Is pain patients' psychophysiological arousal while watching their videotaped medical interview similar to their arousal during participation in this medical interview?

Abstract

Showing videos of medical consultation as a proxy for participation is being increasingly applied in research in order to let patients (re-)experience social interaction in medical settings. If subjects do indeed experience the interaction process when watching this on video, then they should show similar patterns in physiological arousal as when actually participating. We assessed whether watching one's own interaction in a medical setting on video lead to the same skin conductance activity (SC) as when participating in that interaction. Fifteen women with fibromyalgia participated in a medical interview and, after a break, watched the video of this interview. Skin conductance activity was measured throughout the medical interview and, again, while the participants watched their own video. Coherence in SC between these two conditions was assessed. In eleven subjects (73%) a significant positive coherence between the two measurements was found, indicating that watching your own videotaped consultations evokes comparable psychophysiological arousal in most but not all participants. This physiological coherence might be an indication that people are capable of re-experiencing their interaction process by watching replays of these situations, although further research is needed. The positive coherence also supports skin conductance as a reliable moment-to-moment measure for physiological arousal throughout the doctor-patient interaction process. The next step should be linking the changes in physiological arousal to what exactly is happening at that moment in the interaction between doctor and patient. This could provide support for the validity of experimental designs in which standardized videotaped medical visits are shown to patients. More research is needed on predictors of (non-)coherence in certain subjects.

Analogue patients’ self-reported engagement and psychophysiological arousal in a video-vignettes design: Patients versus disease-naïve individuals

“…research confirmed that the AP methodology is a valid approach to gathering data about patient-provider interaction [2,3,13], this research did not differentiate between patients and disease-naive individuals as APs. An assumption critical to the ecological validity of video-vignette designs, i.e., the extent to which the experience of APs resembles the experience of patients in real-life medical consultations, is that APs engage with the video vignette, and this engagement may differ between AP groups.…”

How can communication by oncologists enhance patients' trust? An experimental study

“…Use of this design has previously invoked the question to what extent analog patients' perceptions are comparable with perceptions of a real oncologist [27,28]. Yet, accumulating evidence indicates that analog patient designs provide valid results [9,29]. We have maximized patients' identification, and thus external validity, by recruiting real oncologic patients and adjusting the camera perspective and setting of the observation [10].…”

Toward a basic science of communication in serious illness

“…Second, opportunities exist to use physiological measurement techniques to examine the impact of communication at the cellular level [73]. For example, researchers can add to subjective assessment of emotion and cognitive experience psychophysiological measures (e.g., galvanic skin resistance [35,74], pupillary response, or neural activity [75][76][77]) that assess emotional arousal and cognitive load.…”