How does physician empathy interact with patient emotional skills to predict patient quality of life?

Abstract

Research into the effect of physician empathy on cancer patients’ emotional quality of life (QoL) has provided contradictory results: in some studies, empathy was associated with a better QoL while in other studies, no association was found. We hypothesized that the link between physician empathy and QoL would depend on patient emotional skills (emoSkills). Patients with high emoSkills would benefit from physician empathy (as they would be sensitive to empathy and encouraged by it), while those with low emoSkills would not (because of a lack of emoSkills to cope with the disease). Methods. In a cross-sectional design, 149 French cancer patients completed questionnaires about their physician’s empathy (5 physicians assessed using the CARE), their emoSkills (S-PEC) and QoL (FACT-G emotional dimension). Multiple regressions were performed. Findings: Four emoSkills interacted with physician empathy to predict QoL: the patient’s ability to express his/her emotions (p <.01), to listen to the emotions of others (p<.05), to use his/her emotions (p<.05), and to use the emotions of others (p<.005). However, contrary to our hypothesis, patients with low emoSkills were those for whom their physician’s empathy was beneficial, i.e. related to a better QoL. For these patients, QoL was poor when the physician was not empathic, but much better with an empathic doctor. Patients with high emoSkills had a good QoL, which was not affected by their physician’s empathy. Discussion. This study demonstrates the importance of medical empathy, particularly for patients with low emoSkills. Indeed, physician empathy “compensates for†patient low emotional skills.