Does Age Really Matter? Recall of Information Presented to Newly Referred Patients With Cancer

Jansen, Jesse; Butow, Phyllis; Weert, Julia C.M. van; Dulmen, Sandra van; Devine, Rhonda; Heeren, Thea J.; Bensing, J.M.; Tattersall, Martin H. N.

doi:10.1200/jco.2007.15.2322

Cited by 144 publications

(128 citation statements)

References 52 publications

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“…Findings from a recent experimental study in humans also indicate that learning under stress impairs long term memory; free recall as well as recognition of information . This all fits with the finding that, in patients, receiving a poorer prognosis leads to a worse overall recall of information (Jansen et al, 2008a). Yet, the relationship between stress and memory is complex (Schwabe et al, , 2012 and this relationship has not been adequately investigated within the field of medical communication.…”

Section: Introductionsupporting

confidence: 72%

Are psychophysiological arousal and self-reported emotional stress during an oncological consultation related to memory of medical information? An experimental study

Visser

Tollenaar

Bosch

et al. 2017

Stress

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(2017) Are psychophysiological arousal and self-reported emotional stress during an oncological consultation related to memory of medical information? An experimental study, Stress, 20:1, 103-111, DOI: 10.1080/10253890.2017 Patients forget 20-80% of information provided during medical consultations. The emotional stress often experienced by patients during consultations could be one of the mechanisms that lead to limited recall. The current experimental study therefore investigated the associations between (analog) patients' psychophysiological arousal, self-reported emotional stress and their (long term) memory of information provided by the physician. One hundred and eighty one cancer-naïve individuals acted as so-called analog patients (APs), i.e. they were instructed to watch a scripted video-recoding of an oncological bad news consultation while imagining themselves being in the patient's situation. Electrodermal and cardiovascular activity (e.g. skin conductance level and heart rate) were recorded during watching. Self-reported emotional stress was assessed before and after watching, using the STAI-State and seven Visual Analog Scales. Memory, both free recall and recognition, was assessed after 24-28 h. Watching the consultation evoked significant psychophysiological and self-reported stress responses. However, investigating the associations between 24 psychophysiological arousal measures, eight self-reported stress measures and free recall and recognition of information resulted in one significant, small (partial) correlation (r ¼ 0.19). Considering multiple testing, this significant result was probably due to chance. Alternative analytical methods yielded identical results, strengthening our conclusion that no evidence was found for relationships between variables of interest. These null-findings are highly relevant, as they may be considered to refute the long-standing, but yet untested assumption that a relationship between stress and memory exists within this context. Moreover, these findings suggest that lowering patients' stress levels during the consultation would probably not be sufficient to raise memory of information to an optimal level. Alternative explanations for these findings are discussed. ARTICLE HISTORY Lay summaryHigh levels of emotional stress experienced by patients during medical consultations might explain why they forget 20-80% of information provided by their physician. Although we were able to induce emotional stress in the participants of this experimental study, no evidence was found for a relationship between stress levels and memory of medical information. These results suggest that to improve patients' memory more is needed than lowering patients' stress levels only.

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Section: Introductionsupporting

confidence: 72%

Are psychophysiological arousal and self-reported emotional stress during an oncological consultation related to memory of medical information? An experimental study

Visser

Tollenaar

Bosch

et al. 2017

Stress

View full text Add to dashboard Cite

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“…Most importantly, physician life-expectancy estimates were patient reported, which may be subject to recall bias and/or physicians communicating an estimate at odds with their true expectation 8 or patient mishearing. One study showed that patients remembered less than half of what their providers told 37 and this may be compounded by the emotional stress of the situation. 38 Finally, the data presented here were collected from 2002 to 2011, however, there is no evidence to suggest that the accuracy of physician estimates has changed substantially in the interim.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Oncologists' Life-Expectancy Estimates Recalled by Their Advanced Cancer Patients: Correlates and Outcomes

LambdenJason

ZhangBaohui

FriedlanderRobert

et al. 2016

Journal of Palliative Medicine

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Background: Oncologists are often reluctant to discuss life-expectancy estimates with their patients because of concerns about their inaccuracy and limited evidence regarding benefits. Objective: Determine oncologist accuracy in predicting their advanced cancer patients' life expectancy and correlates associated with accuracy. Design: Multicenter prospective, longitudinal study of patients with advanced cancer, assessed once at baseline and followed to death. At baseline, patients were asked whether their oncologist had provided them with a lifeexpectancy estimate. Setting/Subjects: Eighty-five patients with advanced cancer recruited from outpatient cancer clinics. Measurements: Patients' baseline sociodemographic and time to death, and clinical characteristics were examined to determine their associations with the accuracy of the oncologists' life-expectancy estimates as recalled by their patients. Results: Seventy-four percent (63/85) of patients recalled that physician life-expectancy estimates were accurate to within a year; estimates were most accurate when patients had 9-12 months to live. Factors significantly ( p < 0.05) positively associated with oncologists' greater accuracy to within a year were the patient's age, recruitment from a community-based oncology clinic, poor performance status, and quality-of-life at baseline. Oncologists' prognoses that were accurate to within a year were associated with greater likelihood of patients, at baseline, acknowledging that they were terminally ill (OR = 12.20, 95% CI = 2.24-66.59), engaging in an end-of-life discussion (OR = 4.22, 95% CI = 1.45-12.29), completing a do-not-resuscitate (DNR) order (OR = 2.94, 95% CI = 1.03-8.41), a lower likelihood of using palliative chemotherapy (OR = 0.30, 95% CI = 0.11-0.85), and clinical trial enrollment (OR = 0.09, 95% CI = 0.02-0.50). Conclusions: Oncologists are able to estimate their patients' life expectancy to within a year. Accuracy to within a year is associated with higher rates of DNR order completion, advance care planning, and lower likelihood of chemotherapy use near death.

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“…Studies have shown that patient age has a significant impact on manner and scope of requested and perceived information. This has to be appropriately taken into consideration during informative discussions [241][242][243][244][245][246][247][248][249].…”

Section: Weichenthalmentioning

confidence: 99%

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

Pflugfelder

Kochs

Blum

et al. 2013

J Deutsche Derma Gesell

180

146

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Does Age Really Matter? Recall of Information Presented to Newly Referred Patients With Cancer

Cited by 144 publications

References 52 publications

Are psychophysiological arousal and self-reported emotional stress during an oncological consultation related to memory of medical information? An experimental study

Are psychophysiological arousal and self-reported emotional stress during an oncological consultation related to memory of medical information? An experimental study

Accuracy of Oncologists' Life-Expectancy Estimates Recalled by Their Advanced Cancer Patients: Correlates and Outcomes

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

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