Physician empathy improves patients' psychological well-being
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Physicians who demonstrate empathy in their interactions with individuals with breast cancer foster better psychological well-being and adjustment in this patient population, according to a study published in Patient Education and Counseling.
“In this study, we were looking at the idea of illness uncertainty, which includes uncertainty related to a health event or uncertainty about prognosis,” study lead author Liesl Broadbridge, ScM, CGC, a genetic counselor and doctoral degree candidate at the Rutgers School of Communication and Information, told Healio. “We wanted to know whether empathic communication is something that can potentially help to reduce that uncertainty and improve well-being for patients with breast cancer.”
Broadbridge spoke with Healio about the study's findings, its implications for clinical practice, and what oncologists can do to foster empathy and clarity in their patient communications.
Healio: What motivated you to conduct this study?
Broadbridge: As a clinician and health communication researcher, I am very interested in how effective communication can help to support our patients and better facilitate their psychological well-being.
The survey data were collected through a partnership with the Dr. Susan Love Foundation's Love Research Army, which is a patient registry database of current and former patients with breast cancer. We analyzed these data for how provider communication interacted with different parts of psychological processing, which we know can be either facilitated or hindered by communication with health care providers. We looked at how empathic communication could alleviate uncertainty about symptoms or prognosis, and how that, in turn, can influence psychological well-being.
Healio: What did you find?
Broadbridge: We found that more empathetic communication was associated with less symptom uncertainty and less illness uncertainty, and having less uncertainty was then associated with better psychological well-being and increased psychological adjustment.
Healio: Do oncologists in general need to work on improving empathy in their patient communications?
Broadbridge: As providers, we all strive to relate to our patients and have empathic communication where we can. Having this evidence that reduced uncertainty is related to better well-being is a useful way to target the issue of empathic communication that providers are already working on. We can think about how we might elicit or ask about uncertainty in our interactions, and what patients might still be questioning about their diagnosis and their symptoms during treatment. We also want to think about uncertainty that might occur after treatment. When patients with breast cancer have concluded treatment but are still coming in for appointments, we can consider how we might respond with the empathy that providers are already striving to use. This doesn’t necessarily need to take up much time in a patient interaction — it could be something very small that has a big impact on well-being. I think it’s always possible for us to be more empathic, but it’s useful to think specifically about which contexts might need additional empathy, instead of viewing it in broader, more vague terms.
Healio: What can oncologists do to improve their empathy in patient interactions?
One finding that was very interesting to us was the differences between patients who were currently undergoing treatment and patients who had already completed treatment in our study. We found that for those who had completed treatment, the uncertainty that they were experiencing had a stronger effect on adjustment and psychological well-being. So, oncologists can help by emphasizing the importance of illness and symptom uncertainty not just during treatment and when everything is still fresh, but also as we’re continuing through the illness trajectory. Checking back in on what uncertainty might still be present is one potentially important way to demonstrate empathy.
Healio: Is there anything else you’d like to mention?
What makes this study unique and hasn’t been explored in the literature before is that some of these processes of uncertainty occur throughout the illness trajectory. There is a lot of research about psychological well-being and the uncertainties that are present for patients currently undergoing treatment, but much less about patients who are past treatment and into the survivorship stage. Because uncertainty was found to be more strongly related to well-being for patients later in the illness trajectory, it might be even more important to keep illness uncertainty in mind in terms of communication and empathy.
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For more information:
Liesl Broadbridge, ScM, CGC, can be reached at Rutgers University, 4 Huntington Street, New Brunswick, NJ 08901; email: liesl.broadbridge@rutgers.edu.
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