Effects of empathic and positive communication in healthcare consultations: a systematic review and meta-analysis

Abstract

Background Practitioners 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. Objective To estimate the effects of empathy and expectations interventions for any clinical condition. Design Systematic review and meta-analysis of randomised trials. Data sources Six databases from inception to August 2017. Study selection Randomised trials of empathy or expectations interventions in any clinical setting with patients aged 12 years or older. Review methods Two 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. Results We 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. Conclusions Greater practitioner empathy or communication of positive messages can have small patient benefits for a range of clinical conditions, especially pain. Protocol registration Cochrane Database of Systematic Reviews (protocol) DOI: 10.1002/14651858.CD011934.pub2.

The empathy continuum: An evidenced‐based teaching model derived from an integrative review of contemporary nursing literature

“…The impact of communication as a component of empathy is significant. For example, in one systematic review by Howick et al (), where the outcomes of seven randomized control trials were examined, empathic communication was shown to reduce symptoms of chronic pain and irritable bowel syndrome and improve patient satisfaction and quality of life. Other studies have demonstrated that empathic communication can reduce anxiety, distress and depression (Scott, ).…”

How placebo characteristics can influence estimates of intervention effects in trials

“…20 In some instances, these could augment the effect of the placebo. 21 In an even more complex exam ple, sham acupuncture contains features such as acupressure and longer consultations. Making sham acupuncture more similar to real acupuncture is likely to improve the success of blinding.…”

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Impact of Forced Migration on Communication and Social Adaptation

“…Effective communication including empathy can have a positive impact on diagnostic accuracy as well as on intervention outcomes. A recent systematic review and meta-analysis indicated that such intervention provides some improvement to a range of psychological and physical patient conditions [23]. Professional empathy and positive communication also resulted in improvement of overall satisfaction with care from the patients’ point of view.…”

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