Objectives Empirical literature on patient decision role preferences regarding treatment and screening was reviewed to summarize patients’ role preferences across measures, time and patient population. Methods Five databases were searched from January 1980-December 2007 (1980- 2007 Ovid MEDLINE, Cochrane Database of Systematic Reviews, PsychInfo, Web of Science and PubMed (2005-2007). Eligible studies measured patient decision role preferences, described measures, presented findings as percentages or mean scores and were published in English from any country. Studies were compared by patient population, time of publication, and measure. Results 115 studies were eligible. The majority of patients preferred sharing decisions with physicians in 63% of the studies. A time trend appeared. The majority of respondents preferred sharing decision roles in 71% of the studies from 2000 and later, compared to 50% of studies before 2000. Measures themselves, in addition to patient population influenced the preferred decision roles reported. Conclusion Findings appear to vary with the measure of preferred decision making used, time of the publication and characteristics of the population. Practice implications The role preference measure itself must be considered when interpreting patient responses to a measure or question about a patient's preference for decision roles.

No 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 hours 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 understand the importance of the perception of empathy in a therapeutic encounter.

No abstract

No abstract