The power of clinicians' affective communication: how reassurance about non-abandonment can reduce patients' physiological arousal and increase information recall in bad news consultations. An experimental study using analogue patients.
OBJECTIVE
The diagnosis of incurable cancer may evoke physiological arousal in patients. Physiological arousal can negatively impact patients' recall of information provided in the medical consultation. We aim to investigate whether clinicians' affective communication during a bad news consultation will decrease patients' physiological arousal and will improve recall.


METHODS
Healthy women (N=50), acting as analogue patients, were randomly assigned to watch one out of the two versions of a scripted video-vignette of a bad news consultation in which clinician's communication differed: standard vs. affective communication. Participants' skin conductance levels were obtained during video-watching, and afterwards their recall was assessed.


RESULTS
While the diagnosis increased skin conductance levels in all analogue patients, skin conductance levels during the remainder of the consultation decreased more in the affective communication condition than in the standard condition. Analogue patients' recall was significantly higher in the affective condition.


CONCLUSIONS
Breaking bad news evokes physiological arousal. Affective communication can decrease this evoked physiological arousal and might be partly responsible for analogue patients' enhanced information recall.


CONCLUSIONS
Although our findings need to be translated to clinical patients, they suggest that clinicians need to deal with patients' emotions before providing additional medical information.
NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.
Milou S C
MS
Sep
NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.
Mara
M
van Osch
NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.
Liesbeth M
LM
van Vliet
Department of Medical Psychology, Academic Medical Centre, University of Amsterdam, The Netherlands.
Ellen M A
EM
Smets
NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands; Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands. Electronic address: j.bensing@nivel.nl.
Jozien M
JM
Bensing
D000328:Adult; D000339:Affect; D000368:Aged; D001143:Arousal / Q000502:physiology*; D001943:Breast Neoplasms / Q000523:psychology; D003142:Communication; D004645:Empathy; D005260:Female; D005712:Galvanic Skin Response; D006801:Humans; D011939:Mental Recall / Q000502:physiology*; D008875:Middle Aged; D016544:Patient Simulation; D010817:Physician-Patient Relations; D011603:Psychophysiology; D012017:Referral and Consultation; D014342:Truth Disclosure; D014743:Videotape Recording
Analogue patients; Communication; Empathy; Memory; Psychophysiology; Skin conductance