Does silence speak louder than words? The impact of oncologists’ emotion-oriented communication on analogue patients’ information recall and emotional stress

Leonie N.C. Visser, Marieke S. Tollenaar, Lorenz J.P. van Doornen, Hanneke C.J.M. de Haes, Ellen M.A. Smets

Research output: Contribution to journalArticleAcademicpeer-review

31 Citations (Scopus)


Objective: The impact of two types of oncologists’ emotion-oriented communication on participants’ recall of medical information was investigated, and the potential mediation by a reduction in emotional stress. Additionally, moderation effects by personal characteristics were explored. Methods: An oncologist's communication in response to a patient's emotional expressions was manipulated during a videotaped, scripted bad-news consultation. Three conditions were created: 1) standard communication, 2) emotion-oriented silence, and 3) emotion-oriented speech. Participants (N = 217) were randomly allocated to one of the three conditions. Measurements included information recall (free recall and recognition), emotional stress (self-reported and physiological), and personal characteristics. Results: Emotion-oriented silence (p =.002) and speech (p =.019) enhanced information recognition compared to standard communication. No differences in free recall were found. Emotional stress did not mediate these relations. Poorer functional health literacy predicted poorer recognition, but this was counteracted by emotion-oriented communication. Conclusions: By means of acknowledging, exploring, empathic and supportive statements, and attentive silence, the oncologist's communication resulted in better information recognition. How oncologists’ communication impacts patients’ information recall warrants further investigation, as this could not be explained by reducing emotional stress. Practice implications: These insights will help educators to validate the relevance of emotion-oriented strategies, and encourage oncologists to adopt them.

Original languageEnglish
Pages (from-to)43-52
Number of pages10
JournalPatient Education and Counseling
Issue number1
Early online date2018
Publication statusPublished - 1 Jan 2019


  • Emotions
  • Information recall
  • Medical communication
  • Oncology
  • Physician-Patient relations
  • Psychophysiology

Cite this