Table 3:

Components of the patient-derived clinical empathy model corresponding to the presence of clinical empathy, and illustrative quotations

Model item; patient-perceived phenomenonIllustrative quotation*
Physician factors

  • Adequate time and resources

  • Being treated kindly by patients

  • Personal experience with chronic illness

I think there may be some room here for training patients to try to recognize that doctors are people, too. (6A)
Having cancer made [my oncologist] a better doctor because, all of a sudden, he realized what it was like being helpless, and in that bed, and waiting for somebody who knew something to do something, and having no control. (5A)
Being a doctor doesn’t just mean curing or giving medicine or diagnoses. … The responsibility, to me, is just so great. So, I take my hat off to anyone who wants to be in medicine, I’m very grateful … because we really do need them. But we really need them to help us, too. (2B)
Engaging with patient’s experience

  • Listening mindfully to patient to learn about their experience, while acknowledging the physician cannot fully understand it

  • Seeing patient as a whole person rather than just their disease

  • Believing and trusting patient as an expert on their own body

There’s only one [doctor] that’s been able to communicate to me … not that they understand, but they’re truthful in the fact that they say that they can’t understand. (2A)
[The doctor] heard me, and she knew my whole story as a human being, not just my illness. (4A)
If a doctor believes, and I go home, I’m happy, I’m very happy. (6D)
Behaviours showing presence of clinical empathy

  • Communication that is honest, supportive, validating and normalizing

  • Willingness to put in effort, even if physician does not know exactly what to do

  • Trauma-informed care

  • Collaborating with patient to develop care plan, valuing their perspective/research

The doctor taking the time and acknowledging feelings, validating feelings and providing that … reassurance or encouragement, or just saying ‘Yes, it sucks, but this is what we’re going to do.” (5B)
I’ve had some times with doctors who’ve been really, really great. … I’ve been able to come with them to research about medications that I thought, “Hey, can we try this?” and we’ve talked about it, and we’ve come up with a collaborative plan, and that’s been awesome. (1C)
Positive processing

  • Feelings of hope and empowerment

  • Increased trust in physician and health care system

I guess just to listen to you and make you feel … validated and that it’s not all in your head, and just give you some hope to just get through to your next appointment, something to try. … My mood definitely gets better … I feel less hopeless, less depressed, just not as scared or … nervous to go to the doctor the next time because of … “How is this appointment gonna go?” (1A)
Enhanced health care

  • More likely to self-educate, try new treatments, adhere to treatments and make healthier lifestyle changes

I’ve been a smoker for 43 years, on and off, and this time was the easiest time for me to quit … I think because my physician was supporting me and all of the aspects. (1B)
Enhanced mental health and well-being

  • Improved mood and energy levels

  • Increased confidence, self-image and resilience

“If you can’t see the light at the end of the tunnel, there’s no point in being alive” is the way I talked to myself. … I think I have renewed hope because I have a medical professional on my side. … I don’t even think you can quantify or put a value to having somebody that works with you and listens to you, and it makes you feel valid. (1B)
You feel more hopeful. Not necessarily that your pain will go away or your disease will go away. It’s just that I’ll have as normal a life as I possibly can given my current condition. And you feel validated, so it gives you the courage to try new things, it improves your actual physical and mental energy, and, trust me, when you suffer from chronic pain, that is depleted before you even get out of bed. (1B)

  • ↵* Participants are designated by a number representing the focus group they attended and a unique letter within that group.