Factors related to the expression of emotions by early-stage breast cancer patients

Piccolo, Lidia Del; Mazzi, Maria Angela; Mascanzoni, Andrea; Lonardi, Miriam; Felice, Mariangela De; Danzi, Olivia Purnima; Buizza, Chiara; Ghilardi, Alberto; Bottacini, Alessandro; Goss, Claudia

doi:10.1016/j.pec.2019.04.002

Cited by 14 publications

(16 citation statements)

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“…Scores for components related to client emotions and the veterinary surgeon responding to them were generally lower than those related to structuring the consultation and gathering information, which is consistent with the dominance of biomedical over psychosocial dialogue as well as the lesser attention to emotion seen in other veterinary communication studies (Shaw et al, 2004;Shaw et al, 2008;Vijfhuizen et al, 2017) and in a study of breast cancer patients in which the original version of the VR-COPE was used (Del Piccolo et al, 2019).…”

Section: Discussionsupporting

confidence: 76%

Preliminary assessment of a tool for measuring relationship-centred communication in veterinary consultations (adapted VR-COPE)

McDermott¹,

Cobb²,

Robbé³

et al. 2021

MedEdPublish

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Relationship-centred communication is considered a desirable goal in veterinary medicine, and a number of different tools have been developed to measure relationship-centred communication. This study was designed as an initial assessment of an adapted version of the Verona Patient-centred Communication Evaluation (VR-COPE) scale, originally developed for medical communication research, to evaluate its potential for measuring relationship-centredness in veterinary consultations. Fifty-five consultations in the United Kingdom and United States of America were videotaped and analysed. The median VR-COPE total score (out of a potential 100 points) was 76.00 for all consultations. The highest overall score was for "Structuring" (of the consultation), whereas the lowest scores were for "Client Worries," "Psychological Impact," and "Empathy." This initial assessment of the adapted VR-COPE suggests it may be helpful in measuring content, process, and structuring skills related to relationship-centredness in veterinary consultations. It may also help uncover aspects of relationship-centredness that are unique from those uncovered by other tools. Further research is needed to fully assess the role of VR-COPE in veterinary communication research and the contributions it can make to relationship-centredness in veterinary consultations.

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Section: Discussionsupporting

confidence: 76%

Preliminary assessment of a tool for measuring relationship-centred communication in veterinary consultations (adapted VR-COPE)

McDermott¹,

Cobb²,

Robbé³

et al. 2021

MedEdPublish

View full text Add to dashboard Cite

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“…Having enough time for emotional care is also a crucial issue, and was the most cited staff barrier in a recent oncology systematic review [45]. Staff in our study thought that patients may self-censor in relation to distress if they perceive staff to be too busy, which mirrors findings from a recent breast cancer study [36]. It is hard to argue against staff being increasingly pressed for time in the NHS.…”

Section: Discussionsupporting

confidence: 68%

“…It became apparent that both sites had variable and unstandardized approaches to patient distress, which led to some patient distress not being identified and/or responded to, a finding in common with the oncology literature [36,44]. Most of the barriers we identified are similar to those found in oncology services: staff preference for/prioritising medical care [36,45]; differences between doctors and nurses in role perceptions [46]; difficulties identifying distress unless directly expressed by patients [36,46]; unwillingness to probe for distress [44,47]; not knowing how to handle distressed patients [44,46,47]; fear of getting too involved/saying the wrong thing [45,48]; negative emotional impacts on staff [45,48]; lack of time [45,46,48]; lack of skills/training [45,46], and lack of services for onward referral [44–46]. Interestingly, consultation style was only identified as a barrier by a few staff, although a recent study with oncologists suggested that fewer distress cues are expressed by patients during tightly structured physician-led consultations [36].…”

Section: Discussionmentioning

confidence: 99%

“…Renal staff may be particularly well placed to provide emotional and psychological support, as they may develop close relationships with patients over time. However, a few small-scale studies suggest that renal staff find it hard to recognise distress [20,22,34], and evidence from oncology studies suggests that patients tend not to spontaneously express emotional concerns in clinics [8,35], or that they do so indirectly through verbal and non-verbal cues [36]. Furthermore, during time-limited consultations, doctors are reluctant to raise emotional issues, focusing instead on clinical/medical issues [37,38].…”

