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The effect of patient–practitioner communication on pain: a systematic review

The effect of patient–practitioner communication on pain: a systematic review
The effect of patient–practitioner communication on pain: a systematic review
Background and objective: Communication between patients and health care practitioners is expected to benefit health outcomes. The objective of this review was to assess the effects of experimentally varied communication on clinical patients’ pain.

Databases and data treatment: We searched in July 2012, 11 databases supplemented with forward and backward searches for (quasi-) randomized controlled trials in which face-to-face communication was manipulated. We updated in June 2015 using the four most relevant databases (CINAHL, Cochrane Central, Psychinfo, PubMed).

Results: Fifty-one studies covering 5079 patients were included. The interventions were separated into three categories: cognitive care, emotional care, procedural preparation. In all but five studies the outcome concerned acute pain. We found that, in general, communication has a small effect on (acute) pain. The 19 cognitive care studies showed that a positive suggestion may reduce pain, whereas a negative suggestion may increase pain, but effects are small. The 14 emotional care studies showed no evidence of a direct effect on pain, although four studies showed a tendency for emotional care lowering patients’ pain. Some of the 23 procedural preparation interventions showed a weak to moderate effect on lowering pain.

Conclusions: Different types of communication have a significant but small effect on (acute) pain. Positive suggestions and informational preparation seem to lower patients’ pain. Communication interventions show a large variety in quality, complexity and methodological rigour; they often used multiple components and it remains unclear what the effective elements of communication are. Future research is warranted to identify the effective components.
1090-3801
675-688
Mistiaen, P.
e7bdcf50-21c2-4874-b22b-6591fe19b6fa
van Osch, M.
e640c0d3-368c-4cb5-bcb6-4f3cebdc15ad
van Vliet, L.
c51a6b05-3c62-4908-8296-9ba7783041f4
Howick, J.
c6a90b32-af65-42b4-a004-714c96bfb615
Bishop, F.L.
1f5429c5-325f-4ac4-aae3-6ba85d079928
Di Blasi, Z.
d638e139-abff-4dde-bfde-4b8cd50fe17e
Bensing, J.
a0a8b659-ca87-469d-8f7d-5273ab5d5ab6
van Dulmen, S.
d5d82261-42c3-46d5-bb89-1fd6ebe74a5c
Mistiaen, P.
e7bdcf50-21c2-4874-b22b-6591fe19b6fa
van Osch, M.
e640c0d3-368c-4cb5-bcb6-4f3cebdc15ad
van Vliet, L.
c51a6b05-3c62-4908-8296-9ba7783041f4
Howick, J.
c6a90b32-af65-42b4-a004-714c96bfb615
Bishop, F.L.
1f5429c5-325f-4ac4-aae3-6ba85d079928
Di Blasi, Z.
d638e139-abff-4dde-bfde-4b8cd50fe17e
Bensing, J.
a0a8b659-ca87-469d-8f7d-5273ab5d5ab6
van Dulmen, S.
d5d82261-42c3-46d5-bb89-1fd6ebe74a5c

Mistiaen, P., van Osch, M., van Vliet, L., Howick, J., Bishop, F.L., Di Blasi, Z., Bensing, J. and van Dulmen, S. (2016) The effect of patient–practitioner communication on pain: a systematic review. European Journal of Pain, 20 (5), 675-688. (doi:10.1002/ejp.797). (PMID:26492629)

Record type: Article

Abstract

Background and objective: Communication between patients and health care practitioners is expected to benefit health outcomes. The objective of this review was to assess the effects of experimentally varied communication on clinical patients’ pain.

Databases and data treatment: We searched in July 2012, 11 databases supplemented with forward and backward searches for (quasi-) randomized controlled trials in which face-to-face communication was manipulated. We updated in June 2015 using the four most relevant databases (CINAHL, Cochrane Central, Psychinfo, PubMed).

Results: Fifty-one studies covering 5079 patients were included. The interventions were separated into three categories: cognitive care, emotional care, procedural preparation. In all but five studies the outcome concerned acute pain. We found that, in general, communication has a small effect on (acute) pain. The 19 cognitive care studies showed that a positive suggestion may reduce pain, whereas a negative suggestion may increase pain, but effects are small. The 14 emotional care studies showed no evidence of a direct effect on pain, although four studies showed a tendency for emotional care lowering patients’ pain. Some of the 23 procedural preparation interventions showed a weak to moderate effect on lowering pain.

Conclusions: Different types of communication have a significant but small effect on (acute) pain. Positive suggestions and informational preparation seem to lower patients’ pain. Communication interventions show a large variety in quality, complexity and methodological rigour; they often used multiple components and it remains unclear what the effective elements of communication are. Future research is warranted to identify the effective components.

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More information

Accepted/In Press date: 27 August 2015
e-pub ahead of print date: 22 October 2015
Published date: May 2016

Identifiers

Local EPrints ID: 391091
URI: https://eprints.soton.ac.uk/id/eprint/391091
ISSN: 1090-3801
PURE UUID: 13cd6b26-61f1-4e87-a875-ae1e64e26332
ORCID for F.L. Bishop: ORCID iD orcid.org/0000-0002-8737-6662

Catalogue record

Date deposited: 08 Apr 2016 09:11
Last modified: 17 Jul 2019 00:57

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