47; after: r2 =  41) On average, participants recalled 62 2% of

47; after: r2 = .41). On average, participants recalled 62.2% of the information provided (Fig. 3). Total recall was significantly better in the affective condition (M(SD) = 66.3%(9.3)) than in the standard condition (M(SD) = 58.2%(14.8); t(48) = 2.31, p = .025, r2 = .10). Further analysis revealed that recall only differed between both conditions, for information provided during the

part of the consultation in which clinician’s communication differed, i.e. between T3 and T4. Participants in the affective communication recalled 67.8% (SD = 2.5) PD-1 inhibitor of the information provided after T3, whereas participants in the standard condition recalled 58.3% (SD = 3.58) of this information (t(48) = 2.17, p = .035, r2 = .09). Variance in SCL did not

significantly explain variance in percentage correct recall of information provided during the first part of the consultation, before clinicians’ communication was Androgen Receptor Antagonist manipulated (affective condition: F(1,23) = 0.09, p = .77, r2 = -.04; standard condition: F(1,23) = 0.14, p = .71, r2 = -.04), nor in the second part in the standard condition (F(1,23) = 0.47, p = .50, r2 = -.02). However, in the affective condition, after the start of the manipulation, SCL did affect recall. Regression analyses revealed that, in this condition, variance in SCL explained 21.1% of the variance in percentage correct recall of information provided after T3 in this condition (F(1,23) = 7.42, p = .01, r2 = .21). This experimental study examined the effect of clinician’s affective communication on APs’ physiological arousal and information recall. As expected, breaking bad news evoked physiological arousal in APs. According to our expectations, subsequent affective clinical communication enhanced the decrease of APs’ physiological arousal and improved APs’ recall of provided information, in comparison to standard communication. Our results provide evidence that emotional arousal evoked by bad news is not limited to self-reported psychological arousal [6], [7] and [8], but also

includes objectively measured physiological arousal. These findings illustrate the profound impact of an incurable cancer diagnosis and contribute to a better Molecular motor understanding of the acute stress response patients have to deal with in these consultations. Previous research already emphasised the connection between mental stress and increased physiological arousal across a variety of contexts and measurements, for instance cardiac autonomic reactivity and cortisol responses to social stressors in a laboratory [9], increased inflammatory markers in response to psychological distress [11], cortisol responses during care-giving [14] and cardiovascular reactivity to stressors in real-life [13]. However, to the best of our knowledge this is the first study demonstrating this connection in a bad news consultation.

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