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: Vignette study with qualitative semi-structured interviews.
Setting: Purposefully sampled patients (n=33) aged 45+ with hip/knee OA from Wessex GP practices.
Method: Fifteen participants watched two filmed OA consultations with a GP, and eighteen 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.
Aim: To explore patients’ perspectives on clinician communication of empathy and optimism in primary care OA consultations.
Design: Vignette study with qualitative semi-structured interviews.
Setting: Purposefully sampled patients (n=33) aged 45+ with hip/knee OA from Wessex GP practices.
Method: Fifteen participants watched two filmed OA consultations with a GP, and eighteen 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.
| Original language | English |
|---|---|
| Pages (from-to) | 1-11 |
| Number of pages | 11 |
| Journal | British Journal of General Practice Open |
| Volume | 5 |
| Issue number | 3 |
| Early online date | 4 May 2021 |
| DOIs | |
| Publication status | Published - Jun 2021 |
Bibliographical note
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.
Research Groups and Themes
- Physical and Mental Health
Keywords
- physician patient communication
- placebo effect
- primary health care
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This is the final published version of the article (version of record). It first appeared online via Royal College of General Practitioners at https://doi.org/10.3399/BJGPO.2021.0014 . Please refer to any applicable terms of use of the publisher.
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