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Schöps AM, Skinner TC, Fosgerau CF. Tele-health coaches' responses to clients' emotional cues and concerns and engagement with the Bump to Baby and Me Intervention. PATIENT EDUCATION AND COUNSELING 2024; 127:108370. [PMID: 38996574 DOI: 10.1016/j.pec.2024.108370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 06/14/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024]
Abstract
OBJECTIVE To explore the relationship between health coaches' responses to emotional cues/concerns and women's subsequent engagement with the health coaching mHealth platform. METHODS 24 face-to-face video-mediated initial conversations between participants and their health coaches were coded using the VR-CoDES-P method. Women with high risk of developing Gestational Diabetes Mellitus were selected from the study, based on their engagement with the smartphone health coaching platform. 12 women with very low engagement and 12 women with high engagement were identified. RESULTS In interactions with women with high goal engagement, coaches had significantly more counseling codes with prior other codes and no instances of non-explicit response codes that reduce space for further disclosure. Analysis showed that interactions with women with high goal engagement were more frequently met by the coach with affect-acknowledging and empathic responses prior to the counseling speech act. CONCLUSION High goal engagement among women with Gestational Diabetes Mellitus may appear to be associated with coaches facilitating the frequent use of empathy. PRACTICE IMPLICATIONS Findings can draw coaches' attention to the impact that their counseling has on goal engagement, increasing the opportunity for intervention to be person-centered and effective.
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Affiliation(s)
- Antje Maria Schöps
- Department of Nordic Studies and Linguistics, University of Copenhagen, Copenhagen, Denmark.
| | - Timothy Charles Skinner
- Institute of Psychology, University of Copenhagen, Copenhagen, Denmark; Department of Psychology, La Trobe University, Bendigo, Australia; Australian Centre for Behavioural Research in Diabetes, Melbourne, Australia
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Heyn LG, Brembo EA, Eide H, Hafskjold L, Sundling V. Older persons' expressed worries during nursing care at home: Do health complexity and nature of nursing care in the visit matter? PATIENT EDUCATION AND COUNSELING 2021; 104:2418-2424. [PMID: 34294490 DOI: 10.1016/j.pec.2021.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Older persons receiving home care express more cues and concerns compared to other clinical contexts. Increased health condition complexity requires a corresponding increase in nursing competence. The aim of this study was to explore how complexity of older persons' health and nature of the visit influenced their expressed worries. METHODS In this cross-sectional explorative study, we analysed older persons' expressed worries (n = 508) identified by the Verona Coding Definitions of Emotional Sequences (VR-CoDES) in 129 audio-recorded home care visits with older persons (≥65 years), collected in 3 city districts and 1 rural area in Norway. RESULTS Expressed worries of 45 older persons were included in the analysis: 18 had low health complexity, 5 moderate and 22 high health complexity. The nature of the visit affected the number of expressed worries, health complexity did not. Most of the worries were expressed during basic nursing care visits and/or medication administration. CONCLUSION Findings suggest that home visit type may influence the older persons' expressed worries. The complexity of the older persons' health condition seems to have little impact on the expressed worries. PRACTICE IMPLICATIONS Knowledge about communication in different complexity of visits is important when planning care for older persons.
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Affiliation(s)
- Lena Günterberg Heyn
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway.
| | - Espen Andreas Brembo
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway.
| | - Hilde Eide
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway.
| | - Linda Hafskjold
- Faculty of Health and Social Sciences, Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway.
| | - Vibeke Sundling
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway; National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway.
