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He S, Sultana R, Anantham D, Loh HP, Zhou JX, Tang JY, Sim M, Ayre TC, Fong KY, Tan KH. Empathy Levels Among Healthcare Professionals: An Asian Multi-professional Cross-Sectional Study. Cureus 2024; 16:e53750. [PMID: 38465054 PMCID: PMC10921128 DOI: 10.7759/cureus.53750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND The aim of the study was to measure empathy in healthcare professionals in Singapore and to compare the scores between the different professions: doctors, nurses, and allied health professionals. METHODS An online survey questionnaire was conducted using the Jefferson Scale of Empathy (JSE) from July 2019 to January 2020. The total JSE score was calculated and compared among the different groups. Multiple linear regression was performed to assess predictors of total empathy scores for groups with statistically lower scores. RESULTS The survey was completed by 4,188 healthcare professionals (doctors (n=569, 13.6%), nurses (n=3032, 72.4%), and allied health professionals (n=587, 14.0%)) out of the 9,348-strong survey population, with a response rate of 44.8%. The study revealed a mean empathy score (SD) of 103.6 (15.6) for the cohort. The mean empathy score (SD) was 112.3 (14.7), 101.3 (15.2), and 107.0 (15.0), respectively for doctors, nurses, and allied health professionals. These were statistically significantly different among the groups (p< 0.0001), with nurses scoring significantly lower than either doctors (p< 0.0001) or allied health professionals (p< 0.0001). Multiple linear regression showed that age < 30 years old, male gender, Malay ethnicity, and working in a hospital setting were associated with significantly lower empathy scores in the nursing group. CONCLUSION Nurses in Singapore had significantly lower empathy scores compared to doctors and allied health professionals. Further research on the underlying causes should be undertaken and measures to improve empathy among Singapore nursing staff should be explored and implemented.
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Affiliation(s)
- Song He
- Department of Obstetrics and Gynaecology, KK (Kandang Kerbau) Women's and Children's Hospital, Singapore, SGP
| | - Rehena Sultana
- Centre for Quantitative Medicine, Duke-NUS (National University of Singapore) Medical School, Singapore, SGP
| | - Devanand Anantham
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore, SGP
| | - Huey Peng Loh
- Institute for Patient Safety & Quality, SingHealth Duke-NUS (National University of Singapore) Academic Medical Centre, Singapore, SGP
| | - Jamie X Zhou
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, SGP
| | - Joo Ying Tang
- Institute for Patient Safety & Quality, SingHealth Duke-NUS (National University of Singapore) Academic Medical Centre, Singapore, SGP
| | - Mabel Sim
- Institute for Patient Safety & Quality, SingHealth Duke-NUS (National University of Singapore) Academic Medical Centre, Singapore, SGP
| | | | - Kok Yong Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, SGP
| | - Kok Hian Tan
- Institute for Patient Safety & Quality, SingHealth Duke-NUS (National University of Singapore) Academic Medical Centre, Singapore, SGP
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Zhong F, Pengpeng L, Qianru Z. Grouping Together to Fight Cancer: The Role of WeChat Groups on the Social Support and Self-Efficacy. Front Public Health 2022; 10:792699. [PMID: 35359783 PMCID: PMC8963820 DOI: 10.3389/fpubh.2022.792699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/31/2022] [Indexed: 12/25/2022] Open
Abstract
With the increasing number of cancer survivors, the question of how to coexist with cancer has become more and more pressing. This research uses a mutual help WeChat group organized by cancer patients as the research field to observe the daily interactions of cancer patients, so as to improve understanding of how social media technology can help cancer patients in the treatment and recovery process. The study found that the WeChat group is the main source of health knowledge for the participating cancer patients, and that when compared to traditional web-based patient mutual aid communities, the WeChat group is a more timely, popular, continuous, and accurate source of information. Patients in the group can listen and respond to each other's questions and worries, providing both an outlet for patients to vent their emotions and concerns and a source of recognition and encouragement. In addition, this study found that the WeChat mutual aid group improves patients' self-efficacy of disease on four levels: successful experience in curing patients, imitating patients' behavior, verbal persuasion, and emotional support.
