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Communication skills in pain medicine

  • Helen J. Makins
    Affiliations
    Helen J Makins FRCA FFPMRCA is a consultant anaesthetist specialist in pain management at Gloucestershire Hospitals NHS Foundation Trust and Clinical Lead for the Essential Pain Management UK project at the Faculty of Pain Medicine, Royal College of Anaesthetists, UK. Conflicts of interest: none declared
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      Abstract

      This article considers why communication technique may be particularly relevant to pain management consultations. Background is provided from evidence in both primary and palliative care research. The techniques are introduced and explained and include generic communication skills appropriate for all consultations and more advanced techniques. The generic skills described are empathy, allaying anxiety, breaking bad news and shared decision making. Advanced techniques are aimed at facilitating changes in behaviour and include coaching, mentoring and motivational interviewing. The focus is on the complexities of the chronic pain presentation and a variety of potential challenges in a consultation are explored. Example scenarios are used to illustrate how aspects of each specific communication skill might be useful to prevent avoidable distress, diffuse anger and engender change. The expectation is that anaesthetists who communicate well will help patients to make informed decisions and empower them to take steps to optimise their own pain management.

      Keywords

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      References

      1. Terminology | International Association for the Study of Pain (www.iasp-pain.org/resources/terminology/#pain) (accessed 13/4/22).

        • Redelmeier D.A.
        • Molin J.P.
        • Tibshirani R.J.
        A randomised trial of compassionate care for the homeless in an emergency department.
        Lancet. 1995; 345: 1131-1134
        • Balint John
        The doctor, his patient and the illness.
        2nd edn. Hardcover, February 8, 2000 (ISBN: 9780443064609)
        • Moore P.M.
        • Rivera S.
        • Bravo-Soto G.A.
        • et al.
        Communication skills training for healthcare professionals working with people who have cancer.
        Cochrane Database Syst Rev. 2018; 7 (CD003751)
        • Stewart M.A.
        Effective physician-patient communication and health outcomes: a review.
        Can Med Assoc J. 1995; 152: 1423
      2. NHS nd. Health and wellbeing coaches. Available at https://www.england.nhs.uk/personalisedcare/supported-self-management/health-and-wellbeing-coaches/ (accessed 27/12/21).

        • Fogarty L.A.
        • Curbow B.A.
        • Wingard J.R.
        • et al.
        Can 40 seconds of compassion reduce patient anxiety?.
        J Clin Oncol. 1999; 17: 371
      3. NICE nd. Shared decision making. Available at https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-guidelines/shared-decision-making (accessed 8/12/21).

        • O'Connor A.M.
        • Bennett C.L.
        • Stacey D.
        • et al.
        Decision aids for people facing health treatment or screening decisions.
        Cochrane Database Syst Rev, 2009 (3: CD001431)
      4. https://www.nice.org.uk/guidance/ng193 (accessed 14/12/21).

      5. Update: Faculty position statement on the medicinal use of cannabinoids in pain medicine | Faculty of Pain Medicine (http://fpm.ac.uk/sites/fpm/files/documents/2019-12/FPM-Cannabis-statement-2019-final_0.pdf) (accessed 13/4/22).

      6. Opioids Aware | Faculty of Pain Medicine (http://fpm.ac.uk/opioids-aware) (accessed 13/4/22).

      7. Bird J, Gomall S. The Art of Coaching: a handbook of tips and tools. Routledge: New York. ISBN 975-1-136-52158-9.

        • Rollnick S.
        Motivational interviewing.
        BMJ. 2010; 340: c1900
      8. https://www.stephenrollnick.com/ (accessed 29/12/21).