Patient narratives or personal stories are often used in resources for patients, but there is a paucity of research on what their active ingredients are (Bekker et al., 2012; Shaffer & Zickmund-Fisher, 2013). This study investigated the emotions elicited, at both subjective and physiological level, while reading narratives about colorectal cancer screening.
Method:
A mixed design was used, with a between-participants factor (group: emotion vs. no emotion) and a within-participants factor (type of narrative). Participants read an informative leaflet about fecal occult blood testing and three narratives. In the emotion condition the three characters explicitly reported their emotions at the end of their story, whereas in the no emotion condition they did not refer to their emotions. All narratives described the experience of a character who underwent testing and: a) was still waiting for the result (control narrative), b) had a negative result (reassuring narrative) and c) had a positive result and was successfully treated for early-stage cancer (anticipated regret narrative).
Participants (N=39; 50% females; aged 45-50, M=48) read all the three narratives (in random order) on a computer screen while physiological measures (skin conductance and corrugator muscle activity) were recorded; then they evaluated the intensity of emotions evoked by each narrative.
Result:
Relative to the control condition, the regret and the reassurance narratives elicited stronger and weaker negative emotions, respectively, regardless of the group manipulation. Fear and anxiety were the most intense negative emotions reported for all narratives. However, peace of mind was the most intense emotion overall.
The group manipulation (emotion vs. no emotion) significantly affected the physiological responses while reading the narratives. Skin conductance, an index of physiological arousal, was significantly lower in the emotion condition than in the no emotion condition. EMG corrugator activity, which typically increases in response to unpleasant stimuli, comparably increased from baseline in both groups at the beginning of the narratives. However, in the second half, in the no emotion group EMG remained steady, while in the emotion group it decreased.
Conclusion:
The regret narrative was the one eliciting the strongest self-reported negative emotions. Making explicit the emotions experienced by the character reduced the negative emotions unveiled by the physiological activation. These findings contribute to shed light on what makes narratives powerful and under which circumstances.