Affective communication during bad news consultation. Effect on analogue patients’ heart rate variability and recall

Danzi, Olivia Purnima; Perlini, Cinzia; Tedeschi, Federico; Nardelli, M.; Greco, Alberto; Scilingo, Enzo Pasquale; Valenza, Gaetano; Piccolo, Lidia Del

doi:10.1016/j.pec.2018.06.009

Cited by 13 publications

(32 citation statements)

References 48 publications

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“…low-frequency reflects sympathetic activity with some degree of parasympathetic measure, and high-frequency derives from vagal or parasympathetic activity. The ratio between low-frequency and high-frequency is regarded as an index of sympathetic-parasympathetic balance on heart rate modulation and reflects the sympathovagal interaction of the autonomic nervous system [58] Quality assessment…”

Section: Resultsmentioning

confidence: 99%

“…Concerning information-related outcomes, one randomised controlled trial discovered better recall during affective versus standard communication [53], while another could not find a similar effect on self-perceived recall ability or actual recall [58]. Regarding physiological outcomes, affective communication led to a significantly stronger decrease of physiological arousal compared with standard communication, based on skin conductance levels [53].…”

Section: Affective Prognostic Communicationmentioning

confidence: 99%

“…In the experiment of Sep et al [53], a significant increase of skin conductance was detected after physicians revealed the absence of cure in a simulated bad news consultation. In a similar experiment, Danzi et al [58] studied activation of the autonomic nervous system through cardiac measures. Findings suggested significantly reduced parasympathetic activity, as well as increased sympathetic activity, among a part of the sample following disclosure of incurability [58].…”

Section: Physiological Outcomesmentioning

confidence: 99%

“…In a similar experiment, Danzi et al [58] studied activation of the autonomic nervous system through cardiac measures. Findings suggested significantly reduced parasympathetic activity, as well as increased sympathetic activity, among a part of the sample following disclosure of incurability [58]. Increased physiological arousal, revealed in both studies, can be regarded as a marker of emotional stress [53,58].…”

Section: Physiological Outcomesmentioning

confidence: 99%

“…Three experimental studies examined the impact of affective prognostic communication on patient outcomes [53,54,58]. The effect of affective communication was investigated by comparing respondents' reactions to video-recorded simulated bad news consultations, including communication about survival and treatment options, with and without physicians' reassurance of nonabandonment [54] and support [53,58]. The absence of affective messages was referred to as standard communication [53,54,58].…”

Section: Affective Prognostic Communicationmentioning

confidence: 99%

See 4 more Smart Citations

The Effect of Prognostic Communication on Patient Outcomes in Palliative Cancer Care: a Systematic Review

Velden

Meijers

Han

et al. 2020

Curr. Treat. Options in Oncol.

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Background While prognostic information is considered important for treatment decisionmaking, physicians struggle to communicate prognosis to advanced cancer patients. This systematic review aimed to offer up-to-date, evidence-based guidance on prognostic communication in palliative oncology. Methods PubMed and PsycInfo were searched until September 2019 for literature on the association between prognostic disclosure (strategies) and patient outcomes in palliative cancer care, and its moderators. Methodological quality was reported. * The Author(s) 2020 Results Eighteen studies were included. Concerning prognostic disclosure, results revealed a positive association with patients' prognostic awareness. Findings showed no or positive associations between prognostic disclosure and the physician-patient relationship or the discussion of care preferences. Evidence for an association with the documentation of care preferences or physical outcomes was lacking. Findings on the emotional consequences of prognostic disclosure were multifaceted. Concerning disclosure strategies, affective communication seemingly reduced patients' physiological arousal and improved perceived physician's support. Affective and explicit communication showed no or beneficial effects on patients' psychological well-being and satisfaction. Communicating multiple survival scenarios improved prognostic understanding. Physicians displaying expertise, positivity and collaboration fostered hope. Evidence on demographic, clinical and personality factors moderating the effect of prognostic communication was weak. Conclusion If preferred by patients, physicians could disclose prognosis using sensible strategies. The combination of explicit and affective communication, multiple survival scenarios and expert, positive, collaborative behaviour likely benefits most patients. Still, more evidence is needed, and tailoring communication to individual patients is warranted. Implications Future research should examine the effect of prognostic communication on psychological well-being over time and treatment decision-making, and focus on individualising care.

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Section: Resultsmentioning

confidence: 99%

Section: Affective Prognostic Communicationmentioning

confidence: 99%

Section: Physiological Outcomesmentioning

confidence: 99%

Section: Physiological Outcomesmentioning

confidence: 99%

Section: Affective Prognostic Communicationmentioning

confidence: 99%

See 3 more Smart Citations

The Effect of Prognostic Communication on Patient Outcomes in Palliative Cancer Care: a Systematic Review

Velden

Meijers

Han

et al. 2020

Curr. Treat. Options in Oncol.

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Effects of Physicians’ Information Giving on Patient Outcomes: a Systematic Review

et al. 2021

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Background Providing diagnostic and treatment information to patients is a core clinical skill, but evidence for the effectiveness of different information-giving strategies is inconsistent. This systematic review aimed to investigate the reported effects of empirically tested communication strategies for providing information on patient-related outcomes: information recall and (health-related) behaviors. Methods The databases MEDLINE, Embase, PsycINFO (Ovid), Cochrane Central Register of Controlled Trials, and relevant bibliographies were systematically searched from the inception to April 24, 2020, without restrictions, for articles testing information-giving strategies for physicians (PROSPERO ID: CRD42019115791). Pairs of independent reviewers identified randomized controlled studies with a low risk of selection bias as from the Cochrane risk of bias 2 tool. Main outcomes were grouped into patient information recall and behavioral outcomes (e.g., alcohol consumption, weight loss, participation in screening). Due to high heterogeneity in the data on effects of interventions, these outcomes were descriptively reported, together with studies’, interventions’, and information-giving strategies’ characteristics. PRISMA guidelines were followed. Results Seventeen of 9423 articles were included. Eight studies, reporting 10 interventions, assessed patient information recall: mostly conducted in experimental settings and testing a single information-giving strategy. Four of the ten interventions reported significant increase in recall. Nine studies assessed behavioral outcomes, mostly in real-life clinical settings and testing multiple information-giving strategies simultaneously. The heterogeneity in this group of studies was high. Eight of the nine interventions reported a significant positive effect on objectively and subjectively measured patients’ behavioral outcomes. Discussion Using specific framing strategies for achieving specific communication goals when providing information to patients appears to have positive effects on information recall and patient health–related behaviors. The heterogeneity observed in this group of studies testifies the need for a more consistent methodological and conceptual agenda when testing medical information-giving strategies. Trial Registration PROSPERO registration number: CRD42019115791

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Discussing Prognosis with Empathy to Cancer Patients

Lelorain

2021

Curr Oncol Rep

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Affective communication during bad news consultation. Effect on analogue patients’ heart rate variability and recall

Cited by 13 publications

References 48 publications

The Effect of Prognostic Communication on Patient Outcomes in Palliative Cancer Care: a Systematic Review

The Effect of Prognostic Communication on Patient Outcomes in Palliative Cancer Care: a Systematic Review

Effects of Physicians’ Information Giving on Patient Outcomes: a Systematic Review

Discussing Prognosis with Empathy to Cancer Patients

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