title: How does a physician's accurate understanding of a cancer patient's unmet needs contribute to patient perception of physician empathy?
abstract: OBJECTIVE
  Unmet supportive care needs of patients decrease patient perception of physician empathy (PE). We explored whether the accurate physician understanding of a given patient's unmet needs (AU), could buffer the adverse effect of these unmet needs on PE.
  
  
  METHODS
  In a cross-sectional design, 28 physicians and 201 metastatic cancer patients independently assessed the unmet supportive care needs of patients. AU was calculated as the sum of items for which physicians correctly rated the level of patient needs. PE and covariates were assessed using self-reported questionnaires. Multilevel analyses were carried out.
  
  
  RESULTS
  AU did not directly affect PE but acted as a moderator. When patients were highly expressive and when physicians perceived poor rapport with the patient, a high AU moderated the adverse effect of patient unmet needs on PE.
  
  
  CONCLUSIONS
  Physician AU has the power to protect the doctor-patient relationship in spite of high patient unmet needs, but only in certain conditions.
  
  
  CONCLUSIONS
  Physicians should be encouraged toward AU but warned that high rapport and patient low emotional expression may impede an accurate reading of patients. In this latter case, they should request a formal assessment of their patients' needs.
authors: Univ Lille Nord de France, Department of Psychology, Lille, France; UDL3, SCALab UMR CNRS 9193, Villeneuve d'Ascq, France. Electronic address: sophie.lelorain@univ-lille3.fr.
authors: Sophie
authors: S
authors: Lelorain
authors: Institut Curie, Psycho-oncology Unit, Paris, France; Paris Descartes University, LPPS EA 4057-IUPDP, Boulogne-Billancourt, France.
authors: Anne
authors: A
authors: Brédart
authors: Institut Curie, Psycho-oncology Unit, Paris, France; Inserm, U 669, Paris, France; Univ Paris-Sud and Univ Paris Descartes, UMR-S0669, Paris, France.
authors: Sylvie
authors: S
authors: Dolbeault
authors: Institut Curie, Psycho-oncology Unit, Paris, France.
authors: Alejandra
authors: A
authors: Cano
authors: University of Nantes, EA4275 SPHERE 'bioStatistics, Pharmacoepidemiology and Human sciEnces Research', Nantes, France.
authors: Angélique
authors: A
authors: Bonnaud-Antignac
authors: University of Montpellier 3, Laboratory Epsylon 'Dynamics of Human Abilities & Health Behaviors', Montpellier, France; ICM, Institut Régional du Cancer de Montpellier, Epidaure Prevention and Education Cancer Center, Montpellier, France.
authors: Florence
authors: F
authors: Cousson-Gélie
authors: University of Montreal, Sainte Justine University Hospital Research Center, Montreal, Canada.
authors: Serge
authors: S
authors: Sultan
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003142:Communication; D003430:Cross-Sectional Studies; D004645:Empathy; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D018802:Patient-Centered Care; D010465:Perception; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Expressive suppression; Oncology; Perceived empathy; Physician accurate understanding; Rapport; Supportive care needs