title: Clinician empathy is associated with differences in patient-clinician communication behaviors and higher medication self-efficacy in HIV care.
abstract: OBJECTIVE
  We examined associations of clinicians' empathy with patient-clinician communication behaviors, patients' rating of care, and medication self-efficacy.
  
  
  METHODS
  We analyzed 435 adult patients and 45 clinicians at four outpatient HIV care sites in the United States. Negative binomial regressions investigated associations between clinician empathy and patient-clinician communication, assessed using the Roter Interaction Analysis System (RIAS). Logistic regressions investigated associations between clinician empathy and patient ratings of clinician communication, overall satisfaction, and medication self-efficacy.
  
  
  RESULTS
  Clinicians in the highest vs. lowest empathy tertile engaged in less explicitly emotional talk (IRR 0.79, p<0.05), while clinicians in the middle vs. lowest engaged in more positive talk (IRR 1.31, p<0.05), more questions (IRR 1.42, p<0.05), and more patient activating talk (IRR 1.43, p<0.05). Patients of higher empathy clinicians disclosed more psychosocial and biomedical information. Patients of clinicians in both the middle and highest (vs. lowest) empathy tertiles had greater odds of reporting highest medication self-efficacy (OR 1.80, 95% CI 1.16-2.80; OR 2.13, 95% CI 1.37-3.32).
  
  
  CONCLUSIONS
  Clinician empathy may be expressed through addressing patient engagement in care, by fostering cognitive, rather than primarily emotional, processing.
  
  
  CONCLUSIONS
  Clinicians should consider enhancing their own empathic capacity, which may encourage patients' self-efficacy in medication adherence.
authors.affiliation: University of Virginia School of Medicine, Charlottesville, VA, USA. Electronic address: TES3J@hscmail.mcc.virginia.edu.
authors.forename: Tabor E
authors.initials: TE
authors.lastname: Flickinger
authors.affiliation: Portland VA Medical Center, Portland, OR, USA; Oregon Health and Science University, Portland, OR, USA.
authors.forename: Somnath
authors.initials: S
authors.lastname: Saha
authors.affiliation: Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Debra
authors.initials: D
authors.lastname: Roter
authors.affiliation: Oregon Health and Science University, Portland, OR, USA.
authors.forename: P Todd
authors.initials: PT
authors.lastname: Korthuis
authors.affiliation: St Luke's Roosevelt, New York, NY, USA.
authors.forename: Victoria
authors.initials: V
authors.lastname: Sharp
authors.affiliation: Wayne State University, Detroit, MI, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cohn
authors.affiliation: Wayne State University, Detroit, MI, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Eggly
authors.affiliation: Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Moore
authors.affiliation: Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Mary Catherine
authors.initials: MC
authors.lastname: Beach
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D003430:Cross-Sectional Studies; D004645:Empathy; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D020377:Self Efficacy; D013637:Tape Recording; D016896:Treatment Outcome
keywords: Empathy; HIV/AIDS; Medication adherence; Patient–clinician communication; Self-efficacy