Physiological and psychological effects of delivering medical news using a simulated physician-patient scenario.
We examined the acute stress response associated with having to deliver either bad or good medical news using a simulated physician-patient scenario. Twenty-five healthy medical students were randomly assigned to a bad medical news (BN), a good medical news (GN), or a control group that read magazines during the session. Self-report measures were obtained before and after the task. Blood pressure and heart rate were measured throughout the task period. Four blood samples were obtained across the task period. The BN and GN tasks produced significant increases in self-reported distress and cardiovascular responses compared with the control group. There was also a significant increase in natural killer cell function 10 min into the task in the BN group compared with the control group. The BN task was also somewhat more stressful than the GN task, as shown by the self-report and cardiovascular data. These findings suggest that a simulated physician-patient scenario produces an acute stress response in the "physician," with the delivery of bad medical news more stressful than the delivery of good medical news.
Department of Behavioral Science, Box 243, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, Texas 77030, USA. lcohen@mdanderson.org
Lorenzo
L
Cohen
Walter F
WF
Baile
Evelyn
E
Henninger
Sandeep K
SK
Agarwal
Andrzej P
AP
Kudelka
Renato
R
Lenzi
Janet
J
Sterner
Gailen D
GD
Marshall
D000328:Adult; D000339:Affect; D000704:Analysis of Variance; D001794:Blood Pressure; D005260:Female; D006801:Humans; D007694:Killer Cells, Natural / Q000378:metabolism; D008297:Male; D009369:Neoplasms / Q000523:psychology; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D013315:Stress, Psychological / Q000276:immunology / Q000503:physiopathology*; D013781:Texas; D014342:Truth Disclosure