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Affiliation(s)
- Fangqi Zhong
- College of Communication, National Chengchi University, Taipei, Taiwan
| | - Li Pengpeng
- College of Communication, National Chengchi University, Taipei, Taiwan
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Keppers R, McCarthy Veach P, Schema L, LeRoy BS, MacFarlane IM. Differences in genetic counseling student responses to intense patient affect: A study of students in North American programs. J Genet Couns 2021; 31:398-410. [PMID: 34514687 DOI: 10.1002/jgc4.1505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 11/06/2022]
Abstract
Research indicates genetic counseling patients often experience intense emotions. No studies, however, have investigated how genetic counseling students respond to patient affect. This survey study investigated student responses to patient emotions and select factors affecting their responses. One-hundred fifty-one genetic counseling students in North American programs wrote a response to each of three hypothetical prenatal scenarios, identical except for the patient affect expressed (anger, fear, or sadness). They also completed measures of empathy tendency and tolerance of negative affect and demographic questions. Multivariate analysis of covariance (MANCOVA), used to analyze the effects of major study variables on the types of responses given by participants, was significant. Follow-up univariate ANCOVAs indicated small to moderate effect sizes for student clinical experience, race/ethnicity, and relationship status within and across scenarios. For example, as number of patients counseled increased, participants used more feeling reflections and fewer self-involving statements. There were no significant differences in responses due to empathy tendency or affect tolerance. Most common responses were information provision and feeling reflections for the Anger scenario, information provision for the Fear scenario, and influencing responses for the Sadness scenario. Responses to each scenario typically involved multiple thoughts (range: 1-14; means ranged from 3.25 in the Sadness scenario to 3.62 in the Fear scenario). Most students (82%) reported the Anger scenario was the most difficult. Thematic analysis of reasons a scenario was difficult yielded four themes: Discomfort with situation/emotion, Positive countertransference, Uncertain how to respond, and Negative countertransference. Findings that clinical experience affects how participants responded to patient affect support the essential role of applied experience. Findings also support training and supervision to help genetic counseling students in North America learn ways to respond to strong patient emotions and recognize and manage countertransference.
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Affiliation(s)
- Rachel Keppers
- Department of Clinical Genomics, Mayo Clinic, Eau Claire, WI, USA
| | | | - Lynn Schema
- Minnesota Health Fairview, Minneapolis, MN, USA
| | - Bonnie S LeRoy
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
| | - Ian M MacFarlane
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
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Use of Simulation to Improve Emotional Competence at End-of-Life Care for Healthcare Professionals and Students: A Scoping Review. Clin Simul Nurs 2021. [DOI: 10.1016/j.ecns.2021.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Predictors of therapeutic communication between nurses and hospitalized patients. Heliyon 2019; 5:e02665. [PMID: 31720457 PMCID: PMC6838810 DOI: 10.1016/j.heliyon.2019.e02665] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 05/01/2019] [Accepted: 10/11/2019] [Indexed: 11/20/2022] Open
Abstract
Background Therapeutic communication is a purposeful interaction between health professionals and patients that helps to achieve positive health outcomes. There is a pressing need for research examining factors influencing effective implementation of therapeutic communication in relation to patient-centered care and satisfaction. Objective This study was aimed at determining the effective implementation of therapeutic communication and its predictors. Methods Institution based cross-sectional study was conducted at the Jimma University Specialized Hospital from March 21 to April 9, 2016. One hundred ninety two patients were recruited using stratified sampling. A questionnaire was used to collect data. One-way ANOVA for mean difference by socio-demographic characteristics, simple and multivariable linear regressions were conducted. Results The study revealed that 67(34.9%) of the patients rated high level of therapeutic communication. Significant predictors of therapeutic communication implementation were educational status (β = 5.87, P = 0.011), language difference (β = -6, P = 0.014), education difference (β = 5.21, P = 0.010) and perceived patient view score (β = 3.57, P˂0.001). Conclusion Therapeutic communication was poorly implemented. Education, language difference, education difference and perceived patient view scores were significant predictors of therapeutic communication.
