Overthrowing barriers to empathy in healthcare: empathy in the age of the Internet

Howick, Jeremy; Rees, Siân

doi:10.1177/0141076817714443

Cited by 39 publications

(28 citation statements)

References 28 publications

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“…It is crucial to effectively inform about the efficacy of a specific treatment [ 169 , 172 ], considering that beliefs and behaviors could influence patients’ attitudes in a positive or negative way [ 7 , 169 ]. It is suitable to individualize consultation style according to the patient’s preference opting for a personal interaction and seeking for a warm, authentic and empathic style, limiting technical contacts to the minimum [ 169 , 171 , 172 , 176 , 188 – 190 ].…”

Section: Clinical Applications and Translational Researchmentioning

confidence: 99%

Clinical relevance of contextual factors as triggers of placebo and nocebo effects in musculoskeletal pain

Rossettini

Carlino

Testa

2018

BMC Musculoskelet Disord

196

172

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Placebo and nocebo effects are embodied psycho-neurobiological responses capable of modulating pain and producing changes at different neurobiological, body at perceptual and cognitive levels. These modifications are triggered by different contextual factors (CFs) presented in the therapeutic encounter between patient and healthcare providers, such as healing rituals and signs. The CFs directly impact on the quality of the therapeutic outcome: a positive context, that is a context characterized by the presence of positive CFs, can reduce pain by producing placebo effects, while a negative context, characterized by the presence of negative CFs, can aggravate pain by creating nocebo effects. Despite the increasing interest about this topic; the detailed study of CFs as triggers of placebo and nocebo effects is still lacked in the management of musculoskeletal pain.Increasing evidence suggest a relevant role of CFs in musculoskeletal pain management. CFs are a complex sets of internal, external or relational elements encompassing: patient’s expectation, history, baseline characteristics; clinician’s behavior, belief, verbal suggestions and therapeutic touch; positive therapeutic encounter, patient-centered approach and social learning; overt therapy, posology of intervention, modality of treatment administration; marketing features of treatment and health care setting. Different explanatory models such as classical conditioning and expectancy can explain how CFs trigger placebo and nocebo effects. CFs act through specific neural networks and neurotransmitters that were described as mediators of placebo and nocebo effects.Available findings suggest a relevant clinical role and impact of CFs. They should be integrated in the clinical reasoning to increase the number of treatment solutions, boosts their efficacy and improve the quality of the decision-making. From a clinical perspective, the mindful manipulation of CFs represents a useful opportunity to enrich a well-established therapy in therapeutic setting within the ethical border. From a translational perspective, there is a strong need of research studies on CFs close to routine and real-world clinical practice in order to underline the uncertainty of therapy action and help clinicians to implement knowledge in daily practice.

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Section: Clinical Applications and Translational Researchmentioning

confidence: 99%

Clinical relevance of contextual factors as triggers of placebo and nocebo effects in musculoskeletal pain

Rossettini

Carlino

Testa

2018

BMC Musculoskelet Disord

196

172

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“…The majorit y of studies on prevention of periodontal diseases have not taken into account behavioral change models and patient empowerment (by incorporating oral health into a healthy lifestyle) such as: COM-B (Capability, Opportunity and Motivation-Behavior) 20 , Patient-Centered Care (5 key components of PCC: connection, attitude, communication, empowerment and feeling valued) 21 and Empathy-Based Medicine. 22 Additionally, a new health perspective included a holistic, global and integrative approach (systems biology and digital revolution) called Proactive P4 medicine (P4: Predictive, Preventive, Personalized, Participatory). 23,24 A major oral health challenge will be to promote proactive strategies in patients and the community.…”

Section: Evidence For the Population (Individual-level Measures)mentioning

confidence: 99%

Strategies for the prevention of periodontal disease and its impact on general health in Latin America. Section III: Prevention

et al. 2020

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Dental plaque removal and the understanding of risk factors, risk indicators and social determinants are important components in the prevention of periodontal disease. Periodontal diseases and dental caries are largely preventable conditions, but require a "common risk factor approach" with non-communicable diseases with the purpose of improving their prevention and control, and positive impact on health. The aim of this consensus was to identify the evidence and gaps in periodontal prevention in Latin American, and to propose individual and collective recommendations for the population, health professionals, dental practice and government. The prevention of periodontal diseases in Latin America has mainly been focused on oral hygiene instruction, use of toothbrushes and interproximal devices, but in some patients, it is necessary to use adjuncts to these measures, such as antimicrobial and/or probiotic products that are backed by broad scientific evidence. Some evidence has shown that there are inadequate knowledge, attitudes and practices among patients, dentist and other health professionals. The prevention of periodontal diseases and caries should be adopted as a healthy lifestyle routine, because of their local and systemic effects. Recently, new empowerment strategies have been proposed in order to generate behavioral changes. Periodontal diseases can often be prevented, or controlled by joined efforts between government health systems, scientific associations, universities, health professionals, private companies and communities. In conclusion, the relations between periodontal diseases, caries, healthy lifestyles and NCD's offer an ideal opportunity to change Latin American prevention strategies at both the individual level and population levels.

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“…It follows from this discussion of empathy that any attempts to apply medicine to individuals must engage with and take into account the growing evidence about empathic care. 19 This takes place in the context of a world in which dramatic changes are taking places as a result of the revolutionary impact of the Internet.…”

Section: Determining the Future Role Of The Clinicianmentioning

confidence: 99%

Personalised healthcare and population healthcare

Gray

Howick

2017

J R Soc Med

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Overthrowing barriers to empathy in healthcare: empathy in the age of the Internet

Cited by 39 publications

References 28 publications

Clinical relevance of contextual factors as triggers of placebo and nocebo effects in musculoskeletal pain

Clinical relevance of contextual factors as triggers of placebo and nocebo effects in musculoskeletal pain

Strategies for the prevention of periodontal disease and its impact on general health in Latin America. Section III: Prevention

Personalised healthcare and population healthcare

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