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Exploring patient views of empathic optimistic communication for osteoarthritis in primary care: a qualitative interview study using vignettes

Exploring patient views of empathic optimistic communication for osteoarthritis in primary care: a qualitative interview study using vignettes
Exploring patient views of empathic optimistic communication for osteoarthritis in primary care: a qualitative interview study using vignettes

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: To explore patients' perspectives on clinician communication of empathy and optimism in primary care OA consultations.Design & setting: Vignette study with qualitative semi-structured interviews. Purposefully sampled patients (n = 33) aged > 45 years with hip or knee OA from GP practices in Wessex (Hampshire, Dorest, Wiltshire, and Somerset).Method: 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: 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: 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

Placebo Effect, Primary Health Care, physician-patient communication, physician-patient relations
1-11
Lyness, Emily
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Vennik, Jane Louise
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Bishop, Felicity
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Misurya, Pranati
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Howick, Jeremy
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Smith, Kirsten A
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Ratnapalan, Mohana
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Hughes, Stephanie
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Dambha-Miller, Hajira
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Bostock, Jennifer
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Morrison, Leanne
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Mallen, Christian
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Yardley, Lucy
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Leydon, Geraldine
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Little, Paul
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Everitt, Hazel
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Lyness, Emily
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Vennik, Jane Louise
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Bishop, Felicity
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Misurya, Pranati
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Howick, Jeremy
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Smith, Kirsten A
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Ratnapalan, Mohana
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Hughes, Stephanie
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Dambha-Miller, Hajira
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Bostock, Jennifer
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Morrison, Leanne
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Mallen, Christian
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Yardley, Lucy
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Leydon, Geraldine
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Little, Paul
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Everitt, Hazel
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Lyness, Emily, Vennik, Jane Louise, Bishop, Felicity, Misurya, Pranati, Howick, Jeremy, Smith, Kirsten A, Ratnapalan, Mohana, Hughes, Stephanie, Dambha-Miller, Hajira, Bostock, Jennifer, Morrison, Leanne, Mallen, Christian, Yardley, Lucy, Leydon, Geraldine, Little, Paul and Everitt, Hazel (2021) Exploring patient views of empathic optimistic communication for osteoarthritis in primary care: a qualitative interview study using vignettes. BJGP Open, 5 (3), 1-11. (doi:10.3399/BJGPO.2021.0014).

Record type: Article

Abstract

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: To explore patients' perspectives on clinician communication of empathy and optimism in primary care OA consultations.Design & setting: Vignette study with qualitative semi-structured interviews. Purposefully sampled patients (n = 33) aged > 45 years with hip or knee OA from GP practices in Wessex (Hampshire, Dorest, Wiltshire, and Somerset).Method: 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: 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: 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

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Accepted/In Press date: 10 February 2021
e-pub ahead of print date: 5 May 2021
Published date: June 2021
Additional Information: Funding Information: The Empathica trial is supported by a National Institute for Health Research (NIHR) School for Primary Care Research (SPCR) grant (project number: 389). The University of Southampton Primary Care Research Centre is a member of the NIHR SPCR and supported by NIHR research funds. Hajira Dambha-Miller is funded through an NIHR Clinical Lectureship. Mohana Ratnapalan is an NIHR SPCR-funded academic clinical fellow. Christian D Mallen is funded by the NIHR Collaborations for Leadership in Applied Health Research and Care West Midlands, the NIHR SPCR, and an NIHR Research Professorship in General Practice (reference: NIHR-RP-2014-04-026). Lucy Yardley is an NIHR senior investigator and her research programme is partly supported by NIHR Applied Research Collaboration (ARC)-West, NIHR Health Protection Research Unit for Behavioural Science and Eval-uation, and the NIHR Southampton Biomedical Research Centre (BRC). The research programme of Lucy Yardley and Leanne Morrison is partly supported by the NIHR Southampton BRC. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and social care Funding Information: The Empathica trial is supported by a National Institute for Health Research (NIHR) School for Primary Care Research (SPCR) grant (project number: 389). The University of Southampton Primary Care Research Centre is a member of the NIHR SPCR and supported by NIHR research funds. Hajira Dambha-Miller is funded through an NIHR Clinical Lectureship. Mohana Ratnapalan is an NIHR SPCR-funded academic clinical fellow. Christian D Mallen is funded by the NIHR Collaborations for Leadership in Applied Health Research and Care West Midlands, the NIHR SPCR, and an NIHR Research Professorship in General Practice (reference: NIHR-RP-2014-04-026). Lucy Yardley is an NIHR senior investigator and her research programme is partly supported by NIHR Applied Research Collaboration (ARC)-West, NIHR Health Protection Research Unit for Behavioural Science and Evaluation, and the NIHR Southampton Biomedical Research Centre (BRC). The research programme of Lucy Yardley and Leanne Morrison is partly supported by the NIHR Southampton BRC. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and social care. Publisher Copyright: © 2021, The Authors.
Keywords: Placebo Effect, Primary Health Care, physician-patient communication, physician-patient relations

Identifiers

Local EPrints ID: 448829
URI: http://eprints.soton.ac.uk/id/eprint/448829
DOI: doi:10.3399/BJGPO.2021.0014
PURE UUID: c8eec3dc-5cc9-45cb-bafb-e9ac8ebbb451
ORCID for Felicity Bishop: ORCID iD orcid.org/0000-0002-8737-6662
ORCID for Mohana Ratnapalan: ORCID iD orcid.org/0000-0002-6505-6107
ORCID for Stephanie Hughes: ORCID iD orcid.org/0000-0003-4801-8245
ORCID for Hajira Dambha-Miller: ORCID iD orcid.org/0000-0003-0175-443X
ORCID for Leanne Morrison: ORCID iD orcid.org/0000-0002-9961-551X
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X
ORCID for Geraldine Leydon: ORCID iD orcid.org/0000-0001-5986-3300
ORCID for Paul Little: ORCID iD orcid.org/0000-0003-3664-1873
ORCID for Hazel Everitt: ORCID iD orcid.org/0000-0001-7362-8403

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Date deposited: 06 May 2021 16:32
Last modified: 12 Jul 2024 02:03

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Contributors

Author: Emily Lyness
Author: Jane Louise Vennik
Author: Felicity Bishop ORCID iD
Author: Pranati Misurya
Author: Jeremy Howick
Author: Kirsten A Smith
Author: Mohana Ratnapalan ORCID iD
Author: Stephanie Hughes ORCID iD
Author: Hajira Dambha-Miller ORCID iD
Author: Jennifer Bostock
Author: Leanne Morrison ORCID iD
Author: Christian Mallen
Author: Lucy Yardley ORCID iD
Author: Geraldine Leydon ORCID iD
Author: Paul Little ORCID iD
Author: Hazel Everitt ORCID iD

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