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Factors Affecting the Levels of Satisfaction With Nurse-Patient Communication Among Oncology Patients. Cancer Nurs 2018; 43:E186-E196. [PMID: 30543568 DOI: 10.1097/ncc.0000000000000672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Nurse-patient communication is of the utmost importance to oncology patients. OBJECTIVE The aim of this study was to investigate the factors influencing the level of satisfaction with nurse-patient communication among oncology patients during their daily routine procedures. METHODS In this observational study, 25 registered nurses and 94 patients were recruited from an oncology unit. The patients were asked to complete a concern checklist before and after each admission, administration of medication, and wound-dressing procedure. Nonverbal cues expressed by the nurses and patients were noted on the checklist during these nursing procedures. RESULTS The results showed that patients at stage 3 cancer and patients receiving admission procedures were significantly more satisfied with their communication with nurses compared with those who were more concerned about the impact of the disease on self-care. CONCLUSIONS Cancer stage, time of admission, and psychological concern related to self-care ability are the potential factors affecting the satisfaction level of nurse-patient communication. IMPLICATIONS FOR NURSING Emphasis could be placed on utilizing the time of admission to interact with patients in a busy environment to strive for better communication with oncology patients. The results underscore the importance of applying the self-care enhancement approach for hospitalized cancer patients.
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Chan EA, Wong F, Cheung MY, Lam W. Patients' perceptions of their experiences with nurse-patient communication in oncology settings: A focused ethnographic study. PLoS One 2018; 13:e0199183. [PMID: 29912967 PMCID: PMC6005521 DOI: 10.1371/journal.pone.0199183] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/01/2018] [Indexed: 11/19/2022] Open
Abstract
Background The nursing shortage and its impact on patient care are well-documented global issues. Patients living with cancer as a chronic illness have many psychosocial problems and often lack adequate support as a result of ineffective nurse-patient communication. A review of the literature on factors influencing the delivery of psychosocial care to cancer patients indicates that the delivery of psychosocial care in routine cancer nursing within a biomedical healthcare system has not been widely explored. Objective To explore patients’ perceptions of their experiences with nurse-patient communication in an oncological clinical environment. Method A focused ethnographic study was undertaken in two oncology wards of a hospital in Hong Kong. Data were collected through observations of the ward environment, the activities and instances of nurse-patient communication, semi-structured interviews with patients, and a review of nursing documents. Results Two main themes were identified: 1. Nurses’ workload and the environment and 2. Nurse-patient partnership and role expectations. Within these two themes were related subthemes on: Sympathy for the busy nurses; Prioritizing calls to the nurses; Partnership through relationship; Nurses’ role in psychosocial care; and Reduction of psychosocial concerns through physical care. Conclusions Many cancer patients do not expect to receive psychosocial care in the form of emotional talks or counseling from busy nurses, but appreciate the attention paid by nurses to their physiological and physical needs. Nurse-patient partnerships in cancer care may reduce the potential workload of nurses. The psychosocial needs of cancer patients could be optimized by providing good physical care through effective communication within a time-constrained oncology setting.
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Affiliation(s)
- Engle Angela Chan
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong
- * E-mail: (EA)
| | - Fiona Wong
- School of Optometry, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Man Yin Cheung
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Winsome Lam
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong
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Lomas T. The quiet virtues of sadness: A selective theoretical and interpretative appreciation of its potential contribution to wellbeing. NEW IDEAS IN PSYCHOLOGY 2018. [DOI: 10.1016/j.newideapsych.2018.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Lanceley A, Berzuini C, Burnell M, Gessler S, Morris S, Ryan A, Ledermann JA, Jacobs I. Ovarian Cancer Follow-up: A Preliminary Comparison of 2 Approaches. Int J Gynecol Cancer 2017; 27:59-68. [PMID: 28002208 DOI: 10.1097/igc.0000000000000877] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The aim of the study was to perform a preliminary comparison of quality of life (QoL) and patient satisfaction in individualized nurse-led follow-up versus conventional medical follow-up in ovarian cancer. METHODS One hundred twelve women who received a diagnosis of ovarian, fallopian tube, or peritoneal cancer, completed primary treatment by surgery alone or with chemotherapy, irrespective of outcome with regard to remission, and expected survival of more than 3 months. Fifty-seven participants were randomized to individualized follow-up and 55 patients to conventional follow-up. Well-being was measured at baseline and at 3, 6, 12, and 24 months after randomization for QoL (QLQ-C30 [European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire], QLQ-Ov28), the Hospital Anxiety and Depression Scale (HADS), and a Patient Satisfaction Questionnaire (PSQ-III). The primary endpoints were the effects of follow-up on each of the scores (via hierarchical mixed-effects model) and on relapse-free time (via Cox model). The total cost of follow-up was compared between each group. RESULTS There was evidence for a QoL and patient satisfaction benefit for individualized versus standard follow-up (QLQ-C30, P = 0.013; 95% confidence interval, -0.03 to -0.001; PSQ-III P = 0.002; 95% confidence interval, -0.003 to -0.015; QLQ-Ov28, P = 0.14). Hospital Anxiety and Depression Scale data provided no evidence in favor of either treatment (P = 0.42). Delivered to protocol individualized follow-up resulted in a delay in the presentation of symptomatic relapse (P = 0.04), although the effect on survival in this study is unknown. Cost was £700 lower on average for the individualized follow-up group, but the difference was not statistically significant at the 5% level (P = 0.07). CONCLUSIONS Individualized follow-up was superior to conventional follow-up in 3 of the 4 QoL and patient satisfaction surveys in this preliminary study. Further prospective studies are needed in a larger population.Trial registration number is ISRCTN59149551.
