Research suggests that therapeutic communication could enhance patient comfort during medical procedures. Few studies have been conducted in clinical settings, with adequate blinding. Our hypothesis was that a positive message could lead to analgesia and anxiolysis, and that this effect would be enhanced by an empathetic interaction with the nurse performing the procedure, compared to an audio-taped message. This study aimed to modulate the contents and delivery vector of a message regarding peripheral intravenous catheter (PIC) placement in the emergency room (ER).
This study was a 2 + 2 randomized controlled trial registered on clinicaltrials.gov (NCT03502655). A positive versus standard message was delivered through audio tape (double blind) in the first phase (N = 131) and through the nurse placing the catheter (single blind) in the second phase (N = 120).
By design, low practitioner empathic behavior was observed in the first phase (median 1 out of 5 points). In the second phase, higher empathic behavior was observed in the positive than in the standard message (median 2 vs. 3, p < 0.001). Contrary to our hypothesis, the intervention did not affect pain nor anxiety reports due to PIC placement in either phase (all p values>0.2).
The positive communication intervention did not impact pain nor anxiety reports following PIC. There might have been a floor effect, with low PIC pain ratings in a context of moderate pain due to the presenting condition. Hence, such a therapeutic communication intervention might not be sufficient to modulate a mild procedural pain in the ER.