title: Comparing oncologist, nurse, and physician assistant attitudes toward discussions of negative emotions with patients.
abstract: OBJECTIVE
  Although research shows that empathic communication improves patient outcomes, physicians often fail to respond empathically to patients. Nurses and physician assistants (PAs) may be able to help fill the need for empathic communication. Our study compares the attitudes of oncologists, nurses, and PAs toward communication with patients who demonstrate negative emotions.
  
  
  METHODS
  We analyzed surveys from 48 oncologists, 26 PAs, and 22 nurses who participated in the Studying Communication in Oncologist-Patient Encounters trial. Surveys included previously validated items that examined attitudes toward communication with patients about emotion.
  
  
  RESULTS
  The mean age of oncology physicians was higher (49 years) than that of PAs (40 years) or nurses (43 years), and 19% of physicians, 81% of PAs, and 100% of nurses were female. Race, years of oncology experience, and previous communication training were similar across provider types. Most nurses (82%) and PAs (68%) described themselves as having a socioemotional orientation, while most oncologists (70%) reported a technological/scientific orientation (p < .0001). PAs and nurses indicated more comfort with psychosocial talk than did oncologists (p < .0001). Discomfort with disclosing uncertainty and provider confidence and expectations when addressing patient concerns were similar across provider types.
  
  
  CONCLUSIONS
  PAs and nurses were more oriented toward socioemotional aspects of medicine and were more comfortable with psychosocial talk than were oncologists. Future studies should examine whether these differences are attributable to other factors, including gender, and whether nurses and PAs are more likely than physicians to demonstrate empathic behaviors when patients express negative emotions.
authors.affiliation: Duke University PA Program, Department of Community and Family Medicine, DUMC 104780, Durham, NC 27710, USA. perri.morgan@duke.edu
authors.forename: Perri A
authors.initials: PA
authors.lastname: Morgan
authors.forename: Justine Strand
authors.initials: JS
authors.lastname: de Oliveira
authors.forename: Stewart C
authors.initials: SC
authors.lastname: Alexander
authors.forename: Kathryn I
authors.initials: KI
authors.lastname: Pollak
authors.forename: Amy S
authors.initials: AS
authors.lastname: Jeffreys
authors.forename: Maren K
authors.initials: MK
authors.lastname: Olsen
authors.forename: Maren K
authors.initials: MK
authors.lastname: Olson
authors.forename: Robert M
authors.initials: RM
authors.lastname: Arnold
authors.forename: Amy P
authors.initials: AP
authors.lastname: Abernethy
authors.forename: Keri L
authors.initials: KL
authors.lastname: Rodriguez
authors.forename: Keri L
authors.initials: KL
authors.lastname: Rodrigues
authors.forename: James A
authors.initials: JA
authors.lastname: Tulsky
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004644:Emotions; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009341:Negativism; D009726:Nurses / Q000523:psychology*; D010823:Physician Assistants / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D011369:Professional-Patient Relations