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Affiliation(s)
- Anne Lanceley
- *Department of Women's Cancer, The UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London; †Centre for Biostatistics, The University of Manchester, Manchester; ‡University College London Hospitals (UCLH) Gynaecological Cancer Centre; §Department of Applied Health Research, University College London; ‖Cancer Research UK and UCL Cancer Trials Centre, University College London, London, United Kingdom; and ¶University of New South Wales, Sydney, New South Wales, Australia
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Lin MF, Lee AY, Chou CC, Liu TY, Tang CC. Factors predicting emotional cue-responding behaviors of nurses in Taiwan: An observational study. Psychooncology 2016; 26:1548-1554. [PMID: 27891700 DOI: 10.1002/pon.4330] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/22/2016] [Accepted: 11/23/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Responding to emotional cues is an essential element of therapeutic communication. The purpose of this study is to examine nurses' competence of responding to emotional cues (CRE) and related factors while interacting with standardized patients with cancer. METHODS This is an exploratory and predictive correlational study. A convenience sample of registered nurses who have passed the probationary period in southern Taiwan was recruited to participate in 15-minute videotaped interviews with standardized patients. The Medical Interview Aural Rating Scale was used to describe standardized patients' emotional cues and to measure nurses' CRE. The State-Trait Anxiety Inventory was used to evaluate nurses' anxiety level before the conversation. We used descriptive statistics to describe the data and stepwise regression to examine the predictors of nurses' CRE. RESULTS A total of 110 nurses participated in the study. Regardless of the emotional cue level, participants predominately responded to cues with inappropriate distancing strategies. Prior formal communication training, practice unit, length of nursing practice, and educational level together explain 36.3% variances of the nurses' CRE. CONCLUSIONS This study is the first to explore factors related to Taiwanese nurses' CRE. Compared to nurses in other countries, Taiwanese nurses tended to respond to patients' emotional cues with more inappropriate strategies. We also identified significant predictors of CRE that show the importance of communication training. Future research and education programs are needed to enhance nurses' CRE and to advocate for emotion-focused communication.
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Affiliation(s)
- Mei-Feng Lin
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - An-Yu Lee
- Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Cheng-Chen Chou
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tien-Yu Liu
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Chun Tang
- School of Nursing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
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Gerhart J, Schmidt E, Lillis T, O’Mahony S, Duberstein P, Hoerger M. Anger Proneness and Prognostic Pessimism in Men With Prostate Cancer. Am J Hosp Palliat Care 2016; 34:497-504. [DOI: 10.1177/1049909116636358] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim: Anger is a common reaction to cancer diagnosis which may impact patients’ perceptions of their prognosis and goals of care. This study tested the hypothesis that men with prostate cancer who are anger prone are pessimistic regarding their cancer prognosis. Methods: Two hundred and twelve men with a history of prostate cancer completed measures of personality traits, their prostate cancer prognosis, and their perception of their doctor’s assessment of their prognosis. Anger proneness was operationally defined by the presence of high levels (ie, above the medians) of neuroticism and disagreeableness. Results: One in 4 men with prostate cancer disagreed with their doctor about prognosis. Anger-prone participants endorsed more pessimistic perceptions of prognosis ( P = .041). This significant association was maintained after accounting for potential confounders. Conclusion: Greater attention paid to patient anger regulation style and pessimistic perceptions will improve discussions about prognosis and goals of care among men with prostate cancer. Given recent calls for wider distress screening and earlier palliative care intervention in cancer settings, providers have an unprecedented opportunity to assess and respond to anger in the clinical setting. Communication could be improved through empathic statements that convey realistic optimism when appropriate, a commitment to the patient–provider relationship and a willingness to explore and address patient needs.
