Physician empathy and dialogic risk communication in online cancer treatment risk consultations: Associations with patient satisfaction and compliance.

Abstract

Effective physician communication is essential in cancer treatment consultations for helping patients understand associated risks such as side effects, complications, and quality-of-life impacts. In China, the growing use of internet health technologies has positioned text-based online medical consultations as a key platform for ongoing physician-patient interaction. Grounded in the patient-centered communication framework and the communication pathway model, this study developed and tested a hypothesized model in an online setting. The model examines relationships between physician empathy, physician dialogic risk communication, patient satisfaction, and patient compliance with physician recommendations, with patient risk understanding and patient emotional engagement as mediating factors. In Phase I, textual analyses of empathy and risk communication features from 102 participants were used to construct experimental stimuli. In Phase II, a 2 × 2 between-subjects experimental design was implemented with 280 participants. The design manipulated two independent variables: empathy (high vs. low) and risk communication (high vs. low), resulting in four experimental conditions. The high conditions reflected a higher level of expression for each variable, while the low conditions reflected a lower level of expression. These conditions were used to test the relationships specified in the hypothesized model. Confirmatory factor analysis assessed model fit, while structural equation modeling was used to examine the hypothesized pathways. Risk communication significantly predicted risk understanding (β =.596, p = .002), and empathy significantly predicted emotional engagement (β =.515, p = .002). Satisfaction was directly associated with compliance (β = 1.122, p = .002) and indirectly associated with empathy through risk understanding (β =.429, p = .023). The relationship between risk communication and satisfaction was fully mediated by risk understanding (β =.423, p = .002). This study identifies key physician communication factors influencing patient satisfaction and experience in Chinese online medical consultations concerning cancer treatment risks, enhancing the understanding of how physician communication affects patient outcomes. Findings inform message-framing strategies that incorporate empathy and dialogic risk communication through content, style, and language to better engage patients online. These skills can improve mutual understanding and enhance the quality of online cancer care consultations.