: A review and meta- analysis of empathic communication and patients' expectations of interventions has shown that if positive messages are delivered there is a small but measurable reduction of pain and anxiety and some improvements in physical outcomes. : To identify elements of health messages that may have a positive impact on patient health outcomes to guide effective nurse-patient- communication. : Data were extracted from each study in a qualitative analysis of a systematic review investigating the health effects of positive messages, and analysed following the principles of thematic analysis. : Central to effective positive messages were good communication skills. Five key features were identified. : The non-treatment care categories such as cognitive care and emotional care can significantly influence health outcomes across a range of interactions. : Strategies to facilitate positivity can be incorporated into nursing education programs designed to improve patient outcomes.
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