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How do non-physician clinicians respond to advanced cancer patients' negative expressions of emotions?

Publication ,  Journal Article
Alexander, SC; Pollak, KI; Morgan, PA; Strand, J; Abernethy, AP; Jeffreys, AS; Arnold, RM; Olsen, M; Rodriguez, KL; Garrigues, SK; Manusov, JRE ...
Published in: Support Care Cancer
January 2011

PURPOSE: Patients with advanced cancer often experience negative emotion; clinicians' empathic responses can alleviate patient distress. Much is known about how physicians respond to patient emotion; less is known about non-physician clinicians. Given that oncology care is increasingly provided by an interdisciplinary team, it is important to know more about how patients with advanced cancer express emotions to non-physician clinicians (NPCs) and how NPCs respond to those empathic opportunities. METHOD: We audio recorded conversations between non-physician clinicians and patients with advanced cancer. We analyzed 45 conversations between patients and oncology physician assistants, nurse practitioners, and nurse clinicians in which patients or their loved ones expressed at least one negative emotion to the NPC (i.e., an empathic opportunity). Empathic opportunities were coded three ways: type of emotion (anger, sadness, or fear), severity of emotion (least, moderate, or most severe), and NPC response to emotion (not empathic, on-topic medical response, and empathic response). RESULTS: We identified 103 empathic opportunities presented to 25 different NPCs during 45 visits. Approximately half of the empathic opportunities contained anger (53%), followed by sadness (25%) and fear (21%). The majority of emotions expressed were moderately severe (73%), followed by most severe (16%), and least severe (12%). The severity of emotions presented was not found to be statistically different between types of NPCs. NPCs responded to empathic opportunities with empathic statements 30% of the time. Additionally, 40% of the time, NPCs responded to empathic opportunities with on-topic, medical explanations and 30% of the responses were not empathic. CONCLUSION: Patients expressed emotional concerns to NPCs typically in the form of anger; most emotions were moderately severe, with no statistical differences among types of NPC. On average, NPCs responded to patient emotion with empathic language only 30% of the time. A better understanding of NPC-patient interactions can contribute to improved communication training for NPCs and, ultimately, to higher quality patient care in cancer.

Duke Scholars

Published In

Support Care Cancer

DOI

EISSN

1433-7339

Publication Date

January 2011

Volume

19

Issue

1

Start / End Page

155 / 159

Location

Germany

Related Subject Headings

  • Tape Recording
  • Professional-Patient Relations
  • Oncology & Carcinogenesis
  • Neoplasms
  • Male
  • Humans
  • Female
  • Fear
  • Empathy
  • Emotions
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Alexander, S. C., Pollak, K. I., Morgan, P. A., Strand, J., Abernethy, A. P., Jeffreys, A. S., … Tulsky, J. A. (2011). How do non-physician clinicians respond to advanced cancer patients' negative expressions of emotions? Support Care Cancer, 19(1), 155–159. https://doi.org/10.1007/s00520-010-0996-5
Alexander, Stewart C., Kathryn I. Pollak, Perri A. Morgan, Justine Strand, Amy P. Abernethy, Amy S. Jeffreys, Robert M. Arnold, et al. “How do non-physician clinicians respond to advanced cancer patients' negative expressions of emotions?Support Care Cancer 19, no. 1 (January 2011): 155–59. https://doi.org/10.1007/s00520-010-0996-5.
Alexander SC, Pollak KI, Morgan PA, Strand J, Abernethy AP, Jeffreys AS, et al. How do non-physician clinicians respond to advanced cancer patients' negative expressions of emotions? Support Care Cancer. 2011 Jan;19(1):155–9.
Alexander, Stewart C., et al. “How do non-physician clinicians respond to advanced cancer patients' negative expressions of emotions?Support Care Cancer, vol. 19, no. 1, Jan. 2011, pp. 155–59. Pubmed, doi:10.1007/s00520-010-0996-5.
Alexander SC, Pollak KI, Morgan PA, Strand J, Abernethy AP, Jeffreys AS, Arnold RM, Olsen M, Rodriguez KL, Garrigues SK, Manusov JRE, Tulsky JA. How do non-physician clinicians respond to advanced cancer patients' negative expressions of emotions? Support Care Cancer. 2011 Jan;19(1):155–159.
Journal cover image

Published In

Support Care Cancer

DOI

EISSN

1433-7339

Publication Date

January 2011

Volume

19

Issue

1

Start / End Page

155 / 159

Location

Germany

Related Subject Headings

  • Tape Recording
  • Professional-Patient Relations
  • Oncology & Carcinogenesis
  • Neoplasms
  • Male
  • Humans
  • Female
  • Fear
  • Empathy
  • Emotions