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Affiliation(s)
- James Gerhart
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Eric Schmidt
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
- Center for Innovation to Implementation (Ci2i), HSR&D, Palo Alto VA Health Care System, Menlo Park, CA, USA
- Stanford Health Policy, Stanford University, Stanford, CA, USA
| | - Teresa Lillis
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Sean O’Mahony
- Hospice and Palliative Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Paul Duberstein
- Department of Psychiatry, University of Rochester, Rochester, NY, USA
- Department of Family Medicine, University of Rochester, Rochester, NY, USA
| | - Michael Hoerger
- Department of Psychology, Tulane Cancer Center, New Orleans, LA, USA
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Zhou Y, Lundy JM, Humphris G, Mercer SW. Do multimorbidity and deprivation influence patients' emotional expressions and doctors' responses in primary care consultations?--An exploratory study using multilevel analysis. PATIENT EDUCATION AND COUNSELING 2015; 98:1063-1070. [PMID: 26111501 DOI: 10.1016/j.pec.2015.05.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 05/27/2015] [Accepted: 05/30/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To explore whether and how patient multimorbidity and socioeconomic deprivation might influence patients' emotional expression and doctors' responses in the general practice (GP) consultations. METHODS Video recordings of 107 consultations (eight GPs) were coded with the Verona Coding Definitions of Emotional Sequences (VR-CoDES). Multilevel logistic regressions modelled the probability of GP providing space response, considering patient multimorbidity, deprivation conditions and other contextual factors. Further multinomial regressions explored the possible impact of multimorbidity and deprivation on expression of and specific responses to patients' emotional distress. RESULTS It was less likely for GPs to provide space as the consultation proceeded, controlling for multimorbidity and deprivation variables. Patients with multimorbidity were less likely to express emotional distress in an explicit form. GPs were more likely to provide acknowledgement to emotions expressed by patients from more deprived areas. CONCLUSION Multimorbidity and deprivation may influence the dynamics of the GP consultations in specific ways. Rigorous methodologies using larger samples are required to explore further how these two variables relate to each other and influence cue expression, provider response and subsequent patient outcomes. PRACTICE IMPLICATIONS Understanding how multimorbidity and deprivation impact on GP consultations may help inform future service improvement programmes.
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Affiliation(s)
- Yuefang Zhou
- School of Medicine, University of St Andrews, St Andrews, UK.
| | - Jenna-Marie Lundy
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Gerry Humphris
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Stewart William Mercer
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Pires CM, Cavaco AM. Communication between health professionals and patients: review of studies using the RIAS (Roter Interaction Analysis System) method. Rev Assoc Med Bras (1992) 2015; 60:156-72. [PMID: 24919004 DOI: 10.1590/1806-9282.60.02.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 08/30/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Systematic review of studies that investigate the communication between patients and health professionals with the application of the RIAS methodology. METHODS Keyword Roter Interaction Analysis System was searched in the following bibliographic resources: Academic Search Complete, Current Contents, ISI Proceedings, PubMed, Elsevier, SpringerLink, Web of Science, RCAAP, Solo and the official RIAS site. Selection period: 2006 to 2011. Studies were selected using multicriteria dichotomous analysis and organized according to PRISMA. RESULTS Identification of 1,262 articles (455 unrepeated). 34 articles were selected for analysis, distributed by the following health professions: family medicine and general practitioners (14), pediatricians (5), nurses (4), geneticists (3), carers of patients with AIDS (2), oncologists (2), surgeons (2), anesthetists (1) and family planning specialists (1). The RIAS is scarcely used and publicized within the scope of healthcare in Portuguese speaking countries. DISCUSSION Main themes studied include the influence of tiredness, anxiety and professional burnout on communication and the impact of specific training actions on professional activities. The review enabled the identification of the main strengths and weaknesses of synchronous and dyadic verbal communication within the provision of healthcare. CONCLUSION Scientific investigation of the communication between health professionals and patients using RIAS has produced concrete results. An improvement is expected in health outcomes through the application of the RIAS.
