The stress-coping paradigm of Folkman and Lazarus (1984) was applied to investigate if the communicative reactions of the physician in a bad news transaction are related to the stressfulness of the situation. A standardized video bad news consultation was presented to 88 medical students. To examine their communicative reactions we selected 10 patient cues with different levels of expressed emotion to which the participants responded from the physician’s point of view. A strongly positive relationship between expressed emotion and perceived difficulty of the cues and a gender effect occurred, confirming that handling emotions is stressful for physicians. The reluctance of physicians to address the emotionally laden issues of the consultation can be understood as a lack of a frame of reference. The problem-solving strategies, which they apply in the instrumental domain of the consultation, are ineffective when dealing with psychosocial suffering.
Batenburg, V. (1997). Medical students’ attitudes: Attitude development in a medical school. Elinkwijk, BV, Utrecht.
2.
Bensing, J. (1994). De rotonde van lichaam en geest. Psychologische aspecten van ziekte, gezondheid en gezondheidszorg [The rotunda of body and mind. Psychological aspects of illness, health and health care] (Unpublished manuscript) University of Utrecht.
3.
Bensing, J. (1997). Care for communication. Underestimated problems and overestimated skills. Paper presented at the Limburgs University Centre: Diepenbeek, Belgium.
4.
Bensing, J. (2000). Bridging the gap. The separate worlds of evidence-based medicine and patientcentred medicine. Patient Education and Counseling, 39, 17–25.
5.
Berglund, G., & Sjøden, P. O. (1987). Communication problems with medical staff: A correlate of distress in cancer patients. Scandinavian Journal of Behavior Therapy, 16, 111–120.
6.
Buchsbaum, D. G. (1986). Reassurance reconsidered. Social Science and Medicine, 23, 423–427.
7.
Buckman, R. (1984a). How to break bad news: A guide for health care professionals. Baltimore: Johns Hopkins University Press.
8.
Buckman, R. (1984b). Breaking bad news: Why is it still so difficult?British Medical Journal, 288,1597–1599.
9.
Butow, P. N., Dunn, S. M., Tattersall, M. H. N., & Jones, Q. J. (1995). Computer-based interaction analysis of the cancer consultation. British Journal of Cancer, 71, 1115–1121.
10.
Cantwell, B. M. & Ramirez, A. J. (1997). Doctor-patient communication: a study of junior house officers. Medical Education, 31, 17–21.
11.
Cohen, J. A. (1960). Coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37–46.
12.
De Ridder, D. T. D., & Te Vaarwerk, M. (1995). Het belang van de omstandigheden. Over de invloed van stresserende situaties op het copingproces [The importance of circumstances. The influence of stressful situations on coping]. In R. Sanderman, W. J. A. van den Heuvel, & B. Krol (Eds.), Interveniëren in de determinanten van gezondheid: resultaten van een onderzoeksprogramma [Intervening in the determinants of health: Results of a research programme. Situational determinants of coping processes] (pp. 27–47). Assen: Van Gorcum.
13.
De Ridder, D. T. D. (2000). Gender, stress and coping: Do women handle stressful situations differently from men? In L. Sherr & J. S. St Lawrence (Eds.), Women, health and the mind. London: John Wiley & Sons.
14.
De Valck, C., & Van de Woestijne, K. P. (1996). Communication problems on an oncology ward. Patient Education and Counseling, 29, 131–136.
15.
Espinosa, E., Gonzales-Baron, M., Zamora, P., Ordonez, A., & Arranz, P. (1996). Doctors also suffer when giving bad news to cancer patients. Support Care Cancer, 4, 61–63.
16.
Fallowfield, L. J., & Lipkin, M. (1995). Delivering sad or bad news. In M. Lipkin, S. M. Putnam, & A. Lazare (Eds.), The Medical Interview. New York: Springer-Verlag.
17.
Fallowfield, L., Lipkin, M., & Hall, A. (1998). Teaching Senior Oncologists Communication Skills: Results from phase 1 of a comprehensive longitudinal program in the UK. Journal of Clinical Oncology, 16, 1961–1968.
18.
Faulkner, A., & Maguire, P. (1996). Talking to cancer patients and their relatives. Oxford: Oxford University Press.
19.
