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Patient Educ Couns. 2012 Oct;89(1):44-50. doi: 10.1016/j.pec.2012.04.005. Epub 2012 May 9.

Why should I talk about emotion? Communication patterns associated with physician discussion of patient expressions of negative emotion in hospital admission encounters.

Author information

1
Department of Medicine, University of California, San Francisco, CA 94143-0903, USA. Kristen.Adams@ucsf.edu

Abstract

OBJECTIVE:

To describe hospital-based physicians' responses to patients' verbal expressions of negative emotion and identify patterns of further communication associated with different responses.

METHODS:

Qualitative analysis of physician-patient admission encounters audio-recorded between August 2008 and March 2009 at two hospitals within a university system. A codebook was iteratively developed to identify patients' verbal expressions of negative emotion. We categorized physicians' responses by their immediate effect on further discussion of emotion - focused away (away), focused neither toward nor away (neutral), and focused toward (toward) - and examined further communication patterns following each response type.

RESULTS:

In 79 patients' encounters with 27 physicians, the median expression of negative emotion was 1, range 0-14. Physician responses were 25% away, 43% neutral, and 32% toward. Neutral and toward responses elicited patient perspectives, concerns, social and spiritual issues, and goals for care. Toward responses demonstrated physicians' support, contributing to physician-patient alignment and agreement about treatment.

CONCLUSION:

Responding to expressions of negative emotion neutrally or with statements that focus toward emotion elicits clinically relevant information and is associated with positive physician-patient relationship and care outcomes.

PRACTICE IMPLICATIONS:

Providers should respond to expressions of negative emotion with statements that allow for or explicitly encourage further discussion of emotion.

Comment in

PMID:
22575434
PMCID:
PMC3462304
DOI:
10.1016/j.pec.2012.04.005
[Indexed for MEDLINE]
Free PMC Article

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