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Trait Anxiety and Reactions to Patient-Centered and Doctor-Centered Styles of Communication: An Experimental Study

From the Department of Behavioral Sciences in Medicine (P.K.G., A.F.), University of Oslo, Oslo, Norway.

Address reprint requests to: Peter Kjær Graugaard, Department of Behavioural Sciences in Medicine, Postboks 1111, Blindern, N-0317 Oslo, Norway.

OBJECTIVE: A patient-centered model of communication has often been advocated in preference to a doctor-centered model. The aim of the present study was to assess in an experimental setting how subjects’ general level of anxiety affects their reactions to these two communication styles as measured by emotional reactions and satisfaction immediately after consultation.

METHODS: Twenty students with low trait anxiety and 21 students with high trait anxiety each had a single consultation with a physician who performed the consultation using either a patient-centered or doctor-centered style of communication. Questionnaires about emotional state were completed by the students before and after the consultation, and a questionnaire about satisfaction was completed after the consultation.

RESULTS: Students with low trait anxiety were significantly more satisfied with a patient-centered than a doctor-centered style of communication. There were no significant differences in emotional response to the two styles of communication. Students with high trait anxiety reacted emotionally more positively to a doctor-centered communication style, with significant and nearly significant change scores for the emotions of tension/anxiety and vigor/activity, respectively. No significant difference was found between satisfaction scores.

CONCLUSIONS: Data indicate that differences between subjects’ emotional traits may be of importance for a differentiated response to patient-centered and doctor-centered communication styles. Subjects’ trait anxiety seems to be a significant factor that should be taken into account when assessing the effects of different communication styles.

Key Words: physician-patient relation • communication skills • patient-centered approach • satisfaction • emotional reactions

Abbreviations: HADC = students with high trait anxiety subjected todoctor-centered intervention; HAPC = students with high traitanxiety subjected to patient-centered intervention; LADC =students with low trait anxiety subjected to doctor-centeredintervention; LAPC = students with low trait anxiety subjected topatient-centered intervention; POMS = Profile of Mood States; STAI = Spielberger State-Trait Anxiety Inventory.

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