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Underhill ML, Sheldon LK, Halpenny B, Berry DL. Communication about symptoms and quality of life issues in patients with cancer: provider perceptions. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2014; 29:753-61. [PMID: 24748096 PMCID: PMC4206668 DOI: 10.1007/s13187-014-0651-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study used qualitative data collection and analysis methods to describe provider perceptions of addressing patient-initiated communication about common or sensitive symptom and quality of life issues (SQIs) in oncology. Eligible participants were health care providers who had participated in a larger trial testing a patient-centered technology to assess cancer SQIs and support self-care. Audio-recorded vignettes were simulated based on recorded clinic visits from the larger trial and presented during semi-structured cognitive interviews with each participant. Transcripts of the interviews were content analyzed. Twelve providers participated. Participants' responses included four themes: the institutional and clinical context, the complexity of addressing SQIs, strategies used to understand SQIs, and creating a plan to address SQIs. Participants felt that approaching SQIs inside and outside of the clinic required ongoing communication within a multidisciplinary team both to gather information and manage the SQI. Forming a relationship with the patient was one strategy to facilitate assessing SQIs. Most participants expressed a need for guidance about effective SQI communication. Providers perceived approaching SQIs as a routine part of interdisciplinary clinical care. The specific symptom and the complexity of its management influenced the process of assessing and managing SQIs. Findings have implications for institutional processes, training, evaluation, and program development.
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Affiliation(s)
- Meghan L Underhill
- Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Ave, Boston, MA, 02115, USA,
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McLeod J, McLeod J. Research on embedded counselling: An emerging topic of potential importance for the future of counselling psychology. COUNSELLING PSYCHOLOGY QUARTERLY 2014. [DOI: 10.1080/09515070.2014.942774] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Zhou Y, Humphris G, Ghazali N, Friderichs S, Grosset D, Rogers SN. How head and neck consultants manage patients' emotional distress during cancer follow-up consultations: a multilevel study. Eur Arch Otorhinolaryngol 2014; 272:2473-81. [PMID: 25078155 DOI: 10.1007/s00405-014-3209-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 07/24/2014] [Indexed: 10/25/2022]
Abstract
Head and neck cancer (HNC) patients suffer substantial emotional problems. This study aimed to explore how utterance-level variables (source, type and timing of emotional cues) and patient-level variables (e.g. age, gender and emotional well-being) relate to consultants' responses (i.e. reducing or providing space) to patient expressions of emotional distress. Forty-three HNC outpatient follow-up consultations were audio recorded and coded, for patients' expressions of emotional distress and consultants' responses, using the Verona Coding Definitions of Emotional Sequence. Multilevel logistic regression modelled the probability of the occurrence of consultant-reduced space response as a function of patient distress cue expression, controlling for consultation and patient-related variables. An average of 3.5 cues/concerns (range 1-20) was identified per consultation where 84 out of 152 total cues/concerns were responded by reducing space. Cue type did not impact on response; likewise for the quality of patient emotional well-being. However, consultants were more likely to reduce space to cues elicited by patients, as opposed to those initiated by themselves. This reduced space response was more pronounced as the consultation continued. However, about 6 min into the consultation, this effect (i.e. tendency to block patients) started to weaken. Head and neck consultants' responses to negative emotions depended on source and timing of patient emotional expressions. The findings are useful for training programme development to encourage consultants to be more flexible and open in the early stages of the consultation.
