Communication at diagnosis of venous thromboembolism: Lasting impact of verbal and nonverbal provider communication on patients

Abstract

Background Establishing trust and effective communication can be challenging in the emergency department, where a prior relationship between patient and provider is lacking and decisions have to be made rapidly. Venous thromboembolism (VTE) represents an emergent condition that requires immediate decision making. Objective The aim of this paper was to document the experiences, perceptions, and the overall impact of health care provider communication on patients during the diagnosis of VTE in the emergency department. Methods This was a qualitative method study using semistructured interviews to increase understanding of the patient experience during the diagnosis of VTE and impact of the health care provider communication on subsequent patient perceptions. Results A total of 24 interviews were conducted. Content analysis revealed that certain aspects of health care providers’ communication—namely, word choice, incomplete information, imbalance between fear over reassurance and nonverbal behavior—used to deliver and explain VTE diagnosis, treatment, and prognosis increases patients’ fears. Conclusion These interviews elucidate areas for improvement of communication in the emergency care setting for acute VTE.

Evaluation of patients' experience and related qualitative outcomes in venous thromboembolism: A scoping review

“…Two of these studies would have met our inclusion criteria, and both describe themes that are consistent with our findings. 12,54 Both studies delve deeper into factors that predispose patients to overt psychological impacts of VTE, specifically highlighting the influence of provider communication techniques on the level of psychological distress, such as the use of alarmist language and misplaced metaphors. Thoughtfully adjusting the content and delivery of information at VTE diagnosis can have lasting effects on patient satisfaction.…”

O impacto emocional do paciente no tromboembolismo venoso

“…Articles report phrases selected by patients as being highly harmful, such as: “you could have died if we did not make this diagnosis today”, “I’ve seen patients die from what you have”, and “you are a walking time bomb”. 5 The physician should always use basic, layman’s language, at times and in places that are appropriate for communicating with the patient, using techniques for communicating bad news, such as the SPIKES protocol (setting up, perception, invitation, knowledge, emotions, strategy, and summary), for example. Constant checks should be made to ensure the patient understands every element covered and care must be taken with posture and non-verbal language, avoiding facial expressions of worry, tension, and indifference.…”

“…Constant checks should be made to ensure the patient understands every element covered and care must be taken with posture and non-verbal language, avoiding facial expressions of worry, tension, and indifference. 5 Terms such as “postthrombotic panic syndrome” and “thromboneurosis” are increasingly common in the specialist literature. 6 …”

“…A linguagem alarmista e as metáforas médicas mal colocadas foram identificadas como fontes de ansiedade neste contexto. Artigos relatam frases selecionadas pelos pacientes como altamente prejudiciais, como: “já vi pacientes morrerem com o que você tem”, “você poderia ter morrido se não tivéssemos feito este diagnóstico hoje” e “você é uma bomba-relógio ambulante” 5 . O médico deve sempre usar linguagem básica e leiga, com tempo e local adequados para se comunicar com o paciente, procurando usar técnicas de comunicação de más notícias, como o protocolo SPIKES (do inglês, setting up, perception, invitation, knowledge, emotions, strategy and summary ), por exemplo.…”

New thematic calls for science at Research and Practice in Thrombosis and Haemostasis

“…Fourteen published articles covered broad areas of venous thromboembolism, hemophilia, anticoagulation adherence, and the impact of anticoagulation complications on patients. I was intrigued by findings on quality of life after pulmonary embolism, 2 negative lasting effects of how providers communicate with patients at the time of diagnosis of venous thromboembolism, 3 the positive impact of fitness and personal training in people with hemophilia, 4,5 and negative impact of heavy menstrual bleeding on quality of life in people with bleeding disorders or treated with anticoagulants 6,7 . A provocative Forum on the concept of living with a “hemophilia‐free mind” was also included 8 …”