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Frakking T, Michaels S, Orbell-Smith J, Le Ray L. Framework for patient, family-centred care within an Australian Community Hospital: development and description. BMJ Open Qual 2021; 9:bmjoq-2019-000823. [PMID: 32354755 PMCID: PMC7213886 DOI: 10.1136/bmjoq-2019-000823] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 03/31/2020] [Accepted: 04/18/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To describe the development of a patient and family-centred care (PFCC) conceptual framework within a small community Australian Hospital. METHODS A scoping review of scientific and grey literature and community hospital stakeholder discussions were used to identify and design a conceptual framework for PFCC across five core pillars of leadership, engagement, service delivery, learning and environment. RESULTS 107 publications were identified and 76 were included for data extraction. A draft framework was constructed and modified following consultation with hospital stakeholders across a small Australian Community Hospital. The 'Caring Together' framework outlines three core layers: (1) the focus of our care is the experiences of our consumers and staff; (2) concepts of leadership, environment, service delivery, engagement and learning; and (3) the overarching fundamental values of being heard, respected, valued and supported by staff and consumers at all levels in an organisation. CONCLUSIONS The conceptual Caring Together framework structures key PFCC concepts across organisational priority areas within an Australian healthcare setting and can be used to guide implementation of PFCC at other small hospital facilities. Changes to national and state healthcare funding may help facilitate improved hospital facility implementation of PFCC, and ultimately improve consumer healthcare satisfaction and clinical outcomes.
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Affiliation(s)
- Thuy Frakking
- Research Development Unit, Metro North Hospital and Health Service, Herston, Queensland, Australia .,School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Suzanne Michaels
- Engagement & Integration, Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, Queensland, Australia
| | - Jane Orbell-Smith
- Education & Training, Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, Queensland, Australia
| | - Lance Le Ray
- Executive Management, Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, Queensland, Australia
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Höglander J, Eklund JH, Spreeuwenberg P, Eide H, Sundler AJ, Roter D, Holmström IK. Exploring patient-centered aspects of home care communication: a cross-sectional study. BMC Nurs 2020; 19:91. [PMID: 33013200 PMCID: PMC7526395 DOI: 10.1186/s12912-020-00483-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 09/17/2020] [Indexed: 11/29/2022] Open
Abstract
Background Communication is a cornerstone in nursing and aims at both information exchange and relationship building. To date, little is known about the naturally occurring communication between older persons and nurses in home care. Communication might heal through different pathways and a patient- or person-centered communication could be important for health and well-being of older persons. However, the delivery of individualized home care is challenged by routines and organizational demands such as time constraints. Therefore, the aim of this study was to explore the patient-centered aspects of home care communication between older persons and registered nurses. Methods In total 37 older persons (aged 65 years or older) and eleven RNs participated in 50 audio-recorded home care visits. Roter Interaction Analysis System (RIAS) was used to code verbal communication. A ratio from these codes, establishing the degree of patient-centeredness, was analyzed using a Generalized Linear Mixed Model. Results The present home care communication contained more socio-emotional than task-oriented communication and the emotional tone was largely positive. The global affect ratings reflected an overall positive tone (m = 39.88, sd = 7.65), with higher ratings on dimensions of, for example, responsiveness/engagement and interactivity or interest were more frequent than those that may be considered as less-positive emotions (m = 15.56, sd = 3.91), e.g. hurried, dominance or anger. The ratio of the degree of patient-centered communication in the home care visits was an average of 1.53, revealing that the communication could be considered as patient-centered. The length of the visits was the only characteristic significantly associated with the degree of patient-centeredness in the communication, with a peak in patient-centeredness in visits 8–9 min long. Sex, age or procedural focus showed no significant effects on the degree of patient-centeredness. Conclusion Overall, the degree of patient-centeredness and a positive emotional tone, which might have a positive outcome on older persons’ health, was high. Longer visits provided a higher degree of patient-centeredness, but no linear increase in patient-centeredness due to length of visit could be observed. The findings can be used for education and training of nurses, and for providing individualized care, e.g. patient- or person-centered care.
