To summarize evidence on how physician self-disclosure and emotional expression affect public perceptions of serious illness conversations.
Approach:
Study design: Staeck and colleagues used a factorial, vignette-based survey of 1,572 members of the Swiss general public.
Measures: Participants rated comfort, trust, compassion, and professionalism after reading scenarios in which physicians expressed sadness, including one scenario with tears.
Key Findings:
Brief physician self-disclosure and verbal expressions of sadness were associated with higher ratings of comfort, trust, compassion, and professionalism.
Sadness accompanied by tears was associated with greater comfort, trust, and compassion, without a significant reduction in perceived professionalism.
Responses varied by language group, age, education, physician experience, and the length of the prior relationship.
Interpretation:
The authors describe clinician emotional expression as relational and context-dependent, and caution against using it as a scripted technique or shifting attention to the clinician’s distress.
Limitations:
Respondents were members of the public, not patients or family members describing actual clinical encounters.
Written vignettes could not represent tone, silence, facial expression, eye contact, gestures, or other body language.
The scenarios did not include uncontrolled distress, prolonged crying, or situations in which patients felt obliged to comfort the clinician.
Conclusion:
The authors call for research with patients and families who have experienced serious illness conversations, across varied linguistic, cultural, and healthcare contexts, and including interdisciplinary clinicians.