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Affiliation(s)
- Yuefang Zhou
- School of Medicine, University of St Andrews, St Andrews, Fife, KY16 9TF, St Andrews, Scotland, UK,
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Clayton MF, Reblin M, Carlisle M, Ellington L. Communication Behaviors and Patient and Caregiver Emotional Concerns: A Description of Home Hospice Communication. Oncol Nurs Forum 2014; 41:311-21. [DOI: 10.1188/14.onf.311-321] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Shaw J, Young J, Butow P, Chambers S, O'Brien L, Solomon M. Delivery of telephone-based supportive care to people with cancer: An analysis of cancer helpline operator and cancer nurse communication. PATIENT EDUCATION AND COUNSELING 2013; 93:444-450. [PMID: 23910248 DOI: 10.1016/j.pec.2013.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Revised: 05/13/2013] [Accepted: 07/01/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Telephone-based supportive care presents a potentially highly accessible means of addressing unmet supportive care needs for people with cancer. Identification of behaviours that facilitate communication is essential for development of training for telephone-based supportive care. The aim of this study was to describe communication behaviours within supportive care telephone calls in two contexts (1) a telephone outreach intervention and (2) cancer helpline calls, to identify potential areas for further training. METHODS 50 recorded calls were analysed using two standardised coding systems: the RIAS and Verona-CoDES-C. RESULTS Mean call length was 21 min (304 utterances) for nurse-outreach calls and 23 min (355 utterances) for helpline calls. Closed questioning, verbal attentiveness and giving information/counselling were the most common communication behaviours identified. Emotional cues were most commonly responded to through non-explicit back-channelling, exploration of content or provision of reassurance or advice. CONCLUSIONS This study confirmed the need to address the manner in which questions are framed to maximise patient disclosure. Responding to patent emotional cues was highlighted as an area for future training focus. PRACTICE IMPLICATIONS Communication skills training that addresses each of these tasks is likely to improve the effectiveness of telephone-based delivery of supportive care.
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Affiliation(s)
- Joanne Shaw
- Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, Australia; University of Sydney, Australia.
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Seibt B, Weyers P, Likowski KU, Pauli P, Mühlberger A, Hess U. Subliminal Interdependence Priming Modulates Congruent and Incongruent Facial Reactions to Emotional Displays. SOCIAL COGNITION 2013. [DOI: 10.1521/soco.2013.31.5.613] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Baer L, Weinstein E. Improving Oncology Nurses' Communication Skills for Difficult Conversations. Clin J Oncol Nurs 2013; 17:E45-51. [DOI: 10.1188/13.cjon.e45-e51] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lanceley A, Clark JM. CANCER IN OTHER WORDS? THE ROLE OF METAPHOR IN EMOTION DISCLOSURE IN CANCER PATIENTS. BRITISH JOURNAL OF PSYCHOTHERAPY 2013; 29:182-201. [PMID: 24748706 PMCID: PMC3985809 DOI: 10.1111/bjp.12023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Despite evidence that nurses may play a crucial part in the wellbeing and recovery of cancer patients by facilitating their expression of feelings, research is lacking into the emotional content of nurse–patient talk and patients' use of language in emotion disclosure. In this study, 23 participating nurses in a variety of cancer care settings were asked to tape-record their conversations with patients during daily care. A data set of 60 nurse–patient conversations was collected. Individual expression of emotion by patients was identified through interpretive literary analysis within a framework of psychodynamic theory. Overall the picture of emotion disclosure was intense. In particular, patients' use of metaphor and figurative language to express their distress was powerful and pervasive. Participating nurses demonstrated responsive skills but their responses to figurative expression were often problematic. The study provides evidence of unconscious processes in nurses' work and advocates career-long psychoanalytically informed supervision for nurses to better support them in challenging dialogue with cancer patients. Research is needed to evaluate the impact of supervision on communications with cancer patients to ensure patients have access to appropriate emotional supportive and care.
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Affiliation(s)
- Anne Lanceley
- Dept. of Women's Cancer, the UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, Medical School Building 74 Huntley Street London WC1E 6AU
| | - Jill Macleod Clark
- Dept. of Women's Cancer, the UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, Medical School Building 74 Huntley Street London WC1E 6AU
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López-Pérez B, Ambrona T, Gregory J, Stocks E, Oceja L. Feeling at hospitals: perspective-taking, empathy and personal distress among professional nurses and nursing students. NURSE EDUCATION TODAY 2013; 33:334-338. [PMID: 23428365 DOI: 10.1016/j.nedt.2013.01.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 01/03/2013] [Accepted: 01/15/2013] [Indexed: 06/01/2023]
Abstract
When facing a person in need, professional nurses will tend to adopt an objective perspective compared to nursing students who, instead, will tend to adopt an imagine-other perspective. Consequently, professional nurses will show lower vicarious emotional reaction such as empathy and distress. Using samples from Spain (Studies 1 and 2) and United states (Study 3), we compared perspective taking strategies and the emotional responses of nurses and nursing students when perceiving a sick child (Study 1) and a sick adult (Studies 2 and 3). Taken together, the results supported our hypotheses. We discuss the applied value of considering the relationship between perspective-taking and its emotional consequences for the nursing profession.
