Clinicians' accuracy in perceiving patients: Its relevance for clinical practice and a narrative review of methods and correlates
ABSTRACT A relatively unexplored aspect of clinicians' communication skill is their interpersonal sensitivity, or ability to perceive their patients accurately with regard to patients' feelings, desires, intentions, needs, physical states, personality, attitudes, beliefs, and values. The present article argues for the importance of this skill in clinical interactions and summarizes supportive research.
Reviews approaches to measuring interpersonal sensitivity and research on correlates of clinicians' and laypersons' interpersonal sensitivity.
Studies on clinicians' interpersonal sensitivity suggest that this skill could be improved. Furthermore, there are important correlates of clinicians' interpersonal sensitivity, including, on the patient's side, satisfaction, appointment-keeping adherence, and learning of conveyed information, and, on the clinician's side, awareness of patients' cues of anxiety and distress, commitment to patient-centered values, self-reported awareness of own emotions, and female gender. Furthermore, a very large non-clinical literature points to many other correlates of interpersonal sensitivity that are relevant to the clinical situation, including empathy, prosocial behavior, skill in negotiating, selling, teaching, and managing, better personal adjustment, and better interpersonal relationships. Research also suggests that interpersonal sensitivity is a trainable skill that could realistically be included in clinical education.
Clinicians' interpersonal sensitivity is an important component of quality of care and deserves further research.
This important skill should be incorporated into training programs to improve clinician-patient communication.
- SourceAvailable from: Danielle Blanch-Hartigan
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ABSTRACT: 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. 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. 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. 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. Physicians should ask patients for feedback regarding their emotions. In parallel, patients should be prompted to express their concerns.Patient Education and Counseling 11/2013; 94(3). DOI:10.1016/j.pec.2013.10.029 · 2.60 Impact Factor
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ABSTRACT: OBJECTIVE: Previous research has examined physicians' ability to respond to or identify the type of emotion cues. Yet in physician-patient interactions, identification and response are preceded by the ability to detect whether an emotion cue has occurred. This research assesses consequences of emotion detection errors for patient satisfaction. METHODS: Participants responding to an online survey read one of six randomly assigned descriptions of a physician-patient interaction varying on: whether the patient presented an emotion cue; whether the physician detected an emotion cue; and whether the physician correctly identified the cue. Participants then rated satisfaction with the physician. RESULTS: Satisfaction was highest when the physician correctly detected the patient's emotion cue and lowest when the physician failed to detect the patient's emotion. Failing to detect the emotion cue had lower satisfaction than other emotion processing errors, including falsely detecting an emotion cue that was not there or incorrectly identifying the type of emotion. CONCLUSIONS: Emotion cue detection has implications for patient satisfaction distinct from emotion identification. PRACTICE IMPLICATIONS: Results suggest it may be better for physicians to incorrectly identify than miss an emotion. Training for healthcare providers should consider incorporating emotion detection.Patient Education and Counseling 05/2013; 93(1). DOI:10.1016/j.pec.2013.04.010 · 2.60 Impact Factor