Communication and mental health in general practice: physicians' self-perceived learning needs and self-efficacy.

Background General practitioners (GPs) often see patients presenting with mental health problems, but their training regarding mental health treatment varies. GPs' communication skills are of particular importance in these consultations, and communication skills training of GPs has been found to improve patients' mental health. To tailor a communication skills training by basing it on GPs' learning needs and self-efficacy, thereby maximising learning, we conducted a questionnaire study. Objective To measure GPs' self-perceived needs regarding communication with and treatment of mental health patients. Methods GPs in training for specialist general practice were given a questionnaire on communication and mental health in general practice. The questionnaire measured prevalence, referring practices, self-efficacy and self-perceived learning need regarding mental health treatment and communication skills, as well as interest in attending training. Results A majority of GPs in our sample was interested in training on communication skills and mental health treatment. However, they reported moderate learning needs and high confidence on the different measures. GPs reported highest learning needs regarding specific communication skills and treatment of the most common mental health problems. At the same time, they reported highest self-efficacy in treating the same disorders. They also reported high confidence in communication skills. Conclusion Despite being confident, GPs in this sample recognise the need for specific skills in consultations with patients with mental health problems, but may underestimate the importance of general communication skills. These results are informative when designing training for GPs in communication and mental health.

Electrodermal activity in response to empathic statements in clinical interviews with fibromyalgia patients.

OBJECTIVE: To study patients' electrodermal response (1) to an interviewer's empathic statements vs. inattention to emotional concerns and (2) to the emotional content in clinical interviews. METHODS: Patients with fibromyalgia (n=48) were given a clinical interview in a randomized 2×2 design, in which interviewer empathic or inattentive behavior (scenario A) and the emotional or neutral content of the interview (scenario B) were manipulated. Electrodermal activity (EDA) was measured during the interview. The patients' affective state (PANAS) and patient satisfaction were also assessed. RESULTS: In scenario A a significant main effect of empathy was found, indicating an increased tonic EDA (skin conduction level, SCL) during the empathy condition (p<.05). In scenario B there was a main effect of empathy (p<.01) and a significant empathy×content interaction effect (p<.01). There was a strong positive association between empathy and patient satisfaction (p<.0001). CONCLUSIONS: Empathic statements by the interviewer were associated with increased SCL in patients, most so in interviews with emotional content. PRACTICE IMPLICATIONS: Psychophysiological variables such as EDA may be applied in clinical communication research on emotional communication, but the limitations of such measures should also be recognized.