Clinician-Patient Connection in Advanced Disease Consultations and its Associations with Affective Patient Outcomes

In serious illness, patients place great value on a personal connection with their clinician. While prior research highlights its importance, it is unknown how clinicians and patients perceive personal connection and how these perceptions relate to affective patient outcomes. This thesis investigated (1) differences between patients’ and clinicians’ perceptions of connection during an advanced disease consultation and (2) associations between these perceptions and affective patient outcomes (trust, satisfaction, self-efficacy, anxiety). Post consultation, patients (n=11), each diagnosed with advanced cancer, and their clinicians (n=4; oncologists and one palliative nurse specialist) filled out a questionnaire assessing their perception of connection and the patients’ affective outcomes. A Wilcoxon signed-rank test, Spearman correlations and multilevel regression analyses were run to draw conclusions. No significant differences were found between patients’ (Mdn = 96.00) and...Show moreIn serious illness, patients place great value on a personal connection with their clinician. While prior research highlights its importance, it is unknown how clinicians and patients perceive personal connection and how these perceptions relate to affective patient outcomes. This thesis investigated (1) differences between patients’ and clinicians’ perceptions of connection during an advanced disease consultation and (2) associations between these perceptions and affective patient outcomes (trust, satisfaction, self-efficacy, anxiety). Post consultation, patients (n=11), each diagnosed with advanced cancer, and their clinicians (n=4; oncologists and one palliative nurse specialist) filled out a questionnaire assessing their perception of connection and the patients’ affective outcomes. A Wilcoxon signed-rank test, Spearman correlations and multilevel regression analyses were run to draw conclusions. No significant differences were found between patients’ (Mdn = 96.00) and clinicians’ (Mdn = 78.50) perceptions of connection, V=38.5, p = .057, with a corresponding medium to large effect size (r = 0.57). Patient-perceived connection was significantly associated with trust (β = 8.48, 95% CI [5.97, 10.99], p < .001) and satisfaction (β = 7.85, 95% CI [6.23, 9.48], p < .001) but not with self-efficacy and anxiety. No significant associations were found between clinician-perceived connection and affective patient outcomes. All results need to be interpreted cautiously due to the small sample size. This study provides novel insights into personal connection in advanced disease consultations, emphasizing the importance of prioritizing the patient’s experience in clinician-patient interactions. Moreover, the findings highlight the need for clinicians to critically assess their own perceptions of connection, as these do not appear to directly influence patients’ affective outcomes nor relate to patients´ perceptions. More research is needed to better understand how personal connection affects patients’ emotional well-being and how it can be strengthened in clinical settings.Show less

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Clinician-Patient Connection in Advanced Disease Consultations and its Associations with Affective Patient Outcomes