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Association of perceived physician communication style with patient satisfaction, distress, cancer-related self-efficacy, and perceived control over the disease
Open accessAbstract
The aim of the study was to investigate the association of physician communication behaviours as perceived by the patient with patient reported satisfaction, distress, cancer-related self-efficacy, and perceived control over the disease in cancer patients. Questionnaires measuring distress, self-efficacy, and perceived control were completed prior to and after the consultation by 454 patients attending an oncology outpatient clinic. After the consultation, the patients also rated the physicians' communicative behaviours by completing a patient-physician relationship inventory (PPRI), and the physicians were asked to estimate patient satisfaction. The overall results showed that higher PPRI scores of physician attentiveness and empathy were associated with greater patient satisfaction, increased self-efficacy, and reduced emotional distress following the consultation. In contrast, lower PPRI scores were associated with reduced ability of the physician to estimate patient satisfaction. The results confirm and expand previous findings, suggesting that communication is a core clinical skill in oncology.
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“Many studies have documented the positive effect of provider empathy on patients, which include increased patient satisfaction, adherence, self-efficacy, perceptions of control, less emotional distress, and better outcomes.87–90”
From Reducing Racial Bias Among Health Care Providers: Lessons from Social-Cognitive Psychology (2007) · cites this paper as [90]
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Tosyalı, H., Sütçü, C., & Tosyalı, F. (2019) · Erciyes İletişim Dergisi · doi:10.17680/erciyesiletisim.454347 · Cited by 12
“Moreover, it is suggested that effective and patient-centered communication skills lead to greater patient satisfaction (Burgener, 2017; Zachariae et al., 2003).”
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Muğla Sıtkı Koçman Üniversitesi Tıp Fakültesi öğrencilerinde duygusal zeka ve empati ilişkisi
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“Clinician empathy infl uences patient satisfaction (Bertakis, Roter, and Putnam 1991; Blatt et al. 2010; Kim, Kaplowitz, and Johnston 2004; Zachariae et al. 2003), adherence to medical recommendations (Kim, Kaplowitz, and Johnston 2004; Pollak et al. 2007; Vermeire et al. 2001), and medical-legal…”
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Lundeby, T., Jacobsen, H. B., Lundeby, P. A., & Loge, J. H. (2017) · Patient Education and Counseling · doi:10.1016/j.pec.2017.06.006 · Cited by 10
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“The benefits of effective communication include, but are not limited to, a clearer understanding of the diagnosis, trust in the provider, and decreased stress related to illness (Zachariae et al., 2003).”
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Shared Decision-Making and the Lower Literate Patient
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“Using effective communication to manage expectations seems to benefit cancer patients’ feelings of control.(36) Furthermore, rural patients who practise self-monitoring, guided by nurses, foster a greater sense of control and self-advocacy,(30) features which were also valued by patients interviewed here.”
BackgroundThyroid Cancer–Related Fear & Anxiety in Patients With Benign Thyroid Nodules: A Mixed-Methods Study
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Using Participant Choice to Enhance Memory Performance
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Outcomes of Physicians’ Communication Goals During Patient Interactions
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“Our findings are consistent with the broader literature on physician-patient communication, which suggests that effective communication is associated with favorable outcomes such as increased patient satisfaction, adherence, and informed decision-making (Sweeny & Shepperd, 2007; Zachariae et al., 2003; Zolnierek & DiM…”
BackgroundResultRaphael, D. L., Frey, R. A., & Gott, M. (2020) · Psychology Health & Medicine · doi:10.1080/13548506.2020.1778752 · Cited by 8
“Furthermore, cancer patients treated with attentiveness and empathy by physicians show lower emotional distress (Zachariae et al., 2003).”
BackgroundJanssen, A. L., Shaw, T. J., Nagrial, A. M., Pene, C., Rabbets, M., Carlino, M. S., Zachulski, C., Phillips, J., Birnbaum, R., Gandhi, T. K., et al. (2016) · JMIR Research Protocols · doi:10.2196/resprot.5547 · Cited by 8
“This is particularly concerning considering the literature has shown that both health literacy and involvement in shared decision making significantly impact patient satisfaction and treatment outcomes [7].”
