Patients' negative emotional cues and concerns in hospital consultations: a video-based observational study. 2011

Trond Arne Mjaaland, and Arnstein Finset, and Bård Fossli Jensen, and Pål Gulbrandsen
HØKH Research Centre, Akershus University Hospital, Lørenskog, Norway. t.a.mjaaland@medisin.uio.no

OBJECTIVE Little is known about the frequency and occurrence of patients' negative emotional cues and concerns (NECC) across specialties in hospital departments. METHODS Ninety-six consultations were videotaped in a general hospital. The VR-CoDES (Verona Coding Definitions of Emotional Sequences) were used to code the patients' NECC. Cohen's kappa was used to establish reliability between coders. RESULTS Cohen's kappa was above 0.60. NECC were observed in more than half of the consultations. The number of NECC in the consultations was 163, with 109 negative emotional cues and 54 concerns. The mean number of NECC in the consultations was 1.69, with a median of 1. The first NECC in consultations were stated after a median duration of 5min 21s. We could not find significant differences related to the gender and age of the patient or the physician, or the specialty of the physician. CONCLUSIONS More than half of the concerns were not preceded by a negative emotional cue. Few consultations contained more than 3 NECC, and NECC tended to be expressed relatively early. CONCLUSIONS Patients' expressions of emotional issues are few, and most of them are subtle. Physicians should be thoroughly trained to identify and respond to them.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009664 Norway A country located in northern Europe, bordering the North Sea and the Atlantic Ocean, west of Sweden. The capital is Oslo. Kingdom of Norway
D010817 Physician-Patient Relations The interactions between physician and patient. Doctor-Patient Relations,Doctor Patient Relations,Physician Patient Relations,Physician Patient Relationship,Doctor Patient Relation,Doctor-Patient Relation,Physician Patient Relation,Physician Patient Relationships,Physician-Patient Relation,Relation, Doctor Patient,Relation, Doctor-Patient,Relation, Physician Patient,Relation, Physician-Patient,Relations, Doctor Patient,Relations, Doctor-Patient,Relations, Physician Patient,Relations, Physician-Patient,Relationship, Physician Patient,Relationships, Physician Patient
D012017 Referral and Consultation The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide. Consultation,Gatekeepers, Health Service,Hospital Referral,Second Opinion,Consultation and Referral,Health Service Gatekeepers,Hospital Referrals,Referral,Referral, Hospital,Referrals, Hospital,Consultations,Gatekeeper, Health Service,Health Service Gatekeeper,Opinion, Second,Opinions, Second,Referrals,Second Opinions
D003142 Communication The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups. Miscommunication,Misinformation,Social Communication,Communication Programs,Communications Personnel,Personal Communication,Communication Program,Communication, Personal,Communication, Social,Communications, Social,Miscommunications,Misinformations,Personnel, Communications,Program, Communication,Programs, Communication,Social Communications
D003463 Cues Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. Cue
D004644 Emotions Those affective states which can be experienced and have arousing and motivational properties. Feelings,Regret,Emotion,Feeling,Regrets
D005260 Female Females
D006769 Hospitals, General Large hospitals with a resident medical staff which provides continuous care to maternity, surgical and medical patients. General Hospital,General Hospitals,Hospital, General

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