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Affiliation(s)
- Jessica Höglander
- School of Health, Care and Social Welfare, Mälardalen University, SE-721 23 Västerås, Sweden
| | - Jakob Håkansson Eklund
- School of Health, Care and Social Welfare, Mälardalen University, SE-721 23 Västerås, Sweden
| | - Peter Spreeuwenberg
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, the Netherlands
| | - Hilde Eide
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Annelie J Sundler
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Debra Roter
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Inger K Holmström
- School of Health, Care and Social Welfare, Mälardalen University, SE-721 23 Västerås, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Sundling V, Hafskjold L, Eklund JH, Holmström IK, Höglander J, Sundler AJ, van Dulmen S, Eide H. Emotional communication in home care: A comparison between Norway and Sweden. PATIENT EDUCATION AND COUNSELING 2020; 103:1546-1553. [PMID: 32173215 DOI: 10.1016/j.pec.2020.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 01/16/2020] [Accepted: 03/01/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Given the free movement of workers across countries, knowledge regarding communication differences between countries is imperative. In this study, we explored and compared the supportive responses of nursing staff to older persons' emotions in home care in Norway and Sweden. METHODS The study had an observational, cross-sectional, comparative design, which included 383 audio-recorded home-care visits. Communication was coded using Verona Coding Definitions of Emotional Sequences. Worries and responses were categorised with regard to reference, communicative function and level of person-centredness. Standard statistical tests were used to analyse the data. RESULTS The Swedish nursing staff provided space for further disclosure of worry more frequently than the Norwegian nursing staff (75.0 % versus 60.2 %, χ2 = 20.758, p < 0.01). In all, 65 % of the responses were supportive. Multiple logistic regression analyses showed that highly person-centred responses were independently associated with worries phrasing an emotion, OR (95 % CI) 3.282 (1.524-7.067). CONCLUSION The level of person-centredness was associated with the way in which older persons expressed their distress. The Swedish nursing staff provided opportunities for further disclosure of worries more frequently than the Norwegian nursing staff. PRACTICE IMPLICATIONS Findings of intercultural differences should be incorporated into the training of nursing staff.
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Affiliation(s)
- Vibeke Sundling
- Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway; National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway; Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway.
| | - Linda Hafskjold
- Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway; Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway
| | | | - Inger K Holmström
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Jessica Höglander
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Annelie J Sundler
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Sweden
| | - Sandra van Dulmen
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway; NIVEL (Netherlands Institute for Health Services Research), Utrecht, the Netherlands; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, the Netherlands
| | - Hilde Eide
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway
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van Eikenhorst L, van Dijk L, Cords J, Vervloet M, de Gier H, Taxis K. Pharmacists' responses to cues and concerns of polypharmacy patients during clinical medication reviews-A video observation study. PATIENT EDUCATION AND COUNSELING 2020; 103:930-936. [PMID: 31859122 DOI: 10.1016/j.pec.2019.11.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/28/2019] [Accepted: 11/30/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The research questions of this study are 1) How do pharmacists respond to negative emotions of patients during a clinical medication review (CMR)? 2) How do patients express negative emotions during a CMR? 3) Who (pharmacist or patient) initiates a negative emotion to be discussed during a CMR? METHODS We used video-recordings to observe 132 CMR interviews of 49 pharmacists. Videos were coded with the Verona coding definitions on emotional sequences(-provider responses) (VR-CoDES(-P)). RESULTS In total 2538 negative emotions were identified, mainly expressed as cues (95.0 %). Often cues were expressed as verbal hints to hidden concerns (33.2 %) or were related to cognitive or physical causes (28.3 %).Three-quarters of the negative emotions were elicited by patients. 2670 pharmacists' responses were coded. The most common response was non-explicit providing space (77.6 %) and the least common response was explicit reducing space (5.8 %). CONCLUSION Pharmacists are mainly non-explicitly providing space in their responses. While this hinders their ability to capture patients' problems it also may enable patients to initiate topics. PRACTICE IMPLICATIONS Pharmacists are able to respond to patients' negative emotions. Training should focus on developing pharmacist's skills to be more explicit in their responses to get more in-depth knowledge of patients' problems.
