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Voice analysis during bad news discussion in oncology: reduced pitch, decreased speaking rate, and nonverbal communication of empathy

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Abstract

Purpose

This study was designed to determine if differences exist in the speaking rate and pitch of healthcare providers when discussing bad news versus neutral topics, and to assess listeners’ ability to perceive voice differences in the absence of speech content.

Methods

Participants were oncology healthcare providers seeing patients with cancer of unknown primary. The encounters were audio recorded; the information communicated by the oncologist to the patient was identified as neutral or bad news. At least 30 seconds of both bad news and neutral utterances were analyzed; provider voice pitch and speaking rate were measured. The same utterances were subjected to low pass filtering that maintained pitch contours and speaking rate, but eliminated acoustic energy associated with consonants making the samples unintelligible, but with unchanged intonation. Twenty-seven listeners (graduate students in a voice disorders class) listened to the samples and rated them on three features: caring, sympathetic, and competent.

Results

All but one provider reduced speaking rate, the majority also reduced pitch in the bad news condition. Listeners perceived a significant difference between the nonverbal characteristics of the providers’ voice when performing the two tasks and rated speech produced with the reduced rate and lower pitch as more caring and sympathetic.

Conclusions

These results suggest that simultaneous assessment of verbal content and multiparameter prosodic analysis of speech is necessary for a more thorough understanding of the expression and perception of empathy. This information has the potential to contribute to the enhancement of communication training design and of oncologists’ communication effectiveness.

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Conflict of interest disclosure

Funding was provided by National Cancer Institute K07 CA093562 and The University of Texas M. D. Anderson Cancer Center Institutional Research Grant The Authors have no conflict of interest to disclose. They have full control of all primary data and agree to allow the journal to review their data if requested.

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Correspondence to Renato Lenzi.

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McHenry, M., Parker, P.A., Baile, W.F. et al. Voice analysis during bad news discussion in oncology: reduced pitch, decreased speaking rate, and nonverbal communication of empathy. Support Care Cancer 20, 1073–1078 (2012). https://doi.org/10.1007/s00520-011-1187-8

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  • DOI: https://doi.org/10.1007/s00520-011-1187-8

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