Balancing Knowledge Delivery and Emotional Comfort in Healthcare Conversational Systems (2025)

Abstract: With the advancement of large language models, many dialogue systems are now capable of providing reasonable and informative responses to patients’ medical conditions. However, when patients consult their doctor, they may experience negative emotions due to the severity and urgency of their situation. If the model can provide appropriate comfort and empathy based on the patient’s negative emotions while answering medical questions, it will likely offer a more reassuring experience during the medical consultation process. To address this issue, our paper explores the balance between knowledge sharing and emotional support in the healthcare dialogue process. We utilize a large language model to rewrite a real-world interactive medical dialogue dataset, generating patient queries with negative emotions and corresponding medical responses aimed at soothing the patient’s emotions while addressing their concerns. The modified data serves to refine the latest large language models with various fine-tuning methods, enabling them to accurately provide sentences with both emotional reassurance and constructive suggestions in response to patients’ questions. Compared to the original LLM model, our experimental results demonstrate that our methodology significantly enhances the model’s ability to generate emotional responses while maintaining its original capability to provide accurate knowledge-based answers.

## introduction a healthcare conversational system is a dialoguebased framework specifically developed for the medical domain. its primary purpose is to interact with patients, systematically collect supplementary symptom information, facilitate preliminary diagnostic processes, and provide automated recommendations for treatment plans @xcite @xcite . healthcare conversational systems demonstrate significant potential to enhance the efficiency of diagnostic procedures while reducing the costs associated with patient information collection @xcite . in recent years, large language models (llms), e.g. chatgpt @xcite , llama @xcite , qwen @xcite have been widely applied in medical fields and catalyzed substantial technological transformations in dialogue systems. through high-quality instruction fine-tuning and reinforcement learning based on human feedback (rlhf) @xcite , large language models (llms) possess the ability to generate human-like responses with exceptional accuracy, thereby redefining the foundational framework of healthcare dialogue systems. while large language models fine-tuned for medical dialogues have demonstrated the ability to produce knowledge-intensive and contextually appropriate responses @xcite @xcite @xcite @xcite , a discrepancy persists between the generated responses and the appropriate real-world answers in certain medical consultation scenarios, particularly in emotionrelated contexts. for example, in figure 1 , when patients exhibit intense negative emotions during consultations due to the severity of their condition, employing a comforting tone while delivering solutions can significantly mitigate their psychological distress. however, existing llm-based medical dialogue systems primarily focus on the rationality and accuracy of the responses' knowledge. in contrast, emotion-focused large language models @xcite emphasize emotion recognition without prioritizing the acquisition of medical knowledge. in this paper, we aim at developing an approach that effectively trains a model to deliver knowl-hi doctor. i hope this isn't too silly, but i had a ruptured eardrum seven years ago, and i recently went back to my doctor because i've been experiencing some hearing loss and pain in my right ear. they told me it healed but there's a lot of scarring. so, um, why does it still hurt if it's supposed to be better now? ## methodology to develop a model to deliver knowledge-rich responses while simultaneously addressing emotional comfort for emotion-sensitive healthcare conversations, we first construct a dataset tailored to this specific scenario. then, we fine-tuned a base model to the constructed dataset with three renowned fine-tuning methods to enhance its ability. the details of the components are described in the following sections. ## conclusion in this paper, we develop a method that enables the model to provide timely emotional comfort in response to the patient's negative emotions during healthcare conversations, while simultaneously offering knowledge-based solutions to address their concerns. we design two kinds of prompts for generating emotionally-aware medical conversations by rewriting existing real-world medical dialogues using a large language model. the first involves modifying doctors' responses into sentences infused with empathy and compassion. the second adds negative emotional tones to patients' statements and generates corresponding comforting responses. next, we fine-tuned a base model on our (a) emotional question doctor, i'm really scared. i had unprotected sex for three minutes with a broken condom with a sex worker who seemed young and healthy, around 18 years old. it was my first time with a sex worker, and now i can't shake the fear that i might have been exposed to hiv. from the moment the condom broke, i've been filled with dread. she assured me that she doesn't have hiv and that they never allow sex without a condom to avoid infections, but i can't trust that. i've been reading about hiv and its symptoms, and now i'm worried because i have these red dots on my finger pits, plus i've been feeling cold and have a sore throat. what could these red dots be? i've tested negative multiple times in the past three months, but i'm so anxious about the six-month test. soothing response with sft: i understand that you're feeling anxious, and it's completely normal to have concerns in this situation. while hiv can indeed be transmitted through unprotected sex, it's important to remember that not everyone with hiv will develop hiv. the red dots you mentioned could be related to other factors, such as a skin infection or a minor injury. i recommend that you get tested for hiv to put your mind at ease. in the meantime, try to stay calm and focus on your health. if you have any more questions or need further support, please don't hesitate to reach out. soothing response with dpo: i understand how unsettling these circumstances can be, and i'm here to help you feel more at ease. it's completely understandable to feel anxious, and i want to reassure you that we'll work through this together. i recommend taking some time to relax and focus on your health. you've taken the first step by seeking help, which is truly commendable. it's possible that the symptoms you're experiencing could be related to your exposure, and i'm here to guide you through the process. to alleviate your concerns, i suggest we schedule a follow-up appointment for six months from now. in the meantime, i advise you to take care of yourself and avoid any strenuous activities. i'm also going to prescribe you some antiretroviral medication, which should help reduce your risk of hiv. additionally, we'll be running some tests to ensure you're healthy and safe. please don't worry; we'll get through this together. you're not alone in this, and i'm here to support you every step of the way. you're doing the right thing by seeking help, and i'm proud of you for taking this crucial step. soothing response with kto: i understand that you're feeling anxious, and it's completely normal to have concerns after such an experience. the red dots you're seeing are likely due to a minor skin infection, which can happen after unprotected sex. it's important to keep the area clean and avoid any further irritation. i recommend seeing a dermatologist for a thorough evaluation and appropriate treatment. please know that you're not alone in this, and we're here to help you through it. if you have any more questions or need further reassurance, don't hesitate to reach out. soothing response with sft: i understand that you're feeling overwhelmed and scared right now, and it's completely normal to feel this way given the circumstances. it sounds like you may be experiencing neuropathy, which can occur due to nerve compression in the spine. i recommend that you consult with a neurologist for a thorough evaluation. an mri of your spine will help us understand what's going on, and if it shows any nerve compression, we can discuss treatment options, such as pregabalin or gabapentin, which can be very effective. please know that you're not alone in this, and i'm here to support you. if you have any more questions or need further assistance, don't hesitate to reach out. soothing response with dpo: i understand how unsettling this situation is for you, and i'm here to help. it's completely understandable to feel this way, and i'm here to provide you with the information you need. i recommend we schedule an appointment for you to discuss these symptoms in more detail. in the meantime, i'm going to guide you through some steps to help you better understand what's happening. we can explore some potential treatments, including medications and lifestyle adjustments, to help alleviate your discomfort. you're doing the right thing by seeking help, and i'm here to support you every step of the way. please, don't worry; we'll work together to find a solution. soothing response with kto: i understand that you're feeling overwhelmed, and it's completely normal to be concerned about these symptoms. it's important to know that while cymbalta can be effective for anxiety, it may not be the best choice for your situation. the burning sensation you're experiencing could be related to nerve damage, which can happen with long-term use of cymbalta. i recommend discussing your concerns with your doctor, who can help determine the best course of action for your treatment. remember, you're not alone in this, and there are options available to help you feel better. if you have any more questions or need further assistance, please don't hesitate to reach out.