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Affiliation(s)
- Belén López-Pérez
- Departamento de Psicología Social y Metodología, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain.
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Ellington L, Reblin M, Clayton MF, Berry P, Mooney K. Hospice nurse communication with patients with cancer and their family caregivers. J Palliat Med 2012; 15:262-8. [PMID: 22339285 DOI: 10.1089/jpm.2011.0287] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Effective communication by hospice nurses enhances symptom management for the patient, reduces family caregiver burden and distress, and potentially improves bereavement adjustment. However, research has not kept pace with the rising use of hospice by patients with cancer and thus we know little about how hospice nurses communicate. METHODS The overriding objective of this pilot study was to provide insight into these in-home visits. Hospice nurses audiorecorded their interactions over time with family caregivers and patients with cancer. The communication within these tapes was coded using Roter Interaction Analysis System (RIAS) and analyzed. RESULTS We found that tape recording home hospice nurse visits was feasible. RIAS was suited to capture the general content and process of the home hospice encounter and the coded interactions show the range of topics and emotions that are evident in the dialogue. Implications and future directions for research are discussed.
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Affiliation(s)
- Lee Ellington
- College of Nursing, University of Utah, Salt Lake City, Utah 84112, USA.
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Tay LH, Ang E, Hegney D. Nurses’ perceptions of the barriers in effective communication with inpatient cancer adults in Singapore. J Clin Nurs 2012; 21:2647-58. [DOI: 10.1111/j.1365-2702.2011.03977.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Blanch-Hartigan D. Measuring providers' verbal and nonverbal emotion recognition ability: reliability and validity of the Patient Emotion Cue Test (PECT). PATIENT EDUCATION AND COUNSELING 2011; 82:370-376. [PMID: 21196095 DOI: 10.1016/j.pec.2010.11.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2010] [Revised: 11/23/2010] [Accepted: 11/25/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To describe the development and validation of the Patient Emotion Cue Test (PECT) as a tool to measure providers' emotion cue recognition ability. METHODS The PECT consists of 47 video clips depicting emotion cues that systematically vary in intensity of both verbal and nonverbal contents. The PECT assesses the provider's ability to detect and identify patients' emotion cues accurately. A multi-stage development process produced the PECT. Reliability and validity were assessed in three studies. RESULTS Scores on the PECT are normally distributed with significantly above chance responding. Across three studies, the PECT demonstrates convergent validity through significant correlations with standardized tests representing multiple channels of emotion recognition, including the face, body, and voice. The PECT shows adequate inter-item and split-half reliability. CONCLUSION The PECT is an easily administered, reliable, and valid test of emotion cue recognition. PRACTICE IMPLICATIONS The PECT can be used in future research on providers' emotion recognition ability, for evaluating self-assessment of ability, and as a teaching tool in medical schools.
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Eide H, Sibbern T, Johannessen T. Empathic accuracy of nurses’ immediate responses to fibromyalgia patients’ expressions of negative emotions: an evaluation using interaction analysis. J Adv Nurs 2011; 67:1242-53. [DOI: 10.1111/j.1365-2648.2010.05579.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
In this article, the authors analyze the concept of professional vulnerability, as it relates to crying and the nursing profession. The span of potential professional vulnerability extends through all the nursing clinical, academic, and research environments. A dimensional analysis is the method used to analyze systematically how the concept of professional vulnerability is socially constructed and contextually situated in nursing. Professional vulnerability is demonstrated to have both negative and positive significances. Nurses’ construction of vulnerability as a strength makes a significant difference in providing effective, positive holistic care. The objective of this analysis is to challenge the conventional views toward emotional and moral vulnerability in particular, leading to a holistic vision of hope and encouragement to benefit the future of nursing.
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de Haes HCJM. Responding to patient emotions: the different reactions to sadness and anger. PATIENT EDUCATION AND COUNSELING 2009; 76:1-2. [PMID: 19524140 DOI: 10.1016/j.pec.2009.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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