title: A systematic review of the associations between empathy measures and patient outcomes in cancer care.
abstract: OBJECTIVE
  Despite a call for empathy in medical settings, little is known about the effects of the empathy of health care professionals on patient outcomes. This review investigates the links between physicians' or nurses' empathy and patient outcomes in oncology.
  
  
  METHODS
  With the use of multiple databases, a systematic search was performed using a combination of terms and subject headings of empathy or perspective taking or clinician-patient communication, oncology or end-of-life setting and physicians or nurses. Among the 394 hits returned, 39 studies met the inclusion criteria of a quantitative measure of empathy or empathy-related constructs linked to patient outcomes.
  
  
  RESULTS
  Empathy was mainly evaluated using patient self-reports and verbal interaction coding. Investigated outcomes were mainly proximal patient satisfaction and psychological adjustment. Clinicians' empathy was related to higher patient satisfaction and lower distress in retrospective studies and when the measure was patient-reported. Coding systems yielded divergent conclusions. Empathy was not related to patient empowerment (e.g. medical knowledge, coping).
  
  
  CONCLUSIONS
  Overall, clinicians' empathy has beneficial effects according to patient perceptions. However, in order to disentangle components of the benefits of empathy and provide professionals with concrete advice, future research should apply different empathy assessment approaches simultaneously, including a perspective-taking task on patients' expectations and needs at precise moments. Indeed, clinicians' understanding of patients' perspectives is the core component of medical empathy, but it is often assessed only from the patient's point of view. Clinicians' evaluations of patients' perspectives should be studied and compared with patients' reports so that problematic gaps between the two perspectives can be addressed.
authors.affiliation: Laboratoire de Psychopathologie et Processus de Santé (LPPS EA 4057), IUPDP, Université Paris Descartes, Boulogne-Billancourt, France. sophie.lelorain@parisdescartes.fr
authors.forename: Sophie
authors.initials: S
authors.lastname: Lelorain
authors.forename: Anne
authors.initials: A
authors.lastname: Brédart
authors.forename: Sylvie
authors.initials: S
authors.lastname: Dolbeault
authors.forename: Serge
authors.initials: S
authors.lastname: Sultan
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D004645:Empathy; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D010465:Perception; D011369:Professional-Patient Relations