Department of Communication, Texas A&M University, College Station, TX 77843-4234, USA.
Patient Educ Couns. 2012 Nov;89(2):245-51. doi: 10.1016/j.pec.2012.06.032. Epub 2012 Jul 31.
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.
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.
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.
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.
While clinicians should not mislead patients, communicating hope and optimism for treatment effectiveness has therapeutic value for patients.
本研究检验了一种途径，即针灸师对治疗效果的乐观沟通会提高患者在治疗过程中的满意度，进而改善膝骨关节炎患者的疼痛和功能结果。
一项 2 臂（真实与假针刺、高与中性期望）RCT 的二次分析。311 例膝骨关节炎患者接受了 10-12 次针刺治疗。编码员评估了针灸师对治疗效果乐观程度的程度。在治疗 4 周时评估对针灸的满意度。在治疗 6 周后评估疼痛和功能。
治疗效果更好的患者在治疗过程中对针灸的满意度更高，年龄更小，基线疼痛和功能评分更好。当患者与更乐观的临床医生互动并对针刺疗效有更高的预处理期望时，治疗过程中的满意度更高。
针灸师对治疗效果的乐观沟通通过对治疗过程中满意度的影响，间接地影响了疼痛和功能结果。未来的研究应该建立临床医生-患者沟通影响中介变量的途径，进而改善健康结果。
虽然临床医生不应误导患者，但对治疗效果的希望和乐观沟通对患者具有治疗价值。
