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Cited by 5Patient-Provider Communication in HealthcareEmpathy and Medical EducationDiabetes Management and Education

Is sociodemographic status associated with empathic communication and decision quality in diabetes care?

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Bruno, Brigida A., Guirguis, Karen, Rofaiel, David, Yu, Catherine H.·2022·Journal of General Internal Medicine
DOI 10.1007/s11606-021-07230-5PMC PMC9485322
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Abstract

Objective: To assess the relationship between empathic communication, shared decision-making, and patient sociodemographic factors of income, education, and ethnicity in patients with diabetes. Research Design and Methods: This was a cross-sectional study from five primary care practices in the Greater Toronto Area, Ontario, Canada, participating in a randomized controlled trial of a diabetes goal setting and shared decision-making plan. Participants included 30 patients with diabetes and 23 clinicians (physicians, nurses, dietitians, and pharmacists), with a sample size of 48 clinical encounters. Clinical encounter audiotapes were coded using the Empathic Communication Coding System (ECCS) and Decision Support Analysis Tool (DSAT-10). Results: The most frequent empathic responses among encounters were “acknowledgement with pursuit” (28.9%) and “confirmation” (30.0%). The most frequently assessed DSAT components were “stage” (86%) and knowledge of options (82.0%). ECCS varied by education (p=0.030) and ethnicity (p=0.03), but not income. Patients with only a college degree received more empathic communication than patients with bachelor’s degrees or more, and South Asian patients received less empathic communication than Asian patients. DSAT varied with ethnicity (p=0.07) but not education or income. White patients experienced more shared decision-making than those in the “other” category. Conclusions: We identified a new relationship between ECCS, education and ethnicity, as well as DSAT and ethnicity. Limitations include sample size, heterogeneity of encounters, and predominant white ethnicity. These associations may be evidence of systemic biases in healthcare, with hidden roots in medical education.

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Authors
Bruno, B. A., Guirguis, K., Rofaiel, D., & Yu, C. H.
Affiliations
  • University of Toronto (CA)
  • Western University (CA)
  • Ollscoil na Gaillimhe – University of Galway (IE)
  • St. Michael's Hospital (CA)
ORCID
Venue
Journal of General Internal Medicine
Publisher
Springer Science and Business Media LLC
Published
2022-01-01
Volume
37
Issue
12
Pages
3013-3019
ISSN
  • 0884-8734 (ISSN-L)
  • 1525-1497
DOI
10.1007/s11606-021-07230-5
PMC
PMC9485322
OpenAlex
W4206368891
Cited by
5
References
38
Citations by year
2026: 2 · 2024: 2 · 2023: 1
FWCI
0.86
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of General Internal Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • University of Toronto
  • Canadian Institutes of Health Research (129892_1)
  • Division of Electrical, Communications and Cyber Systems
Topics
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
  • Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords
empathic communication, shared decision-making, diabetes management, sociodemographic factors, patient education level, ethnicity, income, decision quality, primary care, medical education
MeSH terms
Communication, Cross-Sectional Studies, Decision Making, Diabetes Mellitus, Empathy, Humans, Ontario, Physician-Patient Relations

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