Exploring patient views of empathic optimistic communication for osteoarthritis in primary care: a qualitative interview study using vignettes.
physician–patient communication
physician–patient relations
placebo effect
primary health care
Journal
BJGP open
ISSN: 2398-3795
Titre abrégé: BJGP Open
Pays: England
ID NLM: 101713531
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
04
02
2021
accepted:
10
02
2021
pubmed:
14
3
2021
medline:
14
3
2021
entrez:
13
3
2021
Statut:
epublish
Résumé
Osteoarthritis (OA) causes pain and disability. An empathic optimistic consultation approach can improve patient quality of life, satisfaction with care, and reduce pain. However, expressing empathic optimism may be overlooked in busy primary care consultations and there is limited understanding of patients' views about this approach. To explore patients' perspectives on clinician communication of empathy and optimism in primary care OA consultations. Vignette study with qualitative semi-structured interviews. Purposefully sampled patients ( Fifteen participants watched two filmed OA consultations with a GP, and 18 participants read two case vignettes. In both formats, one GP depicted an empathic optimistic approach and one GP had a 'neutral' approach. Semi-structured interviews were conducted with all participants and analysed using thematic analysis. Patients recognised that empathic communication enhanced interactions, helping to engender a sense of trust in their clinician. They felt it was acceptable for GPs to convey optimism only if it was realistic, personalised, and embedded within an empathic consultation. Discussing patients' experiences and views with them, and conveying an accurate understanding of these experiences improves the credibility of optimistic messages. Patients value communication with empathy and optimism, but it requires a fine balance to ensure messages remain realistic and trustworthy. Increased use of a realistic optimistic approach within an empathic consultation could enhance consultations for OA and other chronic conditions, and improve patient outcomes. Digital training to help GPs implement these findings is being developed.
Sections du résumé
BACKGROUND
BACKGROUND
Osteoarthritis (OA) causes pain and disability. An empathic optimistic consultation approach can improve patient quality of life, satisfaction with care, and reduce pain. However, expressing empathic optimism may be overlooked in busy primary care consultations and there is limited understanding of patients' views about this approach.
AIM
OBJECTIVE
To explore patients' perspectives on clinician communication of empathy and optimism in primary care OA consultations.
DESIGN & SETTING
METHODS
Vignette study with qualitative semi-structured interviews. Purposefully sampled patients (
METHOD
METHODS
Fifteen participants watched two filmed OA consultations with a GP, and 18 participants read two case vignettes. In both formats, one GP depicted an empathic optimistic approach and one GP had a 'neutral' approach. Semi-structured interviews were conducted with all participants and analysed using thematic analysis.
RESULTS
RESULTS
Patients recognised that empathic communication enhanced interactions, helping to engender a sense of trust in their clinician. They felt it was acceptable for GPs to convey optimism only if it was realistic, personalised, and embedded within an empathic consultation. Discussing patients' experiences and views with them, and conveying an accurate understanding of these experiences improves the credibility of optimistic messages.
CONCLUSION
CONCLUSIONS
Patients value communication with empathy and optimism, but it requires a fine balance to ensure messages remain realistic and trustworthy. Increased use of a realistic optimistic approach within an empathic consultation could enhance consultations for OA and other chronic conditions, and improve patient outcomes. Digital training to help GPs implement these findings is being developed.
Identifiants
pubmed: 33712500
pii: BJGPO.2021.0014
doi: 10.3399/BJGPO.2021.0014
pmc: PMC8278506
pii:
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
Copyright © 2021, The Authors.
Références
Br J Gen Pract. 2013 Jan;63(606):e76-84
pubmed: 23336477
Disabil Rehabil. 2014;36(5):367-72
pubmed: 23713971
Osteoarthritis Cartilage. 2009 Oct;17(10):1255-62
pubmed: 19410027
Osteoarthritis Cartilage. 2013 Sep;21(9):1229-35
pubmed: 23973135
Qual Health Care. 1994 Jun;3(2):107-13
pubmed: 10137583
Ann Rheum Dis. 2008 Dec;67(12):1716-23
pubmed: 18541604
BMC Fam Pract. 2014 Mar 19;15:46
pubmed: 24641214
Soc Sci Med. 2000 Feb;50(3):309-15
pubmed: 10626757
J Gen Intern Med. 2012 Nov;27(11):1528-43
pubmed: 22700392
Annu Rev Pharmacol Toxicol. 2019 Jan 6;59:191-211
pubmed: 30216744
Patient Educ Couns. 2009 Mar;74(3):295-301
pubmed: 19150199
BMJ. 2001 Oct 20;323(7318):908-11
pubmed: 11668137
Psychooncology. 2011 Mar;20(3):227-41
pubmed: 20878840
Ann Oncol. 2014 Apr;25(4):896-901
pubmed: 24615411
Semin Arthritis Rheum. 2000 Oct;30(2):100-10
pubmed: 11071581
BMC Med Educ. 2017 Aug 21;17(1):136
pubmed: 28823250
J R Soc Med. 2018 Jul;111(7):240-252
pubmed: 29672201
PLoS One. 2011 May 05;6(5):e19634
pubmed: 21573185
Ann Rheum Dis. 2003 Dec;62(12):1145-55
pubmed: 14644851
Pain. 2016 Jun;157(6):1179-1191
pubmed: 26945235
Arthritis Care Res (Hoboken). 2016 Jul;68(7):952-7
pubmed: 26554869
Osteoarthritis Cartilage. 2016 Nov;24(11):1850-1857
pubmed: 27338671
BMJ. 2008 May 3;336(7651):999-1003
pubmed: 18390493
Patient Educ Couns. 2010 Sep;80(3):300-6
pubmed: 20638815
Br J Gen Pract. 2002 Oct;52 Suppl:S9-12
pubmed: 12389763
Br J Gen Pract. 2015 Jun;65(635):e351-6
pubmed: 26009529
J Pain. 2016 Jun;17(6):685-93
pubmed: 26921463
Health Technol Assess. 1999;3(3):1-96
pubmed: 10448203
J Am Board Fam Pract. 2002 Jan-Feb;15(1):25-38
pubmed: 11841136
Acad Med. 2014 Sep;89(9):1245-51
pubmed: 24979285
BMC Musculoskelet Disord. 2010 Jul 02;11:144
pubmed: 20598124