How head and neck consultants manage patients’ emotional distress during cancer follow-up consultations: a multilevel study

Y Zhou, G Humphris, N Ghazali, S Friderichs, D Grosset, Simon N Rogers

Research output: Contribution to journalArticle

15 Citations (Scopus)

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.
Original languageEnglish
JournalEuropean Archives of Oto-Rhino-Laryngology
Early online date31 Jul 2014
DOIs
Publication statusPublished - 30 Sep 2015

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Consultants
Neck
Referral and Consultation
Head
Cues
Neoplasms
Head and Neck Neoplasms
Program Development
Emotions
Outpatients
Logistic Models
Education

Cite this

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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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How head and neck consultants manage patients’ emotional distress during cancer follow-up consultations: a multilevel study. / Zhou, Y; Humphris, G; Ghazali, N; Friderichs, S; Grosset, D; Rogers, Simon N.

In: European Archives of Oto-Rhino-Laryngology, 30.09.2015.

Research output: Contribution to journalArticle

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