Bishop Felicity, Howick Jeremy, Vennik Jane, Bostock Jennifer, Little Paul, Mallen Christian, Morrison Leanne, Steele Mary, Stuart Beth, Hughes Stephanie, Smith Kirsten, Ratnapalan Mohana, Lyness Emily, Dambha-Miller Hajira, Tiwari Riya, Lockyer-Stevens Clare, Everitt Hazel
School of Psychology, University of Southampton, Southampton, Hampshire, United Kingdom.
Faculty of Philosophy, University of Oxford, Oxford, United Kingdom.
PLoS One. 2025 Jul 18;20(7):e0324649. doi: 10.1371/journal.pone.0324649. eCollection 2025.
Patients can benefit when primary care practitioners communicate clinical empathy and optimism during consultations, but previous training interventions for practitioners are overly time-consuming and evidence on patient outcomes is limited. This study assessed the feasibility of a cluster-randomized controlled trial in UK general practice to evaluate effects of a new brief digital learning package in empathy and optimism (EMPathicO) for primary care practitioners.
The study ran January to October 2020, with COVID-19 related modifications (mostly, practitioner and patient data had to be collected separately) from March 2020. 9 practices and 12 primary care practitioners recruited from UK (Southern England, Midlands). 12 practitioners completed EMPathicO training and 11 completed qualitative telephone interviews. Patients recruited through social media completed web-based questionnaires at baseline (<2 weeks post-consultation) and 2-week follow-up (n = 437). Purposively sampled patients completed qualitative telephone interviews (n = 30). Data analysed descriptively and thematically.
Practitioners were keen to reflect on and enhance communication skills and were willing to undertake digital training, even during COVID-19 pandemic. However, some practices and practitioners would have declined if video-recording consultations was a mandatory aid to reflection during training. Practitioners found EMPathicO brief, relevant and engaging and could implement techniques taught in the training. Patients found the online questionnaires acceptable, though retention was suboptimal at 57%; minor easily remedied feasibility and process issues were identified (including incentivizing participation); and patients were enthusiastic about research to improve communication.
An agile research strategy enabled useful feasibility data to be collected despite the challenges of the COVID pandemic. It is feasible to proceed to a full trial of the effects of EMPathicO on patient outcomes in primary care, if video-recording consultations is optional not mandatory. Feasibility work to develop and test sophisticated questionnaire structures is valuable when planning primary care patient surveys. Registration: ISRCTN21215037. Registered: 06/02/2020. https://doi.org/10.1186/ISRCTN21215037.
在诊疗过程中，初级保健从业者若能表达出临床同理心和乐观态度，患者会从中受益，但此前针对从业者的培训干预耗时过长，且关于患者治疗效果的证据有限。本研究评估了在英国全科医疗中开展一项整群随机对照试验的可行性，以评估一种新的简短数字学习包（共情与乐观，EMPathicO）对初级保健从业者在同理心和乐观态度方面的影响。
该研究于2020年1月至10月进行，自2020年3月起有与新冠疫情相关的调整（主要是从业者和患者数据必须分开收集）。从英国（英格兰南部、中部地区）招募了9家诊所和12名初级保健从业者。12名从业者完成了EMPathicO培训，11名完成了定性电话访谈。通过社交媒体招募的患者在基线（会诊后<2周）和2周随访时完成了基于网络的问卷（n = 437）。有目的地抽样的患者完成了定性电话访谈（n = 30）。对数据进行描述性和主题性分析。
从业者热衷于反思并提高沟通技巧，甚至在新冠疫情期间也愿意接受数字培训。然而，如果在培训期间视频记录会诊是反思的强制辅助手段，一些诊所和从业者会拒绝参与。从业者认为EMPathicO简短、相关且引人入胜，并能应用培训中教授的技巧。患者认为在线问卷可以接受，尽管留存率为57%，不太理想；发现了一些易于解决的可行性和流程问题（包括激励参与）；患者对改善沟通的研究很热情。
尽管新冠疫情带来挑战，但灵活的研究策略仍能收集到有用的可行性数据。如果视频记录会诊是可选而非强制的，那么对EMPathicO对初级保健中患者治疗效果进行全面试验是可行的。在规划初级保健患者调查时，开展和测试复杂问卷结构的可行性工作很有价值。注册信息：ISRCTN21215037。注册时间：2020年2月6日。https://doi.org/10.1186/ISRCTN21215