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Affiliation(s)
- Linda van Eikenhorst
- PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands.
| | - Liset van Dijk
- PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands; Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Jasper Cords
- PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands
| | - Marcia Vervloet
- Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Han de Gier
- PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands
| | - Katja Taxis
- PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands
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Tiredness of Life in Older persons: A Qualitative Study on Nurses’ Experiences of Being Confronted With This Growing Phenomenon. THE GERONTOLOGIST 2019; 60:735-744. [DOI: 10.1093/geront/gnz088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Indexed: 02/03/2023] Open
Abstract
Abstract
Background and Objectives
With worldwide aging it is imperative to understand nurses’ perceptions of tiredness of life (ToL) and their ways of dealing with an increasingly common phenomenon. Most research on ToL relates to older individuals’ experiences. This study aimed to gain insight into nurses’ (a) perceptions of, (b) attitude(s) toward, and (c) ways of dealing with ToL in older patients.
Research Design and Methods
Qualitative study with elements of constructivist grounded theory. Data were collected by means of semi-structured interviews between February 2016 and June 2017 with a purposive sample of 25 nurses working in home care and nursing homes.
Results
A careful consideration indicative of an oscillation between 3 levels (e.g., behavioral, cognitive, and affective) is present. The confrontation with persons having ToL instigates a cognitive process of searching to understand the state a person is in, which on its turn ensues in an emotional balancing between courage and powerlessness and a behavioral approach of action or dialogue.
Discussion and Implications
Our findings indicate that nurses aim to provide good care, sensitive to the older person’s needs, but this process is not without ambiguity. This study provides nurse managers with valuable guidance to (a) support nursing staff in dealing with ToL, and (b) advance opportunities for emotionally sensitive care and (individual- and team-based) reflection. Finally, this study offers suggestions for education programs to incorporate ToL in curricula.
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Höglander J, Sundler AJ, Spreeuwenberg P, Holmström IK, Eide H, van Dulmen S, Eklund JH. Emotional communication with older people: A cross-sectional study of home care. Nurs Health Sci 2019; 21:382-389. [PMID: 30957364 DOI: 10.1111/nhs.12611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 02/05/2019] [Accepted: 03/09/2019] [Indexed: 01/25/2023]
Abstract
The aim of this study was to explore the influence of characteristics of nurses and older people on emotional communication in home care settings. A generalized, linear, mixed model was used to analyze 188 audio-recorded home care visits coded with Verona Coding Definitions of Emotional Sequences. The results showed that most emotional distress was expressed by older females or with female nurses. The elicitation of an expression of emotional distress was influenced by the nurses' native language and profession. Older women aged 65-84 years were given the most space for emotional expression. We found that emotional communication was primarily influenced by sex for nurses and older people, with an impact on the frequency of expressions of and responses to emotional distress. Expressions of emotional distress by older males were less common and could risk being missed in communication. The results have implications for students' and health professionals' education in increasing their knowledge of and attentiveness to the impacts of their and others' characteristics and stereotypes on emotional communication with older people.
