Exploring the Interplay Between Emotions and Medical Decision-Making: Insights from an Empirical Patient-Centred Study

Abstract

Background: Patient-centred decision-making is shaped by clinical information as well as patients’ emotional and relational experiences during care. This cross-sectional study examined how positive and negative emotions, physician trust, perceived empathy, and patient involvement were associated with patient-reported decision outcomes. Methods: A structured 30-item questionnaire using 5-point Likert scales was administered to 600 adult patients recruited by convenience sampling from Wuxi Hospital of Traditional Chinese Medicine, Jiangsu Province, China. The measurement model assessed negative emotions, positive emotions, trust in physicians, physician empathy, patient involvement, and decision outcomes. Reliability, exploratory factor analysis, confirmatory factor analysis, common-method-bias diagnostics, and covariance-based structural equation modelling were conducted. Results: The model showed acceptable-to-good fit (CFI = 0.961, TLI = 0.954, RMSEA = 0.043, SRMR = 0.038). Positive emotions (β = 0.312), physician trust (β = 0.398), and physician empathy (β = 0.361) were positively associated with patient involvement, whereas negative emotions were negatively associated with involvement (β = −0.284; all p < 0.001). Patient involvement partly mediated associations between emotional/relational factors and decision outcomes and also moderated predictor-outcome associations. Conclusions: In this single-institution sample, emotional states and relational perceptions were meaningfully associated with patient involvement and decision outcomes. Given the cross-sectional design, these findings indicate associations rather than causal effects; longitudinal and multi-centre studies are needed before causal or broadly generalizable conclusions can be drawn.