavioral) was assessed using medical student’s self-evaluations. Results indicate that self-awareness was significantly related to behavioral empathy, however, not clearly in the direction we expected. <br>Global results are integrated in existing theories of physician patient communication. Based on the empirical results conceptual and methodological issues of empathy are discussed.

Thèse de doctorat : Université de Neuchâtel, 2013 ; 2373