Ford, S., Fallowfield, L., & Lewis, S. (1994). Can oncologists’ detect distress in their out-patients and how satisfied are they with their performance during bad news consultations?British Journal of Cancer, 70,767–770.
20.
Guttman, H. A., Spector, R. M., Sigal, J. J., Rakoff, V. & Epstein, N. B. (1971). Reliability of coding affective communication in family therapy sessions: problems of measurement and interpretation. Journal of Consulting and Clinical Psychology, 37,397–402.
21.
Hall, J. A. (1978). Gender effects in decoding nonverbal cues. Psychological Bulletin, 85, 845–857.
22.
Hall, J. A. (1987). On explaining gender differences: the case of non-verbal communication. In P. Shaver & C. Hendrick (Eds.), Review of Personality and Social Psychology, 7,177–200.
23.
Holland, J. C., & Rowland, J. H. (1990). Handbook of psycho-oncology. Psychological care of the patient with cancer.Oxford: Oxford University Press.
24.
Hox, J. J., Kreft, I. G. G., & Hermkens, P. L. J. (1991). The analysis of factorial surveys. Sociological Methods & Research, 19, 493–510.
25.
Hulsman, R. L., Ros, W. J. G., Janssen, M. & Winnubst, J. A. M. (1997). Interact-cancer. The development and evaluation of a computer-assisted course on communication skills for medical specialists in oncology. Patient Education and Counseling, 30, 129–141.
26.
Humphrey, G. B., Littlewood, J. L., & Kamps, W. A. (1992). Physician–patient communication: A model considering the interaction of physician’s therapeutic strategy and patients’ coping style. Journal of Cancer Education, 7,147–152.
27.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal and coping. New York: Springer.
28.
Levinson, W., Stiles, W. B., Inui, T. S., & Engle, R. (1993). Physician frustration in communicating with patients. Medical Care, 31, 285–295.
29.
Maguire, P., Booth, K., Elliott, C., & Jones, B. (1996). Helping health professionals involved in cancer care acquire key interviewing skills – The impact of workshops. European journal of Cancer, 32,1489–1498.
30.
Maguire, P., & Faulkner, A. (1998). How to improve the counseling skills of doctors and nurses involved in cancer care. British Medical Journal, 297,847–849.
31.
Paraskevaidis, E., Kitchener, H. C., & Walker, L. G. (1993). Doctor-patient communication and subsequent mental health in women with gynaecological cancer. Psycho-oncology, 2,195–200.
32.
Ploeg, H. M. van der, Defares, P. B., & Spielberger, C. D. (1980). Handleiding bij de zelfbeoordelingsvragenlijst [Manual of the self-evaluation test]. Lisse: Swets & Zeitlinger.
33.
Ptacek, J. T., & Eberhardt, T. L. (1996). Breaking bad news: A review of the literature. Journal of the American Medical Association, 276, 496–501.
34.
Ptacek, J. T., Smith, R. E., & Dodge, K. L. (1994). Gender differences in coping with stress when stressors and appraisal do not differ. Personality and Social Psychology Bulletin, 20, 421–430.
35.
Putnam, S. M., & Lipkin, M. (1995). The patientcentred interview: Research support. In M. Lipkin, S. M. Putnam & A. Lazare (Eds.), The Medical Interview. New York: Springer-Verlag.
36.
Query, J. L., & Kreps, G. L. (1996). Testing a relational model for health communication competence among caregivers for individuals with Alzheimer’s disease. Journal of Health Psychology, 1, 335–351.
37.
Roter, D., & Hall, J. (1993). Doctors talking with patients. Patients talking with doctors. Westport, CT: Auburn House.
38.
Roter, D. L., & Hall, J. A. (1998). Why physician gender matters in shaping the physician patient relationship. Journal of Women’s Health, 7,1093–1097.
39.
Rutter, D. R., Iconomou, G., & Quine, L. (1996). Doctor-patient communication and outcome in cancer patients: An intervention. Psychology and Health, 12, 57–71.
40.
Searle S. R., Casella, G., McCullogh, C. E. (1992). Variance Components. New York: John Wiley & Sons.
41.
Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). The State Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.
42.
Taylor, K. M. (1988). Telling bad news: Physicians and the disclosure of undesirable information. Sociology of Health and Illness, 10, 109–132.
