Tabor E Flickinger1, Somnath Saha2, Debra Roter3, P Todd Korthuis4, Victoria Sharp5, Jonathan Cohn6, Susan Eggly6, Richard D Moore3, Mary Catherine Beach3. 1. University of Virginia School of Medicine, Charlottesville, VA, USA. Electronic address: TES3J@hscmail.mcc.virginia.edu. 2. Portland VA Medical Center, Portland, OR, USA; Oregon Health and Science University, Portland, OR, USA. 3. Johns Hopkins University, Baltimore, MD, USA. 4. Oregon Health and Science University, Portland, OR, USA. 5. St Luke's Roosevelt, New York, NY, USA. 6. Wayne State University, Detroit, MI, USA.
Abstract
OBJECTIVE: We examined associations of clinicians' empathy with patient-clinician communication behaviors, patients' rating of care, and medication self-efficacy. METHODS: We analyzed 435 adult patients and 45 clinicians at four outpatient HIV care sites in the United States. Negative binomial regressions investigated associations between clinician empathy and patient-clinician communication, assessed using the Roter Interaction Analysis System (RIAS). Logistic regressions investigated associations between clinician empathy and patient ratings of clinician communication, overall satisfaction, and medication self-efficacy. RESULTS: Clinicians in the highest vs. lowest empathy tertile engaged in less explicitly emotional talk (IRR 0.79, p<0.05), while clinicians in the middle vs. lowest engaged in more positive talk (IRR 1.31, p<0.05), more questions (IRR 1.42, p<0.05), and more patient activating talk (IRR 1.43, p<0.05). Patients of higher empathy clinicians disclosed more psychosocial and biomedical information. Patients of clinicians in both the middle and highest (vs. lowest) empathy tertiles had greater odds of reporting highest medication self-efficacy (OR 1.80, 95% CI 1.16-2.80; OR 2.13, 95% CI 1.37-3.32). CONCLUSIONS: Clinician empathy may be expressed through addressing patient engagement in care, by fostering cognitive, rather than primarily emotional, processing. PRACTICE IMPLICATIONS: Clinicians should consider enhancing their own empathic capacity, which may encourage patients' self-efficacy in medication adherence.
OBJECTIVE: We examined associations of clinicians' empathy with patient-clinician communication behaviors, patients' rating of care, and medication self-efficacy. METHODS: We analyzed 435 adult patients and 45 clinicians at four outpatient HIV care sites in the United States. Negative binomial regressions investigated associations between clinician empathy and patient-clinician communication, assessed using the Roter Interaction Analysis System (RIAS). Logistic regressions investigated associations between clinician empathy and patient ratings of clinician communication, overall satisfaction, and medication self-efficacy. RESULTS: Clinicians in the highest vs. lowest empathy tertile engaged in less explicitly emotional talk (IRR 0.79, p<0.05), while clinicians in the middle vs. lowest engaged in more positive talk (IRR 1.31, p<0.05), more questions (IRR 1.42, p<0.05), and more patient activating talk (IRR 1.43, p<0.05). Patients of higher empathy clinicians disclosed more psychosocial and biomedical information. Patients of clinicians in both the middle and highest (vs. lowest) empathy tertiles had greater odds of reporting highest medication self-efficacy (OR 1.80, 95% CI 1.16-2.80; OR 2.13, 95% CI 1.37-3.32). CONCLUSIONS: Clinician empathy may be expressed through addressing patient engagement in care, by fostering cognitive, rather than primarily emotional, processing. PRACTICE IMPLICATIONS: Clinicians should consider enhancing their own empathic capacity, which may encourage patients' self-efficacy in medication adherence.
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