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Affiliation(s)
- Jessica Höglander
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Annelie J Sundler
- Department of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Peter Spreeuwenberg
- Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Inger K Holmström
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Hilde Eide
- Science Centre Health and Technology, University of South-Eastern Norway, Drammen, Norway
| | - Sandra van Dulmen
- Netherlands Institute for Health Services Research, Utrecht, the Netherlands.,Science Centre Health and Technology, University of South-Eastern Norway, Drammen, Norway.,Department of Primary and Community Care, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Jakob H Eklund
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Nursing staff's responses to thematic content of patients' expressed worries: observing communication in home care visits. BMC Health Serv Res 2018; 18:597. [PMID: 30075767 PMCID: PMC6091070 DOI: 10.1186/s12913-018-3390-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 07/13/2018] [Indexed: 02/07/2023] Open
Abstract
Background The aim of the study was to explore the thematic content of older persons’ expressed worries in home care visits, and how nursing staff respond to different thematic contents. Methods The study had a descriptive, observational design, including 195 audio-recorded Norwegian home care visits with 33 nursing staff and 48 older persons. In all, 638 patient cues/concerns (worries) and subsequent nursing staff’s responses were identified using Verona Coding Definitions of Emotional Sequences. A novel thematic coding scheme was used to label the thematic content of the cues/concerns. The nursing staff’s responses were grouped based on communicative function as emotion-focused, content-focused or ignoring/blocking the cue/concern. Group difference was analysed using Pearson’s chi-squared test, Fisher’s exact test, and adjusted residuals. Results The theme of worries was associated with elicitation of the cue/concern, either elicited by the nursing staff or spontaneously expressed by the patient (Chi-square, p< 0.001). “Ageing and bodily impairment” was the most common theme (66%) and was equally elicited by patients and nursing staff. Worries about “Relationships with others” (9%), “Health care-related issues” (15%) and “Life narratives and value issues” (9%) were mainly elicited by nursing staff. The nursing staff response was associated with the theme of worries (p˂0.001). For the sub-themes of “Ageing and bodily impairment”, Coping with existential challenges received more frequently emotion-focused responses (adjusted residuals: 3.2) and Expression of pain felt in the moment were more frequently ignored/blocked (adjusted residuals: 4.0, Fisher’s exact test, p< 0.001). For the sub-themes of “Relationships with others”, Being a burden more frequently received a content-focused response (adjusted residuals: 2.8), while Losing social ties more frequently received an emotion-focused response (adjusted residuals: 3.1, Fisher’s exact test, p = 0.009). Conclusion “Ageing and bodily impairment” was the most common theme and more frequently elicited by the older persons than other themes. Emotionally focused nursing staff responses were most common when addressing existential challenges and fear of losing social ties. Whereas nursing staff showed a tendency to ignore patients’ spontaneous expressions of pain. Further research should explore the influence of nursing staff’s responses on quality of care and patient satisfaction.
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Gorawara-Bhat R, Hafskjold L, Gulbrandsen P, Eide H. Exploring physicians' verbal and nonverbal responses to cues/concerns: Learning from incongruent communication. PATIENT EDUCATION AND COUNSELING 2017; 100:1979-1989. [PMID: 28698034 DOI: 10.1016/j.pec.2017.06.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 05/22/2017] [Accepted: 06/22/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Explore physicians' verbal and nonverbal responses to cues/concerns in consultations with older-patients. METHODS Two teams independently coded a sample of Norwegian consultations (n=24) on verbal and nonverbal dimensions of communication using VR-CoDES and NDEPT instruments. Consultations exploring older-patients' verbal emotional expressions were labeled 'Acknowledging of patients' emotional expressions', and 'Distancing from patients' emotional expressions.' Based on type and extent of nonverbal expressiveness, consultations were labeled 'Affective' and 'Prescriptive.' Congruency of verbal and nonverbal communication was assessed and categorized into four types. Incongruent consultations were qualitatively analyzed. RESULTS Types 1 and 2 consultations were described as 'Congruent,' i.e. both verbal and nonverbal behaviors facilitate or inhibit emotional expressions. Types 3 and 4 were considered 'Incongruent,' i.e. verbal inhibits, but nonverbal facilitates emotional expressions or vice versa. Type 3 incongruent encounters occurred most often when it was challenging to meet patients' needs. CONCLUSIONS Frequently physicians' display incongruent behavior in challenging situations. Older patients' may perceive this as either alleviating or increasing distress, depending on their needs. PRACTICE IMPLICATIONS Type 3 consultations may shed light on reasons for physicians' incongruent behavior; therefore, independent measurement and analyses of verbal and nonverbal communication are recommended. Older-patients' perceptions of incongruent communication should be further explored.
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Affiliation(s)
| | - L Hafskjold
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University College of Southeast-Norway, Drammen, Norway
| | - P Gulbrandsen
- University of Oslo, Oslo, Norway; Akershus University Hospital, Norway
| | - H Eide
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University College of Southeast-Norway, Drammen, Norway
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