Empathy and boundary turbulence in cancer communication

PATIENT EDUCATION AND COUNSELING

卷:104

Article

McDaniel, Susan H.^1,2  Morse, Diane S.³  Edwardsen, Elizabeth A.⁴  Taupin, Adam⁵  Gurnsey, Mary Gale⁶  Griggs, Jennifer J.⁷  Shields, Cleveland G.⁸  Reis, Shmuel⁹ 

[1] Univ Rochester, Sch Med, Dr Laurie Sands Distinguished Prof Families & Hlt, Dept Psychiat, Rochester, NY 14618 USA

[2] Univ Rochester, Sch Med, Dept Family Med, Rochester, NY 14618 USA

[3] Univ Rochester, Psychiat & Med, Sch Med, Rochester, NY 14618 USA

[4] Univ Rochester, Emergency Med, Sch Med, Rochester, NY 14618 USA

[5] Equilibria Psychol & Consultat Serv, Philadelphia, PA USA

[6] Private Practice, New York, NY USA

[7] Univ Michigan, Internal Med Hematol & Oncol Div, Ann Arbor, MI 48109 USA

[8] Purdue Univ, Marriage & Family Therapy, W Lafayette, IN 47907 USA

[9] Hebrew Univ Jerusalem Hadassah Hosp & Med Sch, Fac Med, Med Educ, Jerusalem, Israel

关键词: Communication;    Empathy;    Self-disclosure;    Physicians;    Family;    Cancer;    Patient centered;   

DOI  :  10.1016/j.pec.2021.04.002

来源: Elsevier

【 摘 要 】

Objectives: To describe and deepen our understanding of patient-centeredness, empathy, and boundary management in challenging conversations. Previous studies show frequent physician self-disclosure, while empathy and boundary management are infrequent. Methods: Three standardized patients (SPs) portrayed cancer patients consulting a new community-based physician, resulting in 39 audio-recorded SP visits to 19 family physicians and 20 medical oncologists. Transcripts underwent qualitative iterative thematic analysis, informed by grounded theory, followed by directed content analysis. We further defined the identified communicative categories with descriptive and correlational calculations. Results: We identified patient-centered physician response categories-empathy, affirmation, and acknowledgement; and physician-centered categories-transparency, self-disclosure, and projection. Acknowledgement and affirmation responses were frequent and empathy rare. Physician transparency and self-disclosure were common. Useful and not useful self-disclosures were highly correlated; empathy, useful and not useful transparency, and projection were moderately correlated. Most physicians used self disclosure but few of these were judged patient-centered. Conclusions: Physicians expressing empathy and patient-centered transparency were also more likely to use projection and physician-centered transparency, thus engaging in communication boundary turbulence. Patients may benefit from physicians' improved use of empathy and boundary management. (c) 2021 Elsevier B.V. All rights reserved.

【 授权许可】

Free