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

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EAOR_D_14_00761_14.7.14_revision.pdf (1.461Mb)
Date
2014
Author
Zhou, Yuefang
Humphris, Gerald Michael
Ghazali, N
Friderichs, Simon
Grosset, David
Rogers, Simon
Keywords
Head and neck cancer
Emotional distress
The VR-CoDES
Multilevel
RC0254 Neoplasms. Tumors. Oncology (including Cancer)
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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 reduce 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.
Citation
Zhou , Y , Humphris , G M , Ghazali , N , Friderichs , S , Grosset , D & Rogers , S 2014 , ' How head and neck consultants manage patients’ emotional distress during cancer follow-up consultations : a multilevel study ' , European Archives of Oto-Rhino-Laryngology , vol. Online First . https://doi.org/10.1007/s00405-014-3209-x
Publication
European Archives of Oto-Rhino-Laryngology
Status
Peer reviewed
DOI
https://doi.org/10.1007/s00405-014-3209-x
ISSN
0937-4477
Type
Journal article
Rights
© Springer-Verlag Berlin Heidelberg 2014. The final publication is available at Springer via http://dx.doi.org/10.1007/s00405-014-3209-x
Collections
  • University of St Andrews Research
URI
http://hdl.handle.net/10023/7943

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