Negative patient-medical communication can exacerbate symptoms

Doctors who unwittingly communicate to patients that they do not believe or understand them may actually make their symptoms worse, suggests a new study.

Research by the University of Exeter Medical School, and psychology departments at Exeter University and the University of Southampton, published in the American Journal of Medicine, shows that some type of reaction “nocebo” where patients perceive the lack of understanding or acceptance of their doctor deal with anger and anxiety, these physical situations that can make the disease worse.

The lead author, Meddy Graville-Hariss from Southampton University, stressed: Our “Work shows that the effects of patients who feel that their doctor does not believe or understand them can be emotionally and psychologically damaging. This could lead to the deterioration of the disease, known as noncebo response.

Patients bring about certain beliefs and expectations for their professional health care, which are shaped by the culture in which they live, as well as their previous experiences.

Their expectations will no doubt affect the outcome, but improving communication in consultations can have a major impact on patient care. This is a small study, and more research is necessary on a larger scale. ”

Researchers recorded them and analyzed consultations at a pain management clinic involving five women with widespread chronic pain. During the following interviews, patients reported feelings of departure and distrust by health care providers, confrontation with doctors who had not invested in them, or had not shown knowledge of their condition.

Doctors described that they had faced conflict and criticism from patients and that they were confronted with patients who held firm views or who did not believe in their diagnosis.

Patients described feeling hopeless and angry after poor consultations, feeling a growing need to justify their situation, or to avoid doctors or treatment.

The team's first job showed that people who feel distrustful can lead to increased anger and stress and that this was much more powerful than positive reinforcement, of the well-known “laquebo” effect.

In the research, 90 participants took part in mathematical tests, which were specifically assigned to an experimenter who either gave understandable reactions, through phrases like <x0... a lot of people consider these difficult tests”, or unintelligible reactions, through phrases like “I don't understand why you're not trying to ) are just numbers”

Professor Paul Dieppe, senior researcher of NIHR from Exeter University Medical School stressed: “This study is actually about humanity in healthcare. We have found that patients perceive a lack of sensitivity and understanding even when the doctor tries to be encouraging.

Comments like “don't have any physical reasons that you're feeling pain seeking reassurance, but may be perceived as dissolving or skeptical. Now we need to have more research on this field, and invest more in training doctors to be more effective communicators for every patient who accepts it. ”