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“Patient-centred care has been shown to increase patient satisfaction and their understanding of the medical information imparted, while improving their sense of being able to cope with illness (Ha Fong & Longnecker, 2010; Ortmann, Rösler, & Helbig, 2016; Stewart, 1995; Zachariae et al., 2003).”
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“Instead, research regarding the relationship between GPs and patients has focused either on highly vulnerable patients, such as in the field of oncology [28, 29], or on a more heterogeneous patient population encompassing a large age span with an overall view on younger patients [6, 9, 11, 30, 31].”
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“Findings: The adapted IRI-MS (IRI for medical students) consisted of 17 items in four dimensions: empathic concern (5), fictitious situation (4), perspective taking (4), and personal distress (4).”
MethodFunctional Impairments Associated With Patient Activation Among Community-Dwelling Older Adults
Na, L., Kwong, P. L., Xie, D., Pezzin, L. E., Kurichi, J. E., & Streim, J. E. (2018) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0000000000000979 · Cited by 7
“Physician attentiveness and empathy were associated with reduced emotional distress, higher satisfaction, and increased self-efficacy among patients with cancer.(26) Disability is perceived as a barrier to effective patientdoctor communication.”
BackgroundAssessment of Canadian patient education material for oncology pharmaceutics
van Ballegooie, C. (2020) · Journal of Oncology Pharmacy Practice · doi:10.1177/1078155220960823 · Cited by 7
van Ballegooie, C., & Hoang, P. (2021) · Cancer Control · doi:10.1177/1073274821989709 · Cited by 7
“This concept, also known as health literacy, has been linked to positive health outcomes such as increased patient satisfaction and adherence to treatment, improved physician communication, and decreased anxiety and depression.(10-15) Studies have indicated that a substantial proportion of health-care content is writt…”
BackgroundØrnes, K., Finset, A., Storøy, H.-L. E., & Pedersen, R. (2021) · Patient Education and Counseling · doi:10.1016/j.pec.2021.03.042 · Cited by 7
Teaching clinical empathy to undergraduate medical students of Dehradun: A quasi-experimental study
Srivastava, A. K., Tiwari, K., Vyas, S., Semwal, J., & Kandpal, S. D. (2017) · Indian Journal of Community Health · doi:10.47203/ijch.2017.v29i03.008 · Cited by 7
“Clinical empathy comes with enticing packages of patients‟ as well as doctors‟ satisfaction, upgraded diagnosis and management, better patient compliance, reduced medico-legal issues and an overall reform in clinical outcome (3-6).”
BackgroundNasser, F. S., Ritsema, D. F., Cheney, S. M., Stern, K., Sokoloff, M. H., Hu, C., & Nguyen, M. M. (2010) · Journal of Endourology · doi:10.1089/end.2010.0385 · Cited by 7
“13 To our knowledge, there have been no studies investigating if patients benefit from viewing their radiographic images.”
A Shared Interface to Improve Oncologist-Patient Communication
Gonzales, M., & Riek, L. D. (2012) · International Conference on Pervasive Computing Technologies for Healthcare · doi:10.4108/icst.pervasivehealth.2012.248711 · Cited by 7
“In contrast, the study also showed an overall dissatisfaction in patient-physician communication with oncologists who were not able to accurately assess patient satisfaction [5].”
BackgroundResultSenol, Y. Y., Özdoğan, M., & Bozcuk, H. S. (2012) · Journal of Cancer Education · doi:10.1007/s13187-012-0309-4 · Cited by 7
“Evidence also shows that patients giving higher scores to the communication methods of their doctors have higher levels of self-confidence regarding their cancer and lower levels of emotional stress [11].”
BackgroundWestbrook, K. W., Grant, C. C., Rafalski, E. M., & Babakus, E. (2015) · Journal of Health Management · doi:10.1177/0972063415589232 · Cited by 7
“Providing empathetic support during a critical care stay could be manifested as listening, a two-way dialogue with questions and answers, proper explanations of treatments and responding to patient emotions (Zachariae et al., 2003).”
