Resident Physician Empathy and Health Literacy Communications Associated with Diabetes Control

Document Type : Original Article


1 Psychology, Family Medicine, Loma Linda University

2 Department of Psychology, Department of Preventive Medicine, Loma Linda University

3 Department of Family Medicine, Loma Linda University


Background and Objective: One third of U.S. adults struggle to understand health related information. To enhance patient understanding and outcomes, resident physicians must adapt communications to the patient’s health literacy level. These communications are particularly important when treating the patient for diabetes that requires intensive self-management.  The present study examined diverse patients’ perceptions of resident physicians’ communications after resident health literacy communication training. 

Materials and methods: We examined the association between patient perceptions of resident physician’s communications and diabetes control in a cross-sectional, correlational study in a convenience sample or patients with diabetes who consented to the survey within a month of clinic visits. After resident physician training, 160 Medicaid managed care adults seen at a Federally Qualified Health Center for type 2 diabetes were invited to complete a one-page survey on patient-provider communications (i.e., empathy, health literacy from Consumer Assessment of Healthcare Providers and Systems), treatment understanding, and diabetes control in 2018. Clinic staff recorded HbA1c upon survey completion with no patient identifiers and data were analyzed with logistic regression.  

Results: Non-Latino White and English-speaking Latino American patients rated resident physicians higher in empathy and health literate communications than Spanish-speaking Latino Americans. Patient perceptions of resident physician empathy and health literate communications were associated with diabetes treatment plan confidence. Patient perceptions of resident physician empathy were associated with diabetes control.  

Conclusions: Empathetic resident physician communications consistent with health literacy levels may improve patients’ understanding of the self-management required for diabetes control. Investing in training programs that target physician communication skills that are empathic and consistent with the patient’s health literacy may improve diabetes control by encouraging dialogue and shared decision making about the treatment plan. 


Acknowledgements: We would like to thank all participants who assisted the authors to run this study.


Availability of data and materials: Data will be provided by the corresponding author upon request


Conflicts of interest: The authors declare that they have no competing interests.


Consent for publication: Not applicable


Ethical considerations: this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable.


Funding: No financial support was received for this study.


Author ‘s contributions: All researchers have participated equally in this research 

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