Coding patient emotional cues and concerns in medical consultations: The Verona coding definitions of emotional sequences (VR-CoDES)

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• 作者：Christa Zimmermann^a ; ^{christa.zimmermann@univr.it} ; Lidia Del Piccolo^a ; Jozien Bensing^b ; Svein Bergvik^c ; Hanneke De Haes^d ; Hilde Eide^e ; Ian Fletcher^f ; Claudia Goss^a ; Cathy Heaven^g ; Gerry Humphris^h ; Young-Mi Kimⁱ ; Wolf Langewitz^j ; Ludwien Meeuwesen^k ; Matthias Nuebling^l ; Michela Rimondini^a ; Peter Salmon^f ; Sandra van Dulmen^b ; Larry Wissow^m ; Linda Zandbelt^j ; Arnstein Finsetⁿ
• 关键词：Cue ; Concern ; Coding definitions ; VR-CoDES
• 刊名：Patient Education and Counseling
• 出版年：2011
• 出版时间：February 2011
• 年：2011
• 卷：82
• 期：2
• 页码：141-148
• 全文大小：152 K

文摘

Objective

To present the Verona Coding Definitions of Emotional Sequences (VR-CoDES CC), a consensus based system for coding patient expressions of emotional distress in medical consultations, defined as Cues or Concerns.

Methods

The system was developed by an international group of communication researchers. First, consensus was reached in different steps. Second, a reliability study was conducted on 20 psychiatric consultations.

Results

A Cue is defined as a verbal or non-verbal hint which suggests an underlying unpleasant emotion that lacks clarity. A Concern is defined as a clear and unambiguous expression of an unpleasant current or recent emotion that is explicitly verbalized with or without a stated issue of importance. The conceptual framework sets precise criteria for cues and concerns and for whom (health provider or patient) elicits the cue/concern. Inter-rater reliability proved satisfactory (agreement 81.5 % , Cohen's Kappa 0.70).

Conclusion

The VR-CoDES CC will facilitate comparative research on provider–patient communication sequences in which patients express emotional distress.

Practice implications

The VR-CoDES CC may be used to help clinicians in recognizing or facilitating cues and concerns, thereby improving the recognition of patients’ emotional distress, the therapeutic alliance and quality of care for these patients.