BackgroundClinical communication in inflammatory bowel disease: a systematic literature review protocol
Karimi, N., Moore, A. R., Lukin, A., Kanazaki, R., Williams, A., & Connor, S. J. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-039503 · Cited by 7
Sanford, K., Rivers, A. S., Braun, T. L., Schultz, K. P., & Buchanan, E. P. (2018) · Psychological Assessment · doi:10.1037/pas0000594 · Cited by 8
A Structural Analysis of Surgeon-Patient Consultations in Clinic Settings in New Zealand
White, S. J. (2011) · Otago University Research Archive (University of Otago) · Cited by 7
Bedos, C. P., Apelian, N., & Vergnes, J. (2021) · BDJ · doi:10.1038/s41415-021-3322-3 · Cited by 6
Takahashi, N., Matsuhisa, T., Takahashi, K., Aomatsu, M., Mercer, S. W., & Ban, N. (2022) · Family Practice · doi:10.1093/fampra/cmac034 · Cited by 6
“11,17,28 Therefore, we analysed patient satisfaction in this study.”
Suartz, C. V., Quintana, M. I., Lucchese, A. C., & Marco, M. A. D. (2013) · Revista Brasileira de Educação Médica · doi:10.1590/s0100-55022013000300003 · Cited by 6
Malek, K. A., Abdul-Razak, S., Hassan, H. A., & Othman, S. B. (2019) · Europe PMC (PubMed Central) · Cited by 6
Adatia, S., Tellier, P., & Remtulla, R. (2022) · PRiMER · doi:10.22454/primer.2022.535629 · Cited by 6
Alqahtani, O. M., AlSamghan, A. S., Alsaleem, S. A., Alyahya, A. A. S., Alrazhi, F. S., Alshahrani, A. S., Alasmari, A. S. M., Saeed, A. A., Qawwadi, R. A. N., Alotayfi, B. M., et al. (2022) · World Family Medicine Journal/Middle East Journal of Family Medicine · doi:10.5742/mewfm.2022.95251375 · Cited by 6
Stolzenberg, L., Huang, A., Usman, M., & MacGregor, G. (2023) · Cureus · doi:10.7759/cureus.41703 · Cited by 6
“A common theme that has been emphasized in the literature is the focus on the importance of effective communication between healthcare providers and patients [2,4,5].”
BackgroundKrieger, T., Dittmer, K., Reinert, D., Hömberg, M., Tepe, A., Hamm, I., & Vitinius, F. (2024) · BMJ Paediatrics Open · doi:10.1136/bmjpo-2023-002473 · Cited by 7
Smith, D. L. (2013) · Journal of Communications In Healthcare · doi:10.1179/1753807612y.0000000025 · Cited by 6
“Zachariae et al.22 investigated the association of physician communication behaviors as perceived by the patient with patientreported satisfaction, distress, cancer-related self-efficacy, and perceived control over the disease in cancer patients.”
BackgroundAttitudes Toward Aging Among Patients With Upper Extremity Illness
Tran, T. T. H., Kortlever, J. T. P., Teunis, T., Ring, D., Vagner, G. A., & Reichel, L. M. (2019) · Hand · doi:10.1177/1558944719866872 · Cited by 6
“This is also in line with current evidence.(26,27) The association of satisfaction with greater distress (symptoms of depression or anxiety), self-efficacy, and perceived control over the disease is known.”
