• Richard L Street, Vanessa Cox, Michael A Kallen, and Maria E Suarez-Almazor.
• Department of Communication, Texas A&M University, College Station, TX 77843-4234, USA. r-street@tamu.edu
• Patient Educ Couns. 2012 Nov 1; 89 (2): 245-51.

ObjectiveThis study tested a pathway whereby acupuncturists' communication of optimism for treatment effectiveness would enhance patients' satisfaction during treatment, which in turn would contribute to better pain and function outcomes for patients with osteoarthritis of the knee.MethodsSecondary analysis from a 2 arm (real vs. sham acupuncture, high vs. neutral expectations) RCT. 311 patients with knee osteoarthritis received acupuncture over 10-12 sessions. Coders rated the degree to which acupuncturists communicated optimism for the treatment's effectiveness. Satisfaction with acupuncture was assessed 4 weeks into treatment. Pain and function were assessed 6 weeks following treatment.ResultsPatients experiencing better outcomes were more satisfied with acupuncture during treatment, were younger, and had better baseline pain and function scores. Satisfaction during treatment was greater when patients interacted with more optimistic clinicians and had higher pretreatment expectations for acupuncture efficacy.ConclusionAcupuncturists' communication of optimism about treatment effectiveness contributed to pain and function outcomes indirectly through its effect on satisfaction during treatment. Future research should model pathways through which clinician-patient communication affects mediating variables that in turn lead to improved health outcomes.Practical ImplicationsWhile clinicians should not mislead patients, communicating hope and optimism for treatment effectiveness has therapeutic value for patients.Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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