Therefore the inserted remarks not only convey empathy and clinician’s affect, they specifically focus on reassurance (communicating) and ongoing support (acting). Non-verbal communication was not explicitly manipulated in this study; non-verbal click here communication supported verbal communication in all vignettes. Fifty healthy women were recruited through notices on message boards in local supermarkets and snowballing procedures. Only women were included to avoid confounding gender effects, which are often present in clinical communication [48]. Moreover, breast cancer is most common among women and the video depicted a female patient.

Participants were eligible if they never had cancer, were between 18 and 65 years of age, and if they were fluent in Dutch. Participants received €20,- for their participation. Before the experiment, participants’ background characteristics (age, nationality, education, mTOR inhibitor occupation, marital status) were assessed. To validate the effectiveness of the manipulation of clinician’s affective communication, three items aimed at measuring various aspects of affective

communication (empathy, non-abandonment by the clinician, and reassurance of support) of an adapted version of the QUOTE-COM questionnaire [49] were used. Participants rated clinician’s performance on a 4-point Likert scale (e.g. “The doctor showed empathy”, 1 = not, 2 = really not, 3 = really yes, to 4 = yes). These items were added to the (recall) questionnaire participants received after the video-watching. Before and during video-watching, participants’ skin conductance level (SCL) was measured to assess physiological arousal. SCL was selected since electrodermal activity provides a relative direct representation of SNS activation [15] and [50]. Besides, SCL is a good indicator of emotional arousal. Previous research reported a positive correlation between self-reported emotional arousal (anxiety) and SCL [15] and [19]. SCL

was measured in microsiemens (µS), using the BIOPAC MP150 system, which was connected to a Windows 7 operated buy Enzalutamide computer running Acknowledge 4.1 data acquisition program and Observer XT 10.0 (Noldus). The Observer program allowed us to synchronise SCL measures with the video-watching procedure. The BIOPAC GSR100 C transducer module was used for exciting a 0.5 V constant current and 200 samples per second were recorded. Disposable gel finger electrodes (type: Ag–AgCl, contact area: 1 cm diameter) were placed on the second and third finger of the subject’s non-dominant hand. A recall questionnaire containing 22 questions was developed. The questionnaire included a mixture of open-ended questions and completion items (active recall), and multiple-choice questions (recognition). The questionnaire was pre-tested on two individuals; three items were adjusted based on this pilot test.