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abstract
Objective
To examine the
determinants of the accuracy with which physicians assess metastatic
cancer patient distress, also referred to as their empathic accuracy
(EA). Hypothesized determinants were physician empathic attitude,
self-efficacy in empathic skills, physician-perceived rapport with the
patient, patient distress and patient expressive suppression.
Methods
Twenty-eight
physicians assessed their patients’ distress level on the distress
thermometer, while patients (N = 201) independently rated their distress
level on the same tool. EA was the difference between both scores in
absolute value. Hypothesized determinants were assessed using
self-reported questionnaires. Multilevel analyses were carried out.
Results
Little
of the variance in EA was explained by physician variables. EA was
higher with higher levels of patient distress. Physician-perceived
quality of rapport was positively associated with EA. However, for
highly distressed patients, good rapport was associated with lower EA.
Patient expressive suppression was also related to lower EA.
Conclusion
This
study adds to the understanding of EA in oncological settings,
particularly in challenging the common assumption that EA depends
largely on physician characteristics or that better rapport would always
favor higher EA.
Practice implications
Physicians
should ask patients for feedback regarding their emotions. In parallel,
patients should be prompted to express their concerns.
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