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Clinician views on optimism and empathy in primary care consultations: a qualitative interview study

Clinician views on optimism and empathy in primary care consultations: a qualitative interview study
Clinician views on optimism and empathy in primary care consultations: a qualitative interview study
Background Practitioner expressions of optimism and empathy may improve treatment engagement, adherence, and patient satisfaction but are not delivered consistently amid the challenges of everyday clinical practice.

Aim To explore primary care practitioner (PCP) views about optimistic and empathic communication in consultations; and to identify behavioural, attitudinal, and/or contextual issues likely to encourage or deter PCPs from practising such communication.

Design & setting Qualitative interview study with 20 PCPs (GPs, practice nurses, and primary care physiotherapists).

Method Semi-structured telephone interviews with 20 PCPs. Data were analysed thematically.

Results A conceptual mismatch between optimism and patient expectations became apparent; when asked how PCPs communicate about the likely effects of a treatment, answers were focussed around managing patient expectations. When prompted, it became clear PCPs were open to communicating optimistically with patients, but emphasised the need for realism. Concerns arose that patients may not be receptive to optimistic messages, especially when holding negative expectations. PCPs felt that expressing empathy is fundamental to all clinical consultations, noting that it can be challenging. Some PCPs worried that increasing expressions of empathy might increase their risk of clinician burnout and felt guilty about (appropriately) communicating empathy while maintaining some emotional distance.

Conclusion PCPs agreed expressing realistic optimism during consultations could aid communication and would constitute a novel change to practice. PCPs strive for clinical empathy but can struggle to manage emotional self-protection. Specific training to help PCPs express realistic optimism and empathy, and better utilise efficient non-verbal skills could help these issues.
Hughes, Stephanie
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Vennik, Jane Louise
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Smith, Kirsten A
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Bostock, Jennifer
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Howick, Jeremy
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Mallen, Christian D.
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Little, Paul
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Ratnapalan, Mohana
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Lyness, Emily
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Leydon, Geraldine
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Dambha-Miller, Hajira
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Morrison, Leanne
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Everitt, Hazel
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Bishop, Felicity
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Hughes, Stephanie
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Vennik, Jane Louise
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Smith, Kirsten A
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Bostock, Jennifer
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Howick, Jeremy
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Mallen, Christian D.
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Little, Paul
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Ratnapalan, Mohana
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Lyness, Emily
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Leydon, Geraldine
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Dambha-Miller, Hajira
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Morrison, Leanne
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Everitt, Hazel
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Bishop, Felicity
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Hughes, Stephanie, Vennik, Jane Louise, Smith, Kirsten A, Bostock, Jennifer, Howick, Jeremy, Mallen, Christian D., Little, Paul, Ratnapalan, Mohana, Lyness, Emily, Leydon, Geraldine, Dambha-Miller, Hajira, Morrison, Leanne, Everitt, Hazel and Bishop, Felicity (2022) Clinician views on optimism and empathy in primary care consultations: a qualitative interview study. BJGP Open, 6 (3). (doi:10.3399/BJGPO.2021.0221).

Record type: Article

Abstract

Background Practitioner expressions of optimism and empathy may improve treatment engagement, adherence, and patient satisfaction but are not delivered consistently amid the challenges of everyday clinical practice.

Aim To explore primary care practitioner (PCP) views about optimistic and empathic communication in consultations; and to identify behavioural, attitudinal, and/or contextual issues likely to encourage or deter PCPs from practising such communication.

Design & setting Qualitative interview study with 20 PCPs (GPs, practice nurses, and primary care physiotherapists).

Method Semi-structured telephone interviews with 20 PCPs. Data were analysed thematically.

Results A conceptual mismatch between optimism and patient expectations became apparent; when asked how PCPs communicate about the likely effects of a treatment, answers were focussed around managing patient expectations. When prompted, it became clear PCPs were open to communicating optimistically with patients, but emphasised the need for realism. Concerns arose that patients may not be receptive to optimistic messages, especially when holding negative expectations. PCPs felt that expressing empathy is fundamental to all clinical consultations, noting that it can be challenging. Some PCPs worried that increasing expressions of empathy might increase their risk of clinician burnout and felt guilty about (appropriately) communicating empathy while maintaining some emotional distance.

Conclusion PCPs agreed expressing realistic optimism during consultations could aid communication and would constitute a novel change to practice. PCPs strive for clinical empathy but can struggle to manage emotional self-protection. Specific training to help PCPs express realistic optimism and empathy, and better utilise efficient non-verbal skills could help these issues.

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Accepted/In Press date: 30 March 2022
Published date: 29 June 2022

Identifiers

Local EPrints ID: 476199
URI: http://eprints.soton.ac.uk/id/eprint/476199
PURE UUID: cfcf3877-c6c8-4f37-9e5f-78331016cd6d
ORCID for Stephanie Hughes: ORCID iD orcid.org/0000-0003-4801-8245
ORCID for Paul Little: ORCID iD orcid.org/0000-0003-3664-1873
ORCID for Mohana Ratnapalan: ORCID iD orcid.org/0000-0002-6505-6107
ORCID for Geraldine Leydon: ORCID iD orcid.org/0000-0001-5986-3300
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 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: 13 Apr 2023 17:09
Last modified: 12 Jul 2024 02:03

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Contributors

Author: Jane Louise Vennik
Author: Kirsten A Smith
Author: Jennifer Bostock
Author: Jeremy Howick
Author: Christian D. Mallen
Author: Paul Little ORCID iD
Author: Emily Lyness
Author: Leanne Morrison ORCID iD
Author: Hazel Everitt ORCID iD
Author: Felicity Bishop ORCID iD

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