Section: Introductionmentioning

confidence: 99%

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Distress in patients with end-stage renal disease: Staff perceptions of barriers to the identification of mild-moderate distress and the provision of emotional support

et al. 2019

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ObjectivesTo explore staff perceptions of barriers to the identification of mild to moderate distress and the provision of emotional support in patients with end-stage renal disease.MethodsQualitative semi-structured interviews with staff in two hospitals (n = 31), with data analysed using a hybrid approach combining thematic analysis with aspects of grounded theory.ResultsStaff appeared very aware that many patients with end-stage renal disease experience distress, and most thought distressed patients should be helped as part of routine care. However, practice was variable and looking for and addressing distress was not embedded in care pathways. Interviews identified six themes: i) staff perceptions about how distress is manifested and what causes distress were variable; ii) staff perceptions of patients could lead to distress being overlooked because patients were thought to hide their distress whilst some groups were assumed to be more prone to distress than others; iii) role perceptions varied, with many staff believing it to be their role but not feeling comfortable with it, with doctors being particularly ambivalent; iv) fears held back some staff, who were concerned about what might happen when talking about distress, or who found the emotional load for themselves to be too high; v) staff felt they lacked skills, confidence and training, vi) capacity to respond may be limited, as staff perceive there to be insufficient time, with little or no specialist support services to refer patients to.ConclusionsStaff perceived significant barriers in identifying and responding to patient distress. Barriers related to skills and knowledge could be addressed through training, with training ideally targeted at staff with positive attitudes, but who currently lack skills and confidence. Barriers related to role perceptions would be harder to address. The study is relevant internationally as part of improving long-term condition pathways.

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“…By contrast, the study by Takahashi et al 34 underlined how healthcare systems for working survivors to BC are underdeveloped in Japan, with only 23.5% of participants screened about work-related issues by a healthcare provider. As regards the Italian context, a previous study by our group 57 used the Verona Patient-centred Communication Evaluation (VR-COPE) Scale 58 to rate oncologists’ interaction skills on the 308 patients with BC recruited in the previous RCT study. 39 40 The VR-COPE consists of nine items, operationally defined and rated on a scale from 0 (no attempt) to 10 (accomplished).…”

Section: Discussionmentioning

confidence: 99%

Employment status and information needs of patients with breast cancer: a multicentre cross-sectional study of first oncology consultations

et al. 2020

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ObjectivesTo investigate the early information needs of women with a recent diagnosis of breast cancer (BC) according to their employment status.DesignCross-sectional.SettingSecondary-care patients attending three outpatient oncology clinics in northern Italy.Participants377 women with a recent diagnosis of early-stage, non-metastatic BC aged 18–75 were recruited. Of them, 164 were employed, 103 non-employed and 110 retired.Outcome measuresThe first consultation visit with an oncologist was audio-recorded and analysed for the number and type of questions asked. Linear regression models considering consultations’ and patients’ characteristics as confounding variables were applied.ResultsEmployed patients asked significantly more questions than non-employed and retired patients (17 vs 13 and 14; F=6.04; p<0.01). When age and education were included in the statistical model, the significance of employment status was rearranged among all the variables and was no more significant (b=1.2, p=0.44). Employed women asked more questions concerning disease prognosis (0.7 vs 0.4 and 0.6; F=3.5; p=0.03), prevention (1.4 vs 0.6 and 0.7; F=10.7; p<0.01), illness management (7.2 vs 6 and 5.4; F=3.8; p=0.02) and social functioning (37% vs 18% and 20%; χ2=14.3; p<0.01) compared with the other two groups. Finally, they attended more frequently the consultation alone (37% vs 18% and 25%; χ2=10.90, p<0.01), were younger (50 vs 58 and 67 years; F=63.8; p<0.01) and with a higher level of education (77% vs 27% and 45%; χ2=68.2; p<0.01).ConclusionsEmployment status is related to the type of questions asked during the first consultation. Also, it interrelates with other patients' characteristics like age and education in determining the number of questions asked. Patients' characteristics including employment status could be considered in tailoring work and social-related information provided during the first oncological consultation. Future studies could explore potential differences in information needs according to the different kinds of work.

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Factors related to the expression of emotions by early-stage breast cancer patients

Cited by 14 publications

References 50 publications

Preliminary assessment of a tool for measuring relationship-centred communication in veterinary consultations (adapted VR-COPE)

Preliminary assessment of a tool for measuring relationship-centred communication in veterinary consultations (adapted VR-COPE)

Distress in patients with end-stage renal disease: Staff perceptions of barriers to the identification of mild-moderate distress and the provision of emotional support

Employment status and information needs of patients with breast cancer: a multicentre cross-sectional study of first oncology consultations

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