Dual attitudes toward doctors: the role of shared decision-making and empathy in frustrated medical treatment in a randomized trial.

Objectives: Patient attitudes have a direct impact on treatment adherence, health status, and satisfaction. This study is to investigate whether increasing physician empathy and patient involvement can improve patient attitudes in the context of frustration. Methods: The study used a three-factor between-subjects design. 186 medical students initiated the situation through the recall imagination paradigm, watched the video of the simulated doctor-patient communication situation, made medical decisions in different ways, and measured explicit and implicit attitudes. Results: The results showed that implicit attitudes tended to be stable, while explicit attitudes were more variable, and the two were not significantly correlated, but empathic interpretation and shared decision-making significantly improved patients' explicit attitudes. The experimental group showed a more positive explicit attitude and higher satisfaction than the control group under the intervention of empathic interpretation and shared decision-making, especially in the frustration situation. Conclusion: Empathic explanation and shared decision-making have a positive effect on patients' negative explicit attitudes in frustrating medical treatment contexts. Improving physician empathy in doctor-patient communication and implementing shared decision-making may help enhance patients' communication experience, perceived trust, and evaluations of the doctor-patient interaction.