Tracey Parkin

Discrepancies between patient and professionals recall and perception of an outpatient consultation.

Aims  To explore the degree of agreement between patient and health care professionals perceptions of consultations.

Patient and professional accuracy of recalled treatment decisions in out‐patient consultations

Aims  To test the assumption that professional recall of consultation decisions is valid and more accurate than patient recall of consultation decisions.

Greater professional empathy leads to higher agreement about decisions made in the consultation

OBJECTIVE To examine the relationship between professional expression of empathy and agreement about decisions made in the consultation. METHODS Consultations between 86 individuals with diabetes and four dieticians were audio-recorded. Immediately following consultations patients and dieticians independently reported decisions made in a booklet. Audio-recordings were coded directly for empathy using an amended version of the empathic communication coding system (ECCS). RESULTS Empathy correlated significantly with patient and professional agreement about decisions made in the consultation (τ=.283, p=.0005). Multiple regression analysis indicates that for each dietician the greater the empathy the higher the level of agreement about decisions (p<.0005). Professional empathic response to patients statements of challenge was a significant factor in increasing agreement about decisions (p=.008). CONCLUSION Results support the hypothesis that greater professional empathy will result in greater agreement about decisions made in consultations. PRACTICE IMPLICATIONS Findings have implications for empathy training and provide guidance on the communication skills needed to support expression of empathy. Patient and professional agreement about decisions made provides a simple marker of effectiveness and highlights the importance of empathy as a seminal component of professional communication skills during a patient consultation.

People trying to lose weight dislike calorie counting apps and want motivational support to help them achieve their goals.

Background Two thirds of UK adults are overweight or obese and at increased risk of chronic conditions such as heart disease, diabetes and certain cancers. Basic public health support for weight loss comprises information about healthy eating and lifestyle, but internet and mobile applications (apps) create possibilities for providing long-term motivational support. Aims To explore among people currently trying to lose weight, or maintaining weight loss, (i) problems, experiences and wishes in regards to weight management and weight loss support including e-health support; (ii) reactions to Functional Imagery Training (FIT) as a possible intervention. Method Six focus groups (N = 24 in total) were recruited from a public pool of people who had expressed an interest in helping with research. The topics considered were barriers to weight loss, desired support for weight loss and acceptability of FIT including the FIT app. The focus group discussions were transcribed and thematically analysed. Results All groups spontaneously raised the issue of waning motivation and expressed the desire for motivational app support for losing weight and increasing physical activity. They disliked calorie counting apps and those that required lots of user input. All groups wanted behavioural elements such as setting and reviewing goals to be included, with the ability to personalise the app by adding picture reminders and choosing times for goal reminders. Participants were positive about FIT and FIT support materials. Conclusion There is a mismatch between the help provided via public health information campaigns and commercially available weight-loss self-help (lifestyle information, self-monitoring), and the help that individuals actually desire (motivational and autonomous e-support), posing an opportunity to develop more effective electronic, theory-driven, motivational, self-help interventions.

Functional Imagery Training versus Motivational Interviewing for Weight Loss: A randomised controlled trial of brief individual interventions for overweight and obesity

ObjectiveFunctional Imagery Training (FIT) is a new brief motivational intervention based on the Elaborated Intrusion theory of desire. FIT trains the habitual use of personalised, affective, goal-directed mental imagery to plan behaviours, anticipate obstacles, and mentally try out solutions from previous successes. It is delivered in the client-centred style of Motivational Interviewing (MI). We tested the impact of FIT on weight loss, compared with time- and contact-matched MI.DesignWe recruited 141 adults with BMI (kg/m²) ≥25, via a community newspaper, to a single-centre randomised controlled trial. Participants were allocated to one of two active interventions: FIT or MI. Primary data collection and analyses were conducted by researchers blind to interventions. All participants received two sessions of their allocated intervention; the first face-to-face (1 h), the second by phone (maximum 45 min). Booster calls of up to 15 min were provided every 2 weeks for 3 months, then once-monthly until 6 months. Maximum contact time was 4 h of individual consultation. Participants were assessed at Baseline, at the end of the intervention phase (6 months), and again 12 months post-baseline.Main outcome measuresWeight (kg) and waist circumference (WC, cm) reductions at 6 and 12 months.ResultsFIT participants (N = 59) lost 4.11 kg and 7.02 cm of WC, compared to .74 kg and 2.72 cm in the MI group (N = 55) at 6 months (weight mean difference (WMD) = 3.37 kg, p < .001, 95% CI [−5.2, −2.1], waist-circumference mean difference (WCMD) = 4.3 cm, p < .001, 95% CI [−6.3,−2.6]). Between-group differences were maintained and increased at month 12: FIT participants lost 6.44 kg (W) and 9.1 cm (WC) compared to the MI who lost .67 kg and 2.46 cm (WMD = 5.77 kg, p < .001, 95% CI [−7.5, −4.4], WCMD = 6.64 cm, p < .001, 95% CI [−7.5, −4.4]).ConclusionFIT is a theoretically informed motivational intervention which offers substantial benefits for weight loss and maintenance of weight reduction, compared with MI alone, despite including no lifestyle education or advice.