Abstract

Objective: The aim of the present cross-sectional study was to explore patient- and physician-specific determinants of physician empathy (PE) and to analyse the influence of PE on patient-reported long-term outcomes in German cancer patients. Methods: A postal survey was administered to 710 cancer patients, who had been inpatients at the University Hospital Cologne (response rate 49.5%). PE was measured with the German translation of the consultation and relational empathy (CARE) measure, and patient-reported long-term outcomes were assessed using the major (ICD-10) depression inventory (MDI) and the EORTC quality of life (Qol) questionnaire QLQ-C30. Hypotheses were tested by structural equation modelling. Results: PE had (a) a moderate indirect effect on ‘‘depression’’ and a smaller indirect effect on ‘‘socio-emotional-cognitive Qol’’ by affecting ‘‘desire for more information from the physician regarding findings and treatment options’’ and (b) a moderate indirect effect on ‘‘socio-emotionalcognitive Qol’’ and a smaller effect on ‘‘depression’’ via ‘‘desire for more information about health promotion’’. The determinant with the greatest importance was ‘‘patient-perceived general busyness of hospital staff’’: it had a strong negative influence on PE, indirectly influencing ‘‘desire for more information from the physician regarding findings and treatment options’’ and also patients’ ‘‘depression’’. Conclusion: PE seems to be an important pre-requisite for information giving by physicians and through this pathway having a preventive effect on depression and improving Qol. Conversely, physicians’ stress negatively influences these relationships. Practice implications: The research findings suggest that reducing physicians’ stress at the organizational and individual may be required to enhance patient–physician communication. Empathy, as an outcome-relevant professional competence needs to be assessed and developed more intensively in medical students and physicians. # 2007 Elsevier Ireland Ltd. All rights reserved.

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