The Effect of the Content of Patient-Reported Outcome Measures on Patient Perceived Empathy and Satisfaction: A Randomized Controlled Trial

J Hand Surg Am. 2018 Dec;43(12):1141.e1-1141.e9. doi: 10.1016/j.jhsa.2018.04.020. Epub 2018 Jun 8.


Purpose: The purpose of this study was to examine whether positively or negatively phrased Patient-Reported Outcome Measures (PROMs) prior to a visit with the hand surgeon affect patient perceived empathy and patient satisfaction (Patient-Reported Experience Measures [PREMs]).

Methods: Between June 2017 and July 2017, we enrolled 134 patients who presented to 3 hand surgeons at 2 outpatient offices. They were randomly assigned to 1 of 2 groups: completion of negatively framed questionnaires (Patient Health Questionnaire [PHQ-2], Pain Catastrophizing Scale [PCS-4], and Patient-Reported Outcomes Measurement Information System [PROMIS] depression Computer Adaptive Test [CAT]) or completion of positively framed questionnaires (Pain Self-Efficacy Questionnaire [PSEQ-2]) prior to the visit. At the end of the visit, all patients completed questionnaires on patient-perceived physician empathy and patient satisfaction. Five patients were excluded from the analysis after randomization.

Results: There was no statistically significant differences between groups on patient-perceived physician empathy and patient satisfaction.

Conclusions: Our findings suggest that the content of psychological questionnaires completed prior to the visit does not affect patient satisfaction and perceived empathy recorded after the visit.

Clinical relevance: Given the degree to which PROMs are influenced by psychosocial factors, and prior evidence that PROMs are primed by negatively framed questionnaires, it is reassuring that negatively framed PROMs did not affect PREMs, but more research is merited.

Keywords: Empathy; patient-reported outcomes; priming; psychosocial factors; satisfaction.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Empathy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures*
  • Patient Satisfaction*
  • Physician-Patient Relations*
  • Single-Blind Method
  • Surgeons
  • Surveys and Questionnaires
  • Young Adult