BackgroundResultThe Effect of ACT on Self-Esteem and Self-efficacy of Women with Breast Cancer in Iran
Daneshvar, M., Vakilian, K., Zadeh-Emran, A. H., & Zadeh, R. H. (2019) · Current Women s Health Reviews · doi:10.2174/1573404815666191121150647 · Cited by 6
Abdulah, D. M., Piro, R. S., & Yaseen, Y. A. (2021) · Frontiers of Nursing · doi:10.2478/fon-2021-0038 · Cited by 6
Rutkowska, A. (2018) · Medical Science Educator · doi:10.1007/s40670-017-0521-2 · Cited by 6
Senger, A., Venetis, M. K., Greene, K. L., Catona, D., & Devine, K. A. (2024) · PEC Innovation · doi:10.1016/j.pecinn.2024.100259 · Cited by 5
“Ample data exist on patient and caregiver perceptions of provider behavior during treatment visits [8] including recommendations for changes in provider communication, especially within geriatric care [9,10]; limited data categorizes patient and partner evaluation of caregiving behavior in the…”
BackgroundA randomized controlled trial of empathetic refutational learning with health care professionals
Holford, D. L., Mäki, K. O., Karlsson, L. C., Lewandowsky, S., Gould, V. C., & Soveri, A. (2025) · BMC Public Health · doi:10.1186/s12889-025-21787-4 · Cited by 5
Yang, M. E., Barker, K., Goodman, D., & Park, H. L. (2018) · The Breast Journal · doi:10.1111/tbj.13086 · Cited by 5
“In addition, physician communication behaviors that demonstrate attentiveness and empathy, such as listening, letting the patient ask questions, giving information in a precise manner, and ability to respond to the patients' emotions, are also associated with higher self‐efficacy.(10) Using the HBM, we described the i…”
BackgroundGehenne, L., Lelorain, S., Eveno, C., Piessen, G., Mariette, C., Gléhen, O., D’Journo, X. B., Mathonnet, M., Regenet, N., Meunier, B., et al. (2021) · Supportive Care in Cancer · doi:10.1007/s00520-021-06257-y · Cited by 5
Reality, from virtual to augmented
Weiss, T. L., Bailenson, J. N., Bullock, K. D., & Greenleaf, W. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-818914-6.00018-1 · Cited by 5
Effectiveness of a patient-centred sleep study report in the management of obstructive sleep apnoea
Srinivasan, M., Duncan, J. M., Hibbert, M., Joffe, D., Mohammadieh, A. M., Cohen, G., Cistulli, P. A., & Chan, A. S. L. (2022) · Sleep And Breathing · doi:10.1007/s11325-022-02573-7 · Cited by 4
“Strong patient-physician relationships are also positively correlated with improved patient self-efficacy [18].”
BackgroundChanges in the empathy levels of a group of undergraduate medical students: A longitudinal study
Archer, E., & Re, T. (2023) · South African Journal of Bioethics and Law · doi:10.7196/sajbl.2023.v16i2.1015 · Cited by 5
Why should patients and clinicians talk about emotion?
Finset, A. (2012) · Patient Education and Counseling · doi:10.1016/j.pec.2012.09.001 · Cited by 5
“terms of reduced distress [16,17], patient adherence [18,19] and”
BackgroundPositive psychology in women with breast cancer
Pintado, S. (2015) · The European Proceedings of Social & Behavioural Sciences · doi:10.15405/epsbs.2015.07.3 · Cited by 5
“In addition there has been an increase in psychological distress in those patients without feelings of self-efficacy (Han et al., 2005; Zachariae et al., 2003) and greater psychological adjustment, greater emotional well-being and quality of life in patients with high scores in selfefficacy (Han et…”
Background
Metadata
- Authors
- Zachariae, R., Pedersen, C. G., Jensen, A. B., Ehrnrooth, E., Rossen, P. B., & von der Maase, H.
- Affiliations
- Aarhus University Hospital (DK)
- Corresponding author
- Zachariae, R
- Venue
- British Journal of Cancer
- Published
- 2003-03
- Volume
- 88
- Issue
- 5
- Pages
- 658-665
- ISSN
- 0007-0920 (ISSN-L)
- 1532-1827
- PMC
- PMC2376357
- OpenAlex
- W2058562152
- Cited by
- 601
- References
- 40
- Citations by year
- 2026: 13 · 2025: 17 · 2024: 25 · 2023: 32 · 2022: 47 · 2021: 37 · 2020: 34 · 2019: 27 · 2018: 27 · 2017: 40 · 2016: 30 · 2015: 40 · 2014: 30 · 2013: 41 · 2012: 43
- FWCI
- 17.82
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-sa
- www.springer.com/tdm (unspecified)
- Locations
- British Journal of Cancer (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Aarhus Universitet
- Aarhus Universitetshospital
- Kræftens Bekæmpelse
- 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 › Oncology › Cancer survivorship and care
- Keywords
- patient satisfaction, emotional distress, perceived control, physician empathy, physician-patient relationship
- MeSH terms
- Humans, Neoplasms, Physician-Patient Relations, Surveys and Questionnaires, Stress, Psychological, Patient Satisfaction, Self Efficacy
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