Women's Health

Less than a minute of physician compassion can reduce anxiety in women newly diagnosed with breast cancer

A woman newly diagnosed with breast cancer faces difficult and critical treatment decisions while she is still reeling from the life-threatening diagnosis. She is typically so anxious during the consultation when her doctor is describing treatment options that she barely recalls any information. However, when a doctor simply acknowledges her emotional state, which can take as little as 40 seconds, it lessens a woman's anxiety, and she perceives the doctor as more compassionate. This is good news, says Linda A. Fogarty, Ph.D., of Johns Hopkins University School of Hygiene and Public Health.

In a study supported by the Agency for Health Care Policy and Research (HS08449), the researchers recruited 123 healthy breast cancer survivors and 87 women who had not had cancer. Half of each group of women were shown a standard videotape of two treatment options for metastatic breast cancer—high-dose chemotherapy and low-dose chemotherapy—that discussed risks and benefits, side effects, and probability of survival for each treatment. Women in the other half of each group were shown an "enhanced compassion" videotape, which was similar to the first tape except for the addition of two short segments. In these segments, the doctor acknowledged the patient's concerns, expressed partnership and support, validated her emotional state and the difficulty of making a decision involving uncertainty, touched her hand, and tried to reassure her.

In a post-videotape questionnaire, women who watched the enhanced compassion videotape gave the physician a higher average total compassion score (mean of 220 vs. 137) and rated the physician as warmer, more pleasant, more sensitive, and more caring than women who watched the standard videotape. While both tapes aroused anxiety, anxiety scores were significantly lower for women in the enhanced compassion group than for women in the standard videotape group (40 vs. 45), after controlling for pre-video anxiety scores.

For details, see "Can 40 seconds of compassion reduce patient anxiety?" by Dr. Fogarty, Barbara A. Curbow, Ph.D., John R. Wingard, M.D., and others, in the January 1999 Journal of Clinical Oncology 17(1), pp. 371-379.

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