title: Toward an evidence-based patient-provider communication in rehabilitation: linking communication elements to better rehabilitation outcomes.
abstract: BACKGROUND
  There is a growing interest in linking aspects of patient-provider communication to rehabilitation outcomes. However, the field lacks a conceptual understanding on: (a) 'how' rehabilitation outcomes can be improved by communication; and (b) through 'which' elements in particular. This article elaborates on the conceptual developments toward informing further practice and research.
  
  
  METHODS
  Existing models of communication in healthcare were adapted to rehabilitation, and its outcomes through a comprehensive literature review.
  
  
  RESULTS
  After depicting mediating mechanisms and variables (e.g. therapeutic engagement, adjustment toward disability), this article presents the '4 Rehab Communication Elements' deemed likely to underpin rehabilitation outcomes. The four elements are: (a) knowing the person and building a supportive relationship; (b) effective information exchange and education; (c) shared goal-setting and action planning; and (d) fostering a more positive, yet realistic, cognitive and self-reframing.
  
  
  CONCLUSIONS
  This article describes an unprecedented, outcomes-oriented approach toward the design of rehabilitation communication, which has resulted in the development of a new intervention model: the '4 Rehab Communication Elements'. Further trials are needed to evaluate the impact of this whole intervention model on rehabilitation outcomes.
authors.affiliation: Health Psychology Department, Medical School, Universidad Miguel Hernández, Elche, Spain Universidade Fernando Pessoa, Oporto, Portugal jesus-ts@outlook.com.
authors.forename: Tiago Silva
authors.initials: TS
authors.lastname: Jesus
authors.affiliation: Universidade Fernando Pessoa, Oporto, Portugal.
authors.forename: Isabel Lopes
authors.initials: IL
authors.lastname: Silva
mesh_terms: D003142:Communication; D019317:Evidence-Based Medicine; D006801:Humans; D010817:Physician-Patient Relations; D016896:Treatment Outcome
keywords: Patient–physician communication; engagement; patient–physician relations; psychological adaptation; rehabilitation outcomes