Dataset Information

Exploring communication pathways to better health: clinician communication of expectations for acupuncture effectiveness.

ABSTRACT:

Objective

This study tested a pathway whereby acupuncturists' communication of optimism for treatment effectiveness would enhance patients' satisfaction during treatment, which in turn would contribute to better pain and function outcomes for patients with osteoarthritis of the knee.

Methods

Secondary analysis from a 2 arm (real vs. sham acupuncture, high vs. neutral expectations) RCT. 311 patients with knee osteoarthritis received acupuncture over 10-12 sessions. Coders rated the degree to which acupuncturists communicated optimism for the treatment's effectiveness. Satisfaction with acupuncture was assessed 4 weeks into treatment. Pain and function were assessed 6 weeks following treatment.

Results

Patients experiencing better outcomes were more satisfied with acupuncture during treatment, were younger, and had better baseline pain and function scores. Satisfaction during treatment was greater when patients interacted with more optimistic clinicians and had higher pretreatment expectations for acupuncture efficacy.

Conclusion

Acupuncturists' communication of optimism about treatment effectiveness contributed to pain and function outcomes indirectly through its effect on satisfaction during treatment. Future research should model pathways through which clinician-patient communication affects mediating variables that in turn lead to improved health outcomes.

Practical implications

While clinicians should not mislead patients, communicating hope and optimism for treatment effectiveness has therapeutic value for patients.

SUBMITTER: Street RL

PROVIDER: S-EPMC3489966 | biostudies-literature | 2012 Nov

REPOSITORIES: biostudies-literature

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Publications

Exploring communication pathways to better health: clinician communication of expectations for acupuncture effectiveness.

Street Richard L RL Cox Vanessa V Kallen Michael A MA Suarez-Almazor Maria E ME

Patient education and counseling 20120731 2

<h4>Objective</h4>This study tested a pathway whereby acupuncturists' communication of optimism for treatment effectiveness would enhance patients' satisfaction during treatment, which in turn would contribute to better pain and function outcomes for patients with osteoarthritis of the knee.<h4>Methods</h4>Secondary analysis from a 2 arm (real vs. sham acupuncture, high vs. neutral expectations) RCT. 311 patients with knee osteoarthritis received acupuncture over 10-12 sessions. Coders rated the ...[more]

PMID: 22857778

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Project description:BackgroundThe majority of cancer patients and cancer care clinicians-CCCs (e.g., oncologists) believe that exercise is an important adjunct therapy that should be embedded in standard practice. Yet, CCCs do not routinely discuss exercise with their patients, nor do they regularly refer them to exercise professionals (e.g., exercise physiologists-EPs). This study evaluated the feasibility and acceptability of an evidence-based approach to improving exercise communication between CCCs and their patients, including an exercise referral pathway.MethodsImplementation and testing of the Exercise Communication and Referral Pathway (ECRP) occurred in Sydney, Australia. The ECRP included a brief oncology-initiated communication exchange with patients, CCC exercise referral to an EP, followed by EP-initiated telephone consultation with patients concerning tailored exercise advice. Participant perceptions concerning the feasibility and applicability of the ECPR were evaluated. Semi-structured interviews were conducted with CCCs (n = 3), cancer patients (n = 21), and an EP (n = 1). Inductive thematic analysis was undertaken.ResultsAnalysis generated three themes: (1) Navigating the role of CCCs in the ECRP, suggesting that oncology-initiated communication is a cue to action, however there was a lack of role clarity regarding exercise referral; (2) Implementing Patient-Orientated Care within a Standardised Pathway, highlighting the need for tailored information and advice for patients that reflects individual disease, socio-cultural, and environmental factors, and; (3) Taking Steps Towards Action, revealing the need for structural (e.g., EP initiated contact with patients) and policy changes (i.e., changes to Medicare, direct oncologist referral) to engage patients and better integrate exercise as part of standard care.ConclusionsFindings provide important insights into improving oncology-patient exercise communication and developing an exercise referral pathway to increase engagement and patient reach. However, individual (e.g., experience, knowledge) and contextual factors (e.g., time, resources) need consideration when implementing an ECRP.Trial registrationThis trial was prospectively registered with the Australian New Zealand Clinical (#ACTRN12620000358943) on March 13, 2020.

Project description:BackgroundEffective communication is the bedrock of quality health care, but it continues to be a major problem for patients, family caregivers, health care providers, and organizations. Although progress related to communication skills training for health care providers has been made, clinical practice and research gaps persist, particularly regarding how to best monitor, measure, and evaluate the implementation of communication skills in the actual clinical setting and provide timely feedback about communication effectiveness and quality.ObjectiveOur interdisciplinary team of investigators aims to develop, and pilot test, a novel sensing system and associated natural language processing algorithms (CommSense) that can (1) be used on mobile devices, such as smartwatches; (2) reliably capture patient-clinician interactions in a clinical setting; and (3) process these communications to extract key markers of communication effectiveness and quality. The long-term goal of this research is to use CommSense in a variety of health care contexts to provide real-time feedback to end users to improve communication and patient health outcomes.MethodsThis is a 1-year pilot study. During Phase I (Aim 1), we will identify feasible metrics of communication to extract from conversations using CommSense. To achieve this, clinical investigators will conduct a thorough review of the recent health care communication and palliative care literature to develop an evidence-based "ideal and optimal" list of communication metrics. This list will be discussed collaboratively within the study team and consensus will be reached regarding the included items. In Phase II (Aim 2), we will develop the CommSense software by sharing the "ideal and optimal" list of communication metrics with engineering investigators to gauge technical feasibility. CommSense will build upon prior work using an existing Android smartwatch platform (SWear) and will include sensing modules that can collect (1) physiological metrics via embedded sensors to measure markers of stress (eg, heart rate variability), (2) gesture data via embedded accelerometer and gyroscope sensors, and (3) voice and ultimately textual features via the embedded microphone. In Phase III (Aim 3), we will pilot test the ability of CommSense to accurately extract identified communication metrics using simulated clinical scenarios with nurse and physician participants.ResultsDevelopment of the CommSense platform began in November 2021, with participant recruitment expected to begin in summer 2022. We anticipate that preliminary results will be available in fall 2022.ConclusionsCommSense is poised to make a valuable contribution to communication science, ubiquitous computing technologies, and natural language processing. We are particularly eager to explore the ability of CommSense to support effective virtual and remote health care interactions and reduce disparities related to patient-clinician communication in the context of serious illness.International registered report identifier (irrid)PRR1-10.2196/37975.

Dataset Information

Exploring communication pathways to better health: clinician communication of expectations for acupuncture effectiveness.

Objective

Methods

Results

Conclusion

Practical implications

Publications

Exploring communication pathways to better health: clinician communication of expectations for acupuncture effectiveness.

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