{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:59:12Z","timestamp":1790405952291,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["23H03129"],"award-info":[{"award-number":["23H03129"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["22K21097"],"award-info":[{"award-number":["22K21097"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gen and Family Med"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate whether empathetic communication using the NURSE framework mitigates the anxiety\u2010provoking effect of difficult news and improves satisfaction among patients with serious illness and their family members, and to compare culturally adapted and non\u2010adapted versions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u2013Trait Anxiety Inventory (adjusted for baseline) was the primary outcome; satisfaction with communication was secondary.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 120 participants, both NURSE groups had significantly lower anxiety and higher satisfaction than the no\u2010empathy group (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), with no significant difference between the U.S. and Japanese versions. Results were consistent across patients and family members.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Structured empathetic communication using the NURSE framework mitigated the anxiety\u2010provoking effect of difficult news and improved satisfaction, with comparable effects between a directly translated and a culturally adapted version, both delivered within a Japanese\u2010language clinical context.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jgf2.70173","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:58:03Z","timestamp":1790063883000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Clinicians' Empathetic Communication on Anxiety: A Randomized Video Vignette Study"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9723-3550","authenticated-orcid":false,"given":"Tadayuki","family":"Hashimoto","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Brigham and Women's Hospital  Boston Massachusetts USA"},{"name":"Department of General Medicine Osaka Medical and Pharmaceutical University  Takatsuki Osaka Japan"},{"name":"KanwaTalk  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5987-6216","authenticated-orcid":false,"given":"Yoshie","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Home Medical Care Yushoukai Medical Corporation Association  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5276-2064","authenticated-orcid":false,"given":"Kaori","family":"Ito","sequence":"additional","affiliation":[{"name":"KanwaTalk  Tokyo Japan"},{"name":"Department of Acute Care Surgery Teikyo University Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9830-3872","authenticated-orcid":false,"given":"Takeshi","family":"Uemura","sequence":"additional","affiliation":[{"name":"KanwaTalk  Tokyo Japan"},{"name":"Brookdale Department Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4612-8689","authenticated-orcid":false,"given":"Shunichi","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"KanwaTalk  Tokyo Japan"},{"name":"Adult Palliative Care Services Columbia University  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1840-6429","authenticated-orcid":false,"given":"Misuzu","family":"Yuasa","sequence":"additional","affiliation":[{"name":"KanwaTalk  Tokyo Japan"},{"name":"Department of Palliative Care Seirei Mikatahara Hospital  Hamamatsu Shizuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4056-6124","authenticated-orcid":false,"given":"Eriko","family":"Onishi","sequence":"additional","affiliation":[{"name":"KanwaTalk  Tokyo Japan"},{"name":"Department of Family Medicine Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3002-7593","authenticated-orcid":false,"given":"Ayano","family":"Kiyota","sequence":"additional","affiliation":[{"name":"KanwaTalk  Tokyo Japan"},{"name":"Department of Family Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5301-2187","authenticated-orcid":false,"given":"Kenji","family":"Morimoto","sequence":"additional","affiliation":[{"name":"KanwaTalk  Tokyo Japan"},{"name":"Department of Paediatric Emergency and Critical Care Medicine Tokyo Metropolitan Children's Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8812-1134","authenticated-orcid":false,"given":"Masaya","family":"Higuchi","sequence":"additional","affiliation":[{"name":"KanwaTalk  Tokyo Japan"},{"name":"Department of Medicine Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoko","family":"Ariyoshi","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine Hashimoto Municipal Hospital  Hashimoto Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1926-0029","authenticated-orcid":false,"given":"Hiroki","family":"Yasuhara","sequence":"additional","affiliation":[{"name":"Department of General Medicine Wakasa Takahama Hospital  Takahama Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2008-3002","authenticated-orcid":false,"given":"Takaaki","family":"Isoya","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Itoigawa General Hospital  Itoigawa Japan"},{"name":"Department of General Medicine Toyota Regional Medical Center  Toyota Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of General Medicine Itabashi Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3430-1373","authenticated-orcid":false,"given":"Yusuke","family":"Yasumoto","sequence":"additional","affiliation":[{"name":"Department of General Medicine Itabashi Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rie","family":"Maurer","sequence":"additional","affiliation":[{"name":"Center for Clinical Investigation Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liesbeth M.","family":"van Vliet","sequence":"additional","affiliation":[{"name":"Department of Health, Medical and Neuropsychology Leiden University  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2723-4259","authenticated-orcid":false,"given":"Kei","family":"Ouchi","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Brigham and Women's Hospital  Boston Massachusetts USA"},{"name":"KanwaTalk  Tokyo Japan"},{"name":"Department of Emergency Medicine Harvard Medical School  Boston Massachusetts USA"},{"name":"Serious Illness Care Program Ariadne Labs  Boston Massachusetts USA"},{"name":"Department of Psychosocial Oncology and Palliative Care Dana\u2010Farber Cancer Institute  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.5271"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.55.3.164\/full"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15709"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.300.14.1665"},{"issue":"2","key":"e_1_2_11_6_1","first-page":"e101","article-title":"Discussing Prognosis With Patients and Their Families Near the End of Life: Impact on Satisfaction With End\u2010Of\u2010Life Care","volume":"3","author":"Heyland D. 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