Text-based Patient - Doctor Discourse Online And Patients' Experiences of Empathy

Empathic responding matters in face-to-face medical consultations. We have previously shown that patients' perceptions of doctor empathy also support positive experiences at an online clinic. However, there is still little knowledge about what types of communication influence patients' online experiences of empathy. In this study we investigated text-based patient-doctor discourse at an online clinic using an adaptation of the Roter Interaction Analysis System (RIAS). Our aims were 1) to assess the reliability of the adapted RIAS 2) to investigate what characteristics are common during the text-based consultations and 3) to examine how the doctor's discourse relates to the patients' experience of empathy online. Based on the inter-rater reliability analyses the conversational clusters of Social (rho = 0.950), Biomedical (rho = 0.939), and Technology related talk (rho = 0.833), Procedural statements (rho = 0.693) and Agreement (rho = 0.687) were rated with acceptable reliability. Biomedical topics were most common in both patients' and doctors' communication. Patients' experience of doctors' empathy was positively correlated with the amount of doctor's psychosocial talk and procedural statements although the effect sizes were small (rho < 0.30 for all models). These results encourage the use of personal talk and giving clear instructions to patients about the care process at a text-based online clinic focusing on brief consultations.