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

e19695 Background: Expression and perception of empathy are associated with favorable outcomes. It is important to determine if speech prosody influences those results independently of verbal content. This study measured differences in speaking rate and pitch of 12 oncologists discussing bad news versus neutral topics and assessed listeners' ability to perceive voice differences independent of speech content.


METHODS
Encounters of oncologists seeing unknown primary cancer patients were audio recorded; the information communicated 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 measured. The utterances were then filtered eliminating acoustic energy associated with consonants, making the samples unintelligible but with unchanged pitch and speaking rate. Twenty-seven listeners (graduate students in a voice disorders class) rated the samples on features of caring, sympathetic, competent.


RESULTS
Pitch (t = 3.17, df = 11, p = .009) and speaking rate (t = 2.88, df = 11, p = .015) were significantly lower under bad news conditions (all but one provider reduced speaking rate, the majority reduced pitch). Listeners perceived a difference between the nonverbal characteristics of the providers' voice when performing the two tasks and rated lower rate and pitch speech as more caring and competent, while sympathetic approached significance (Table).


CONCLUSIONS
Oncologists decreased speaking rate and pitch when delivering bad versus neutral news. Under conditions of unintelligible verbal content, listeners perceived a significant difference in communication, rating reduced rate and pitch as more caring and competent. These findings have the potential to improve communication training design and oncologists' communication effectiveness. [Table: see text].