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Randomized Controlled Trial
. 2011 Dec;85(3):390-7.
doi: 10.1016/j.pec.2011.01.009. Epub 2011 Feb 5.

Perception of empathy in the therapeutic encounter: effects on the common cold

Affiliations
Randomized Controlled Trial

Perception of empathy in the therapeutic encounter: effects on the common cold

David Rakel et al. Patient Educ Couns. 2011 Dec.

Abstract

Objective: To evaluate the effects of patient-practitioner interaction on the severity and duration of the common cold.

Methods: We conducted a randomized controlled trial of 719 patients with new cold onset. Participants were randomized to three groups: no patient-practitioner interaction, "standard" interaction or an "enhanced" interaction. Cold severity was assessed twice daily. Patients randomized to practitioner visits used the Consultation and Relational Empathy (CARE) measure to rate clinician empathy. Interleukin-8 (IL-8) and neutrophil counts were obtained from nasal wash at baseline and 48 h later.

Results: Patients' perceptions of the clinical encounter were associated with reduced cold severity and duration. Encounters rated perfect on the CARE score had reduced severity (perfect: 223, sub-perfect: 271, p=0.04) and duration (perfect: 5.89 days, sub-perfect: 7.00 days, p=0.003). CARE scores were also associated with a more significant change in IL-8 (perfect: mean IL-8 change 1586, sub-perfect: 72, p=0.02) and neutrophil count (perfect: 49, sub-perfect: 12, p=0.09).

Conclusions: When patients perceive clinicians as empathetic, rating them perfect on the CARE tool, the severity, duration and objective measures (IL-8 and neutrophils) of the common cold significantly change.

Practice implications: This study helps us to understand the importance of the perception of empathy in a therapeutic encounter.

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Figures

Figure 1
Figure 1
Flow diagram of study participants
Figure 2
Figure 2
A: Change in IL-8 for “no visit,”“standard visit” and “enhanced visit” types. B: Change in IL-8 for “no visit,” “
Figure 2
Figure 2
A: Change in IL-8 for “no visit,”“standard visit” and “enhanced visit” types. B: Change in IL-8 for “no visit,” “
Figure 2
Figure 2
A: Change in IL-8 for “no visit,”“standard visit” and “enhanced visit” types. B: Change in IL-8 for “no visit,” “
Figure 2
Figure 2
A: Change in IL-8 for “no visit,”“standard visit” and “enhanced visit” types. B: Change in IL-8 for “no visit,” “
Figure 3
Figure 3
Kaplan-Meir Survival Curve showing time to end of cold for sub-perfect and perfect CARE scores.

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