Good communication on the part of health care professionals can result in less pain for patients

Good communication has a positive impact on how patients perceive pain. This is especially beneficial when health care professionals deliver positive suggestions about pain so that patients expect a positive effect of pain medication, or provide information about procedures patients have to undergo. Researchers from the Netherlands Institute for Health Services Research (NIVEL) have published these findings in the European Journal of Pain. 

Although it has been known for some time that communication can have an effect on patients’ health, the role played by specific forms of communication is not yet clear. To learn more about this, researchers at NIVEL conducted a literature review of clinical studies in which specific communications were varied in order to measure the effect this had on the pain experienced by patients. During their review, they looked at the effect of (1) eliciting outcome expectations (positive, neutral, or negative), (2) empathy, and (3) procedural information.
 
Placebo effects
These three elements of communication were selected to make it possible to identify placebo effects: those effects experienced by patients which, although genuine, cannot be attributed to the medical intervention. Communication can thus play an important role when it comes to placebo effects, for example, by influencing patients’ expectations.
 
Positive expectations
Based on their analysis of the 51 studies included in the review, the researchers concluded that although small, communication has an effect on how patients perceive pain. Eliciting positive expectations (“If you take this medication, you’ll soon have less pain”) leads to less pain, and negative expectations lead to more pain. Information about procedures can also reduce pain, though empathy seems to have less of an effect.
 
Reducing pain
This literature review does have a number of limitations. For example, the studies were all very different in nature, and it was often unclear what had been varied in the communication and what the patients had been told. Because of this, further research is required. Nonetheless, this study demonstrates that a positive attitude on the part of health care professionals and providing information can result in less pain for patients.

Funding
The funding for this project came from the Spinoza Prize awarded to Professor Jozien Bensing by the Netherlands Organisation for Scientific Research (NWO) in 2006.

Cooperation partners
University of Oxford
University of Southampton
University College Cork