Cue-responding in a simulated bad news situation: Exploring a stress hypothesis

The stress-coping paradigm of Folkman and Lazarus (1984) was applied to inv estigate if the communicative reactions of the physician in a bad news tran saction are related to the stressfulness of the situation. A standardized v ideo bad news consultation was presented to 88 medical students. To examine their communicative reactions we selected 10 patient cues with different l evels of expressed emotion to which the participants responded from the phy sician'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 reluctan ce of physicians to address the emotionally laden issues of the consultatio n 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.