News & Commentary

Technique Boosts Doc Personal Touch

A short psychosocial intervention called BATHE (Background, Affect, Trouble, Handling, and Empathy) for hospital patients can do a lot to increase satisfaction, according to a study published last month in Family Medicine. BATHE is supposed to help patients share their psychological and life problems and not just limit discussions with providers to their physical problems.

In a randomized study, researchers at the University of Virginia School of Medicine looked at 25 patients from February through March 2015, and again from February through March 2016.

Corresponding author Claudia Allen tells Managed Care in an email that the two separate time periods strengthens the study “because it means that the results were not just idiosyncratic to the particular team or situation at a given moment.”

The 13 patients in the intervention group received BATHE for five days or until discharged. The 12 patients in the control group received regular care.

BATHE increased the likelihood of patients describing their medical care as excellent. It did this because patients perceived that their physicians showed a genuine interest in them as a person.

BATHE involves asking patients four questions and making a statement to help providers better determine state of mind: “What is going on in your life? “How is that affecting you?” “What troubles you the most about that situation?” “How have you been handling it so far?” “That sounds very scary/frustrating/sad.”

Patients ranged in age from 29 to 77 and were admitted for problems such as pneumonia, pancreatitis, and diabetic complications.

The nine residents who participated were given BATHE training that included a refresher course right before the start of the study, and they carried a copy of the BATHE questions. Other members of the medical team were unaware of the patients’ enrollment and group status.

The patients were asked to grade satisfaction on a five-point, Likert-like scale, with 1 being strongly disagree and 5 being strongly agree.

“Very satisfied with care” received a 4.08 rating from the control group but a 4.69 rating from the BATHE group.

“The added value of the intervention appears to have been to create a daily moment where the physician acknowledged the patient as a whole person rather than solely as a medical patient,” according to researchers.

There were limitations, the obvious one being small sample size but also the lack of a fidelity measure to define the extent that an intervention adhered to BATHE’s protocols.