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- Howick, Jeremy, et al.
(författare)
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Effects of empathic and positive communication in healthcare consultations: a systematic review and meta-analysis
- 2018
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Ingår i: Journal of the Royal Society of Medicine. - : Sage Publications. - 0141-0768 .- 1758-1095. ; 111:7, s. 240-252
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPractitioners 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.ObjectiveTo estimate the effects of empathy and expectations interventions for any clinical condition.DesignSystematic review and meta-analysis of randomised trials.Data sourceSix databases from inception to August 2017.Study selectionRandomised trials of empathy or expectations interventions in any clinical setting with patients aged 12 years or older.Review methodsTwo 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.ResultsWe 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.ConclusionGreater practitioner empathy or communication of positive messages can have small patient benefits for a range of clinical conditions, especially pain.Protocol registrationCochrane Database of Systematic Reviews (protocol) DOI: 10.1002/14651858.CD011934.pub2.
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