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Anatomy of positive messages in healthcare consultations: component analysis of messages within 22 randomised trials

Anatomy of positive messages in healthcare consultations: component analysis of messages within 22 randomised trials
Anatomy of positive messages in healthcare consultations: component analysis of messages within 22 randomised trials
Background: Patients desire both honesty and hope from their healthcare practitioners. A recent systematic review of 22 randomised trials found that healthcare practitioners who deliver positive messages improve patient outcomes, most notably by reducing pain. However, the verbal and non-verbal components of positive messages within these trials varied greatly, which presents a barrier to the implementation of person-centered care.

Objective: This study investigates common components of positive messages within the reviewed trials.

Methods: We extracted the verbal and non-verbal language used to deliver positive messages in 22 trials from a recent systematic review. Three independent researchers coded the components of the messages using content analysis.

Results: Positive messages in our sample had between 2 and 18 different components. These were clustered into 5 areas: specifying the positive outcomes, making the message personal, drawing on associations and meanings, providing a supportive psychological context and providing a rationale. Messages were reinforced through repetition in half the studies. Within the clusters, the most common components of positive messages were suggestions of specific effects (18 studies) and personalised formulations (15 studies). Most studies did not describe the components of positive messages adequately.

Conclusions: Positive messages within randomized trials are complex interventions, with most including strong suggestions about specific effects, presented confidently and made personally relevant to the individual patient. Future trials of positive messages should report all components of these interventions.
2052-5648
656-664
Howick, J.
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Lyness, Emily
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Albury, Charlotte
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Smith, Kirsten
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Dambha-Miller, Hajira
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Ratnapalan, Mohana
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Vennik, Jane
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Hughes, Stephanie
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Bostock, Jennifer
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Morrison, Leanne
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Mallen, Christian D.
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Everitt, Hazel
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Dean, Sue
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Levett-Jones, Tracy
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Ivynian, Serra
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Little, Paul
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Bishop, Felicity
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Howick, J.
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Lyness, Emily
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Albury, Charlotte
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Smith, Kirsten
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Dambha-Miller, Hajira
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Ratnapalan, Mohana
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Vennik, Jane
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Hughes, Stephanie
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Bostock, Jennifer
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Morrison, Leanne
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Mallen, Christian D.
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Everitt, Hazel
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Dean, Sue
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Levett-Jones, Tracy
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Ivynian, Serra
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Little, Paul
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Bishop, Felicity
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Howick, J., Lyness, Emily, Albury, Charlotte, Smith, Kirsten, Dambha-Miller, Hajira, Ratnapalan, Mohana, Vennik, Jane, Hughes, Stephanie, Bostock, Jennifer, Morrison, Leanne, Mallen, Christian D., Everitt, Hazel, Dean, Sue, Levett-Jones, Tracy, Ivynian, Serra, Little, Paul and Bishop, Felicity (2020) Anatomy of positive messages in healthcare consultations: component analysis of messages within 22 randomised trials. European Journal for Person Centered Healthcare, 7 (4), 656-664.

Record type: Article

Abstract

Background: Patients desire both honesty and hope from their healthcare practitioners. A recent systematic review of 22 randomised trials found that healthcare practitioners who deliver positive messages improve patient outcomes, most notably by reducing pain. However, the verbal and non-verbal components of positive messages within these trials varied greatly, which presents a barrier to the implementation of person-centered care.

Objective: This study investigates common components of positive messages within the reviewed trials.

Methods: We extracted the verbal and non-verbal language used to deliver positive messages in 22 trials from a recent systematic review. Three independent researchers coded the components of the messages using content analysis.

Results: Positive messages in our sample had between 2 and 18 different components. These were clustered into 5 areas: specifying the positive outcomes, making the message personal, drawing on associations and meanings, providing a supportive psychological context and providing a rationale. Messages were reinforced through repetition in half the studies. Within the clusters, the most common components of positive messages were suggestions of specific effects (18 studies) and personalised formulations (15 studies). Most studies did not describe the components of positive messages adequately.

Conclusions: Positive messages within randomized trials are complex interventions, with most including strong suggestions about specific effects, presented confidently and made personally relevant to the individual patient. Future trials of positive messages should report all components of these interventions.

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More information

Accepted/In Press date: 28 February 2020
Published date: 30 July 2020

Identifiers

Local EPrints ID: 439120
URI: http://eprints.soton.ac.uk/id/eprint/439120
ISSN: 2052-5648
PURE UUID: 743765ec-ae27-4793-821e-ce4d0516a6dc
ORCID for Hajira Dambha-Miller: ORCID iD orcid.org/0000-0003-0175-443X
ORCID for Mohana Ratnapalan: ORCID iD orcid.org/0000-0002-6505-6107
ORCID for Jane Vennik: ORCID iD orcid.org/0000-0003-4602-9805
ORCID for Leanne Morrison: ORCID iD orcid.org/0000-0002-9961-551X
ORCID for Hazel Everitt: ORCID iD orcid.org/0000-0001-7362-8403
ORCID for Felicity Bishop: ORCID iD orcid.org/0000-0002-8737-6662

Catalogue record

Date deposited: 03 Apr 2020 16:31
Last modified: 13 Dec 2021 05:54

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Contributors

Author: J. Howick
Author: Emily Lyness
Author: Charlotte Albury
Author: Kirsten Smith
Author: Jane Vennik ORCID iD
Author: Jennifer Bostock
Author: Leanne Morrison ORCID iD
Author: Christian D. Mallen
Author: Hazel Everitt ORCID iD
Author: Sue Dean
Author: Tracy Levett-Jones
Author: Serra Ivynian
Author: Paul Little
Author: Felicity Bishop ORCID iD

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