Hamel Lauren M, Moulder Robert, Harper Felicity W K, Manojlovich Milisa, Ramseyer Fabian T, Penner Louis A, Albrecht Terrance L, Boker Steven, Bagautdinova Diliara, Eggly Susan
Department of Oncology, Wayne State University/Karmanos Cancer Institute, Detroit, MI, USA.
Institute of Cognitive Science, University of Colorado, Boulder, CO, USA.
Cancer Control. 2025 Jan-Dec;32:10732748251375517. doi: 10.1177/10732748251375517. Epub 2025 Aug 29.
IntroductionAbundant research documents Black-White disparities in the quality of patient-physician clinical communication during oncology interactions. Prior research shows that Black patients' and non-Black physicians' race-related attitudes and perceptions influence clinical communication and patient and physician perceptions of one another. The aim of this cross-sectional study was to determine the effects of such attitudes and perceptions on another important but understudied aspect of interpersonal communication-nonverbal synchrony. The attitudes and perceptions included non-Black physician implicit racial bias; and Black patients' suspicion of medical care Black patients receive, trust in healthcare systems, and previous experience with discrimination. We predicted that patient and physician race-related attitudes and perceptions would be associated with various nonverbal synchrony measures during oncology interactions between Black patients and non-Black physicians.MethodsThis was a secondary analysis of video-recorded cancer treatment discussions between Black patients and their non-Black physicians collected as part of a larger study. Participants included 66 Black patients and 13 non-Black physicians. Physician implicit racial bias and demographic characteristics and Black patient race-related attitudes, perceptions, and demographic characteristics were assessed prior to the interactions. Using automated motion energy analysis software, we evaluated three measures to examine nonverbal synchrony: (1) global nonverbal synchrony, (2) patient-led nonverbal synchrony, and (3) physician-led nonverbal synchrony.ResultsWe found positive relationships between physicians' implicit racial bias and all measures of nonverbal synchrony. We found a positive relationship between one patient attitude (trust in healthcare systems) and one nonverbal synchrony measure (patient-led nonverbal synchrony).ConclusionsFindings provide evidence of a link between Black patient and non-Black physician race-related attitudes and perceptions and their jointly determined nonverbal synchrony during clinical interactions. Further work is needed to understand the nuances and clinical implications of this complicated relationship, and to inform potential interventions to improve communication quality and related patient outcomes.
引言
大量研究记录了肿瘤治疗互动中患者与医生临床沟通质量方面的黑白差异。先前的研究表明，黑人患者和非黑人医生的种族相关态度和看法会影响临床沟通以及患者和医生对彼此的看法。这项横断面研究的目的是确定这些态度和看法对人际沟通另一个重要但研究不足的方面——非言语同步性的影响。这些态度和看法包括非黑人医生的隐性种族偏见；以及黑人患者对所接受医疗护理的怀疑、对医疗系统的信任以及以往的歧视经历。我们预测，在黑人患者与非黑人医生的肿瘤治疗互动中，患者和医生的种族相关态度和看法将与各种非言语同步性指标相关。
方法
这是对作为一项更大规模研究的一部分收集的黑人患者与其非黑人医生之间的癌症治疗讨论视频记录进行的二次分析。参与者包括66名黑人患者和13名非黑人医生。在互动之前评估了医生的隐性种族偏见和人口统计学特征以及黑人患者的种族相关态度、看法和人口统计学特征。使用自动运动能量分析软件，我们评估了三种用于检查非言语同步性的指标：（1）整体非言语同步性，（2）患者主导的非言语同步性，以及（3）医生主导的非言语同步性。
结果
我们发现医生的隐性种族偏见与所有非言语同步性指标之间存在正相关关系。我们发现一种患者态度（对医疗系统的信任）与一种非言语同步性指标（患者主导的非言语同步性）之间存在正相关关系。
结论
研究结果提供了证据，证明黑人患者和非黑人医生的种族相关态度和看法与他们在临床互动中共同决定的非言语同步性之间存在联系。需要进一步开展工作来理解这种复杂关系的细微差别和临床意义，并为改善沟通质量和相关患者结局的潜在干预措施提供依据。
