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

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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.

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Author information

Authors and Affiliations

  1. Duke Comprehensive Cancer Center, Cancer Prevention, Detection and Control Research Program, Duke University School of Medicine, Durham, USA

    Kathryn I. Pollak, Amy P. Abernethy & James A. Tulsky

  2. Department of Community and Family Medicine, Duke University Medical Center, Durham, USA

    Kathryn I. Pollak

  3. Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA

    Robert Arnold & Keri L. Rodriguez

  4. Institute for Doctor-Patient Communication, University of Pittsburgh School of Medicine, Pittsburgh, USA

    Robert Arnold & Keri L. Rodriguez

  5. Institute to Enhance Palliative Care, University of Pittsburgh School of Medicine, Pittsburgh, USA

    Robert Arnold

  6. Department of Medicine, Duke University Medical Center, Durham, USA

    Stewart C. Alexander, Amy P. Abernethy & James A. Tulsky

  7. Center for Palliative Care, Duke University Medical Center, Durham, USA

    Stewart C. Alexander, Amy P. Abernethy & James A. Tulsky

  8. Center for Health Services Research, Durham VA Medical Center, Durham, USA

    Stewart C. Alexander, Amy S. Jeffreys, Maren K. Olsen & James A. Tulsky

  9. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, USA

    Maren K. Olsen

  10. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA

    Keri L. Rodriguez

  11. Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA

    Keri L. Rodriguez

Authors
  1. Kathryn I. Pollak
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  2. Robert Arnold
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  3. Stewart C. Alexander
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  4. Amy S. Jeffreys
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  5. Maren K. Olsen
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  6. Amy P. Abernethy
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  7. Keri L. Rodriguez
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  8. James A. Tulsky
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Corresponding author

Correspondence to Kathryn I. Pollak.

Additional information

This work was supported by R01CA100387. The authors have no financial disclosures.

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Pollak, K.I., Arnold, R., Alexander, S.C. et al. Do patient attributes predict oncologist empathic responses and patient perceptions of empathy?. Support Care Cancer 18, 1405–1411 (2010). https://doi.org/10.1007/s00520-009-0762-8

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  • DOI: https://doi.org/10.1007/s00520-009-0762-8

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