title: Therapeutic communication part 1: general approaches that enhance the quality of the consultation.
abstract: Consultations that place the patient at the centre of the interaction and actively explore their ideas, concerns, fears, cares and expectations strongly correlate with increased satisfaction, concordance, feelings of enablement and symptom resolution. Primary Care clinicians have developed these therapeutic consultation styles as a result of utilising the extensive research that has been undertaken in General Practice. In contrast, consultations in Accident and Emergency (A&E) have received little investigation and communication has a predominant bio-medical focus. This is the first of two papers which presents the results of a substantive review of the literature which explores therapeutic communication strategies appropriate to Emergency Care. This paper sets the scene by describing the current status of the Emergency Care consultation and reviews the proposed benefits of a consultation centred around the patient. The development of "Patient-Centred Communication" and its philosophical underpinnings are also discussed in order to provide further background. Finally, the general characteristics of therapeutic consultations identified in the substantive review of the literature review are analysed. The second paper describes five key communication strategies which when employed in clinical consultations in Emergency Care, could significantly enhance the therapeutic nature of the clinician-patient interaction.
authors.affiliation: Stepping Hill Hospital, Honorary Lecturer School of Nursing, Midwifery & Health Visiting, University of Manchester, UK. Paula.O'Gara@stockport-tr.nwest.nhs.uk
authors.forename: Paula E
authors.initials: PE
authors.lastname: O'Gara
authors.forename: Wendy
authors.initials: W
authors.lastname: Fairhurst
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D004632:Emergency Medical Services / Q000379:methods*; D006801:Humans; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000379:methods; D011369:Professional-Patient Relations; D011785:Quality Assurance, Health Care / Q000379:methods*