title: Reducing patients' anxiety and uncertainty, and improving recall in bad news consultations.
abstract: OBJECTIVE
  Patients' recall of provided information during bad news consultations is poor. According to the attentional narrowing hypothesis, the emotional arousal caused by the bad news might be responsible for this hampered information processing. Because affective communication has proven to be effective in tempering patients' emotional reactions, the current study used an experimental design to explore whether physician's affective communication in bad news consultations decreases patients' anxiety and uncertainty and improves information recall.
  
  
  METHODS
  Two scripted video-vignettes of a bad news consultation were used in which the physician's verbal communication was manipulated (standard vs. affective condition). Fifty healthy women (i.e., analogue patients) randomly watched 1 of the 2 videos. The effect of communication on participants' anxiety, uncertainty, and recall was assessed by self-report questionnaires. Additionally, a moderator analysis was performed.
  
  
  RESULTS
  Affective communication reduced anxiety (p = .01) and uncertainty (p = .04), and improved recall (p = .05), especially for information about prognosis (p = .04) and, to some extent, for treatment options (p = .07). The moderating effect of (reduced) anxiety and uncertainty on recall could not be confirmed and showed a trend for uncertainty.
  
  
  CONCLUSIONS
  Physicians' affective communication can temper patients' anxiety and uncertainty during bad news consultations, and enhance their ability to recall medical information. The reduction of anxiety and uncertainty could not explain patients' enhanced recall, which leaves the underlying mechanism unspecified. Our findings underline the importance of addressing patients' emotions and provide empirical support to incorporate this in clinical guidelines and recommendations.
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research).
authors.forename: Mara
authors.initials: M
authors.lastname: van Osch
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research).
authors.forename: Milou
authors.initials: M
authors.lastname: Sep
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research).
authors.forename: Liesbeth M
authors.initials: LM
authors.lastname: van Vliet
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research).
authors.forename: Sandra
authors.initials: S
authors.lastname: van Dulmen
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research).
authors.forename: Jozien M
authors.initials: JM
authors.lastname: Bensing
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000517:prevention & control*; D003142:Communication; D005260:Female; D006801:Humans; D011939:Mental Recall / Q000502:physiology*; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000523:psychology; D010817:Physician-Patient Relations; D011379:Prognosis; D011795:Surveys and Questionnaires; D035501:Uncertainty; D014743:Videotape Recording; D055815:Young Adult