During bad news consultation, patients remember more when doctor is empathic

Researchers from the Netherlands Institute for Health Services Research (NIVEL) have shown that patients with cancer feel less anxious and uncertain – and also recall more information correctly – when their doctor makes a few empathic remarks during a consultation. This takes very little extra time on the part of the doctor – only 38 seconds already make a difference. The researchers have published their findings in two scientific journals, Health Psychology and Patient Education and Counseling.

 
When they are given a poor prognosis, patients are known to feel overwhelmed. As a result, they forget much of what they were told during the consultation, even though the information provided by the doctor – for example, about the proposed treatment – is intended to help them cope with their disease and make decisions. The researchers wanted to measure the effect of caring and compassionate, i.e. empathic, communication when breaking bad news. To do this, they used an experimental study design with video recordings.
 
Empathy
One of the hardest parts of a doctor’s job is breaking bad news. This research has shown that doctors who are emotionally supportive can influence their patients’ emotional state. NIVEL research coordinator Professor Sandra van Dulmen: “We have shown that empathy helps. With very little extra time and effort, a doctor can make a difference in how patients experience bad news emotionally, and help them absorb the impact of the bad news with less stress, anxiety, and uncertainty. What’s more, empathy also enhances their recall of the information they’ve been given. They are especially more able to remember the information about the prognosis and also about the treatment options and related technical details. Although this could be related to reduced anxiety and uncertainty, further research is needed to be able to say this with more certainty.”
 
Experimental study using video vignettes
For the study, fifty healthy women watched a video of a bad news consultation. There were two versions of the video. Both versions were identical except for one thing: one version included a small number of empathic remarks such as “No matter what happens, we won’t ever abandon you.” A random half of the women watched one of the versions, and the other half watched the other version. In the communication lab, the women’s skin conductance levels were measured while they watched the videos. This provides an indication of emotional arousal, stress and anxiety levels. They were then asked what they could remember of the information they were given. The healthy women identified with the patient in the video. This experimental study design with video recordings was shown to be a valid approach.
 
Funding
The funding for this project came from the Spinoza Prize awarded to Professor Jozien Bensing by the Netherlands Organisation for Scientific Research (NWO) in 2006. (Information in Dutch: Spinoza-onderzoek naar arts-patiënt communicatie en het placebo-effect)