Effects of expectancy and empathy communication strategies on patient-reported outcomes and experiences during periodontal examination: a pilot randomized clinical trial

Paola Elizabete Bezerra da Silva Galvão; Jamile Mendes Silva; Fernanda Neves Amarante; Manoela Almeida Santos da Figueira; Mariana Fampa Fogacci; Francisco Wilker Mustafa Gomes Muniz; Rafael Scaf de Molon; Davi da Silva Barbirato

doi:10.1590/SciELOPreprints.18331

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Paola Elizabete Bezerra da Silva Galvão Faculdade Pernambucana de Saúde https://orcid.org/0009-0000-8960-1141
- Methodology
- Validation
- Investigation
- Writing – Original Draft Preparation
- Writing – Review & Editing
Jamile Mendes Silva Faculdade Pernambucana de Saúde https://orcid.org/0000-0002-8235-3277
- Methodology
- Validation
- Investigation
- Writing – Review & Editing
Fernanda Neves Amarante Faculdade Pernambucana de Saúde https://orcid.org/0009-0000-4217-1922
- Methodology
- Validation
- Investigation
- Writing – Review & Editing
Manoela Almeida Santos da Figueira Instituto de Medicina Integral Professor Fernando Figueira https://orcid.org/0000-0002-7963-1264
- Methodology
- Validation
- Writing – Review & Editing
- Funding Acquisition
Mariana Fampa Fogacci Federal University of Pernambuco https://orcid.org/0000-0003-3765-2152
- Methodology
- Validation
- Investigation
- Writing – Original Draft Preparation
- Writing – Review & Editing
- Funding Acquisition
Francisco Wilker Mustafa Gomes Muniz Federal University of Pelotas https://orcid.org/0000-0002-3945-1752
- Methodology
- Validation
- Writing – Review & Editing
Rafael Scaf de Molon São Paulo State University https://orcid.org/0000-0003-1110-6233
- Methodology
- Validation
- Writing – Original Draft Preparation
- Writing – Review & Editing
- Funding Acquisition
Davi da Silva Barbirato University of São Paulo https://orcid.org/0000-0003-0527-6092
- Conceptualization
- Validation
- Methodology
- Supervision
- Investigation
- Writing – Original Draft Preparation
- Writing – Review & Editing

DOI:

https://doi.org/10.1590/SciELOPreprints.18331

Keywords:

Periodontal disease, patient-reported experience measures, patient reported outcome measures, periodontitis, periodontal examination

Abstract

Abstract

Objective: This study aimed to evaluate the individual and combined effects of expectation manipulation and empathy manipulation on patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in adults undergoing a periodontal clinical examination. Material and method: Participants were randomized into four groups: (i) Control – standard care; (ii) Expectation manipulation; (iii) Empathy manipulation; and (iv) Combined expectation and empathy manipulation. Outcomes included pain perception and pain expectation, anxiety, mood, empathy, and satisfaction, assessed using validated instruments such as the State-Trait Anxiety Inventory (STAI-state), Positive and Negative Affect Schedule (PANAS), CQ-index, and Interpersonal Reactivity Index (IRI). Result: A total of 24 patients were included, the majority being women, with no significant differences in age or sex across groups. All participants were diagnosed with periodontal health. Empathy manipulation reduced fear of the periodontal clinical examination (p = 0.034) and increased patient satisfaction. However, participants exposed to both expectation and empathy manipulation reported higher pain perception during/after the clinical examination. Overall, empathy-enhanced communication demonstrated clinically benefits, including reduced fear, improved satisfaction, and increased engagement in periodontal care. Expectation manipulation alone appeared to stimulate greater patient interest in the clinical examination but was also associated with heightened anticipation of pain. Conclusion: Our findings suggest that empathy manipulation exerted a potential placebo-like effect, reducing fear, overcoming objections, increasing patient interest and active participation in care, and improving satisfaction with the periodontal clinical examination.