The Influence of Perceived Provider Empathic Communication on Disclosure Decision-Making

ABSTRACT

Provider empathy is a crucial component in establishing therapeutic provider–patient relationships. The benefits of increased perceptions of empathy can support patient psychological adjustment to their cancer as well as patients’ comfort and confidence in disclosing to providers, ultimately promoting patient engagement. Guided by the disclosure decision-making model, this manuscript explores how perceptions of empathy influence patient psychological adjustment and how those variables influence patient disclosure efficacy. The model ultimately predicts patient sharing and withholding of information during the medical interaction. This study tested a mediation model to investigate how current (n = 111) and former (n = 174) breast cancer patients’ psychological adjustment mediates the relationship between patient perceptions of oncologist empathic communication and efficacy to disclose health information to their oncologist and their disclosure enactment in sharing and withholding. Overall, former patients compared to current patients had more positive perceptions of their oncologist’s empathic communication, had better psychological adjustment, felt more self-efficacy to disclose to their oncologist, and shared more and withheld less information from their oncologist (p < .05 in all cases). Structural equation modeling revealed good fit to the data for both current and former patients such that more perceived empathic communication was associated with more efficacy for disclosure, which was associated with more sharing and less withholding. Additionally, there was an indirect relationship from perceptions of empathic communication to disclosure efficacy through patients’ psychological adjustment to the diagnosis. Results reinforce the importance of providers’ empathic communication for cancer patients’ psychological adjustment because patient sharing and withholding of information remain crucially important to achieving holistic care across the cancer trajectory.

Acknowledgements

The authors would like to thank the participants who spent their time and energy to provide these data. Recruitment facilitated by Dr. Susan Love Research Foundation’s Love Research Army®. We would like to acknowledge the Rutgers Cancer Institute of New Jersey’s (CINJ) Cancer Survivorship & Outcomes Center (CSOC).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics approval

This study was approved by the Rutgers University Institutional Review Board (protocol and approval # E17–664).

Data availability statement

The data that support the findings of this study are available from the corresponding author.

Notes

1. Male patients with breast cancer were excluded because there were an insufficient number of participants to draw meaningful inferences.

Additional information

Funding

This study was partially funded by Rutgers School of Communication and Information’s Small Grants for Individual Faculty Research (GFIR) and the Rutgers Cancer Institute of New Jersey (CINJ) and RWJBarnabas Health Mission Support, Cancer Survivorship and Outcomes Center (CSOC) Award.