Lack of empathy ‘worsens illness’


Published: Wednesday 28th January 2015 by The News Editor

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Doctors who give patients the impression they do not believe or understand them could actually make the symptoms worse, according to a new study.

The research by the Universities of Southampton and Exeter indicates that a type of “nocebo” response, where patients perceive a lack of understanding or acceptance from their doctor, could create anger and distress – physiological conditions that can worsen illness.

Lead author Dr Maddy Greville-Harris, from the University of Southampton, said: “Our work indicates that the effects of patients feeling that their doctor doesn’t believe or understand them can be damaging both emotionally and physiologically.

“This could lead to worsening of illness, known as the ‘nocebo response’.

“Patients bring certain beliefs and expectations to their health care professional, which are moulded by the culture they live in and their previous experiences.

“Their expectations will undoubtedly affect the outcome but improving communication in consultations could make a big difference to patient care.

“This is a small study and more research is needed on a larger scale.”

Published in the American Journal of Medicine, the researchers recorded and analysed consultations at a pain management clinic involving five women with chronic wide-spread pain.

During subsequent interviews, patients reported feeling dismissed and disbelieved by healthcare providers, encountering clinicians who did not invest in them or show insight into their condition.

Patients described feeling hopeless and angry after invalidating consultations, feeling an increased need to justify their condition or to avoid particular doctors or treatment altogether.

Professor Paul Dieppe, a National Institute for Health Research senior investigator from the University of Exeter Medical School, said: “This study is really about humanity in healthcare.

“We have found that patients perceive a lack of empathy and understanding, even when the doctor is trying to be comforting.

“Comments such as ‘there’s no physiological reason that you’re experiencing pain’ seek to reassure, but can be perceived as patronising or disbelieving.

“We now need to see more research in this area, and for that to feed into training doctors to be more effective communicators for every patient they see.”

Published: Wednesday 28th January 2015 by The News Editor

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