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Good versus bad news consultations in advanced breast cancer: the role of empathy in information recall – an observational study
  1. Liesbeth M van Vliet1,1,
  2. Margot L R Leeuwenburgh1,
  3. Janine Westendorp1,
  4. Sandra van Dulmen2,3,
  5. Paul C de Jong4 and
  6. Jacqueline M L Stouthard5
  1. 1 Department of Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands
  2. 2 Department of Communication, NIVEL, Utrecht, The Netherlands
  3. 3 Institute for Healh Sciences, Department of Primary and Community Care, Radboudumc, Nijmegen, The Netherlands
  4. 4 Department of Medical Oncology, Sint Antonius Ziekenhuis, Nieuwegein, The Netherlands
  5. 5 Department of Medical Oncology, Antoni van Leeuwenhoek Netherlands Cancer Institute, Amsterdam, The Netherlands
  1. Correspondence to Dr Liesbeth M van Vliet, Leiden University, Leiden, 2311 EZ, The Netherlands; l.m.van.vliet{at}


Objective We explored, in advanced breast cancer, whether: (1) patients recall less information following bad versus good news consultations; (2) empathy has a greater effect on recalled information following bad versus good news consultations.

Methods Observational study using audio-recorded consultations. Participants’ recall of provided information about treatment options, aims/positive effects and side-effects was assessed. Clinician-expressed empathy and consultation type were determined. Regression analyses assessed associations between consultation type and recall, exploring moderating influences of clinician-expressed empathy.

Results For 41 consultations (18 bad news, 23 good news), recall data were completed; total recall (47% vs 73%, p=0.03) and recall about treatment options (67% vs 85%, p=0.08, trend) were significantly worse following bad news compared with good news consultations. Recall about treatment aims/positive effects (53% vs 70%, p=0.30) and side-effects (28% vs 49%, p=0.20) was not significantly worse following bad news. Empathy moderated the relationship between consultation type and total recall (p<0.01), recall about treatment options (p=0.03) and about aims/positive effects (p<0.01) but not about side-effects (p=0.10). Only following good news consultations empathy influenced recall favourably.

Conclusions This explorative study suggests that in advanced cancer, information recall is especially impaired following bad news consultations, for which empathy does not improve remembered information.

  • Communication
  • Breast
  • Quality of life
  • Supportive care

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  • X @Liesbeth_vVliet, @jwestendorp_nl

  • Contributors LMvV—conceptualisation, methodology, data collection, data analyses, writing (original draft). MLRL—data analyses, writing (review and editing). JW—data collection, data analyses, writing (review and editing). SvD—conceptualisation, methodology, data analyses, writing (review and editing). PCdJ—methodology, data collection, data analyses, writing (review and editing). JMLS—methodology, data collection, data analyses, writing (review and editing).

  • Funding This work was supported by a Young Investigator Grant of the Dutch Cancer Society, under grant 10392; and the Netherlands Institute for Advanced Study in the Humanities and Social Sciences (NIAS-KNAW), both grants awarded to LMvV.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.