Effect of Clinicians' Empathetic Communication on Anxiety: A Randomized Video Vignette Study
Tadayuki Hashimoto, Yoshie Inoue, Kaori Ito, Takeshi Uemura, Shunichi Nakagawa, Misuzu Yuasa, Eriko Onishi, Ayano Kiyota, Kenji Morimoto, Masaya Higuchi, Shoko Ariyoshi, Hiroki Yasuhara, Takaaki Isoya, Satoshi Fujita, Yusuke Yasumoto, Rie Maurer, Liesbeth M. van Vliet, Kei OuchiABSTRACT
Context
Empathetic communication is a core component of serious illness conversations. The NURSE statement (Name, Understand, Respect, Support, Explore) is widely used to respond to emotion, but its independent effect on anxiety and the role of cultural adaptation remain unclear.
Objectives
To evaluate whether empathetic communication using the NURSE framework mitigates the anxiety‐provoking effect of difficult news and improves satisfaction among patients with serious illness and their family members, and to compare culturally adapted and non‐adapted versions.
Methods
We conducted a randomized video vignette study in which Japanese patients with serious illness and their families viewed one of three scenarios: no empathetic response, the U.S. NURSE version, or a culturally adapted Japanese NURSE version. The State–Trait Anxiety Inventory (adjusted for baseline) was the primary outcome; satisfaction with communication was secondary.
Results
Among 120 participants, both NURSE groups had significantly lower anxiety and higher satisfaction than the no‐empathy group (all p < 0.01), with no significant difference between the U.S. and Japanese versions. Results were consistent across patients and family members.
Conclusion
Structured empathetic communication using the NURSE framework mitigated the anxiety‐provoking effect of difficult news and improved satisfaction, with comparable effects between a directly translated and a culturally adapted version, both delivered within a Japanese‐language clinical context.