title: Exploring communication pathways to better health: clinician communication of expectations for acupuncture effectiveness.
abstract: OBJECTIVE
  This 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.
  
  
  METHODS
  Secondary 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.
  
  
  RESULTS
  Patients 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.
  
  
  CONCLUSIONS
  Acupuncturists' 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.
  
  
  CONCLUSIONS
  While clinicians should not mislead patients, communicating hope and optimism for treatment effectiveness has therapeutic value for patients.
authors.affiliation: Department of Communication, Texas A&M University, College Station, TX 77843-4234, USA. r-street@tamu.edu
authors.forename: Richard L
authors.initials: RL
authors.lastname: Street
authors.forename: Vanessa
authors.initials: V
authors.lastname: Cox
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kallen
authors.forename: Maria E
authors.initials: ME
authors.lastname: Suarez-Almazor
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020370:Osteoarthritis, Knee / Q000628:therapy*; D059408:Pain Management; D010147:Pain Measurement; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D016896:Treatment Outcome