Mara van Osch1, Sandra van Dulmen2, Liesbeth van Vliet1, Jozien Bensing3. 1. NIVEL (Netherlands institute for health services research), PO Box 1568, 3500 BN Utrecht, The Netherlands. 2. NIVEL (Netherlands institute for health services research), PO Box 1568, 3500 BN Utrecht, The Netherlands; Department of Primary and Community Care, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands; Faculty of Health Science, University College of Southeast Norway, PO Box 7053, NO-3007 Drammen, Norway. Electronic address: s.vandulmen@nivel.nl. 3. NIVEL (Netherlands institute for health services research), PO Box 1568, 3500 BN Utrecht, The Netherlands; Department of Clinical and Health Psychology, Utrecht University, PO Box 80140, 3508 TC Utrecht, The Netherlands.
Abstract
OBJECTIVE: To experimentally test the effects of physician's affect-oriented communication and inducing expectations on outcomes in patients with menstrual pain. METHODS: Using a 2×2 RCT design, four videotaped simulated medical consultations were used, depicting a physician and a patient with menstrual pain. In the videos, two elements of physician's communication were manipulated: (1) affect-oriented communication (positive: warm, emphatic; versus negative: cold, formal), and (2) outcome expectation induction (positive versus uncertain). Participants (293 women with menstrual pain), acting as analogue patients, viewed one of the four videos. Pre- and post video participants' outcomes (anxiety, mood, self-efficacy, outcome expectations, and satisfaction) were assessed. RESULTS:Positive affect-oriented communication reduced anxiety (p<0.001), negative mood (p=0.001), and increased satisfaction (p<0.001) compared to negative affect-oriented communication. Positive expectations increased feelings of self-efficacy (p<0.001) and outcome expectancies (p<0.001), compared to uncertain expectations, but did not reduce anxiety. The combination of positive affect-oriented communication and a positive expectation reduced anxiety (p=0.02), increased outcome expectancies (p=0.01) and satisfaction (p=0.001). CONCLUSION: Being empathic and inducing positive expectations have distinct and combined effects, demonstrating that both are needed to influence patients' outcomes for the best. PRACTICE IMPLICATIONS: Continued medical training is needed to harness placebo-effects of medical communication into practice.
RCT Entities:
OBJECTIVE: To experimentally test the effects of physician's affect-oriented communication and inducing expectations on outcomes in patients with menstrual pain. METHODS: Using a 2×2 RCT design, four videotaped simulated medical consultations were used, depicting a physician and a patient with menstrual pain. In the videos, two elements of physician's communication were manipulated: (1) affect-oriented communication (positive: warm, emphatic; versus negative: cold, formal), and (2) outcome expectation induction (positive versus uncertain). Participants (293 women with menstrual pain), acting as analogue patients, viewed one of the four videos. Pre- and post video participants' outcomes (anxiety, mood, self-efficacy, outcome expectations, and satisfaction) were assessed. RESULTS: Positive affect-oriented communication reduced anxiety (p<0.001), negative mood (p=0.001), and increased satisfaction (p<0.001) compared to negative affect-oriented communication. Positive expectations increased feelings of self-efficacy (p<0.001) and outcome expectancies (p<0.001), compared to uncertain expectations, but did not reduce anxiety. The combination of positive affect-oriented communication and a positive expectation reduced anxiety (p=0.02), increased outcome expectancies (p=0.01) and satisfaction (p=0.001). CONCLUSION: Being empathic and inducing positive expectations have distinct and combined effects, demonstrating that both are needed to influence patients' outcomes for the best. PRACTICE IMPLICATIONS: Continued medical training is needed to harness placebo-effects of medical communication into practice.
Authors: Jihyun Park; Dimitrios Kotzias; Patty Kuo; Robert L Logan Iv; Kritzia Merced; Sameer Singh; Michael Tanana; Efi Karra Taniskidou; Jennifer Elston Lafata; David C Atkins; Ming Tai-Seale; Zac E Imel; Padhraic Smyth Journal: J Am Med Inform Assoc Date: 2019-12-01 Impact factor: 4.497
Authors: Asiya K Kazi; Armaan A Rowther; Najia Atif; Huma Nazir; Maria Atiq; Shaffaq Zulfiqar; Abid Malik; Pamela J Surkan Journal: PLoS One Date: 2021-02-05 Impact factor: 3.240
Authors: Hinke Hoffstädt; Jacqueline Stouthard; Maartje C Meijers; Janine Westendorp; Inge Henselmans; Peter Spreeuwenberg; Paul de Jong; Sandra van Dulmen; Liesbeth M van Vliet Journal: Palliat Med Rep Date: 2020-06-11
Authors: Liesbeth M van Vliet; Sandra van Dulmen; Bram Thiel; Gerard W van Deelen; Stephanie Immerzeel; Marc B Godfried; Jozien M Bensing Journal: BMJ Open Date: 2017-11-03 Impact factor: 2.692