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Effects of empathic and positive communication in healthcare consultations: a systematic review and meta-analysis

Effects of empathic and positive communication in healthcare consultations: a systematic review and meta-analysis
Effects of empathic and positive communication in healthcare consultations: a systematic review and meta-analysis

Background: Practitioners who enhance how they express empathy and create positive expectations of benefit could improve patient outcomes. However, the evidence in this area has not been recently synthesised. Objective: To estimate the effects of empathy and expectations interventions for any clinical condition. Design: Systematic review and meta-analysis of randomised trials. Data sources: Six databases from inception to August 2017. Study selection: Randomised trials of empathy or expectations interventions in any clinical setting with patients aged 12 years or older. Review methods: Two reviewers independently screened citations, extracted data, assessed risk of bias and graded quality of evidence using GRADE. Random effects model was used for meta-analysis. Results: We identified 28 eligible (n = 6017). In seven trials, empathic consultations improved pain, anxiety and satisfaction by a small amount (standardised mean difference −0.18 [95% confidence interval −0.32 to −0.03]). Twenty-two trials tested the effects of positive expectations. Eighteen of these (n = 2014) reported psychological outcomes (mostly pain) and showed a modest benefit (standardised mean difference −0.43 [95% confidence interval −0.65 to −0.21]); 11 (n = 1790) reported physical outcomes (including bronchial function/ length of hospital stay) and showed a small benefit (standardised mean difference −0.18 [95% confidence interval −0.32 to −0.05]). Within 11 trials (n = 2706) assessing harms, there was no evidence of adverse effects (odds ratio 1.04; 95% confidence interval 0.67 to 1.63). The risk of bias was low. The main limitations were difficulties in blinding and high heterogeneity for some comparisons. Conclusions: Greater practitioner empathy or communication of positive messages can have small patient benefits for a range of clinical conditions, especially pain. Protocol registration: Cochrane Database of Systematic Reviews (protocol) DOI: 10.1002/14651858.CD011934.pub2.

Communication, evidence-based practice, family medicine
0141-0768
240-252
Howick, Jeremy
0d21085b-6b93-4a4e-8d87-1cc3a83f8768
Moscrop, Andrew
b01a35bc-1784-4ec5-896b-e99f9d554f21
Mebius, Alexander
17678be2-ad4d-4815-a6fe-ea879437767a
Fanshawe, Thomas R.
7cb37df5-a324-485c-90bb-6640124e6c48
Lewith, George
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Bishop, Felicity L.
1f5429c5-325f-4ac4-aae3-6ba85d079928
Mistiaen, Patriek
8825a2af-38c9-4edc-a523-ccde1f3d7018
Roberts, Nia W.
aaa4c606-0994-479d-a68f-c541fd0671a6
Dieninyte, Egle
c04933ab-851a-4448-9d10-059ea2e39097
Hu, Xiao-Yang
65904b24-3775-4b14-9532-eb703a056655
Aveyard, Paul
cb22de2b-29bc-4886-8a00-6e68aea59509
Onakpoya, Igho J.
dd5fa1be-3da8-42c0-95ca-3add8115797b
Howick, Jeremy
0d21085b-6b93-4a4e-8d87-1cc3a83f8768
Moscrop, Andrew
b01a35bc-1784-4ec5-896b-e99f9d554f21
Mebius, Alexander
17678be2-ad4d-4815-a6fe-ea879437767a
Fanshawe, Thomas R.
7cb37df5-a324-485c-90bb-6640124e6c48
Lewith, George
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Bishop, Felicity L.
1f5429c5-325f-4ac4-aae3-6ba85d079928
Mistiaen, Patriek
8825a2af-38c9-4edc-a523-ccde1f3d7018
Roberts, Nia W.
aaa4c606-0994-479d-a68f-c541fd0671a6
Dieninyte, Egle
c04933ab-851a-4448-9d10-059ea2e39097
Hu, Xiao-Yang
65904b24-3775-4b14-9532-eb703a056655
Aveyard, Paul
cb22de2b-29bc-4886-8a00-6e68aea59509
Onakpoya, Igho J.
dd5fa1be-3da8-42c0-95ca-3add8115797b

Howick, Jeremy, Moscrop, Andrew, Mebius, Alexander, Fanshawe, Thomas R., Lewith, George, Bishop, Felicity L., Mistiaen, Patriek, Roberts, Nia W., Dieninyte, Egle, Hu, Xiao-Yang, Aveyard, Paul and Onakpoya, Igho J. (2018) Effects of empathic and positive communication in healthcare consultations: a systematic review and meta-analysis. Journal of the Royal Society of Medicine, 111 (7), 240-252. (doi:10.1177/0141076818769477).

Record type: Review

Abstract

Background: Practitioners who enhance how they express empathy and create positive expectations of benefit could improve patient outcomes. However, the evidence in this area has not been recently synthesised. Objective: To estimate the effects of empathy and expectations interventions for any clinical condition. Design: Systematic review and meta-analysis of randomised trials. Data sources: Six databases from inception to August 2017. Study selection: Randomised trials of empathy or expectations interventions in any clinical setting with patients aged 12 years or older. Review methods: Two reviewers independently screened citations, extracted data, assessed risk of bias and graded quality of evidence using GRADE. Random effects model was used for meta-analysis. Results: We identified 28 eligible (n = 6017). In seven trials, empathic consultations improved pain, anxiety and satisfaction by a small amount (standardised mean difference −0.18 [95% confidence interval −0.32 to −0.03]). Twenty-two trials tested the effects of positive expectations. Eighteen of these (n = 2014) reported psychological outcomes (mostly pain) and showed a modest benefit (standardised mean difference −0.43 [95% confidence interval −0.65 to −0.21]); 11 (n = 1790) reported physical outcomes (including bronchial function/ length of hospital stay) and showed a small benefit (standardised mean difference −0.18 [95% confidence interval −0.32 to −0.05]). Within 11 trials (n = 2706) assessing harms, there was no evidence of adverse effects (odds ratio 1.04; 95% confidence interval 0.67 to 1.63). The risk of bias was low. The main limitations were difficulties in blinding and high heterogeneity for some comparisons. Conclusions: Greater practitioner empathy or communication of positive messages can have small patient benefits for a range of clinical conditions, especially pain. Protocol registration: Cochrane Database of Systematic Reviews (protocol) DOI: 10.1002/14651858.CD011934.pub2.

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More information

Accepted/In Press date: 18 March 2018
e-pub ahead of print date: 19 April 2018
Published date: July 2018
Keywords: Communication, evidence-based practice, family medicine

Identifiers

Local EPrints ID: 422487
URI: http://eprints.soton.ac.uk/id/eprint/422487
ISSN: 0141-0768
PURE UUID: d994bcb1-0a9c-4d6c-b0d3-84115ab49055
ORCID for Felicity L. Bishop: ORCID iD orcid.org/0000-0002-8737-6662
ORCID for Xiao-Yang Hu: ORCID iD orcid.org/0000-0002-3143-7999

Catalogue record

Date deposited: 24 Jul 2018 16:30
Last modified: 23 May 2020 00:35

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