Negative emotions in cancer care: Do oncologists' responses depend on severity and type of emotion?
Negative emotions in cancer care: Do oncologists' responses depend on severity and type of emotion?
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DOI：
10.1016/j.pec.2008.10.003
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发表时间：
2009-07-01
影响因子：
3.5
通讯作者：
Tulsky, James A.
中科院分区：
文献类型：
--
作者：
Kennifer, Sarah L.;Alexander, Stewart C.;Tulsky, James A.
目的：研究患者负面情绪的类型和严重程度如何影响肿瘤科医生的反应和随后的对话。方法：我们分析了晚期癌症患者与其肿瘤科医生之间的 264 段录音对话。对话根据患者的负面情绪表达进行编码，并按情绪类型和严重程度进行分类。肿瘤科医生的反应被编码为使用移情语言或阻止和疏远方法。结果：患者表现出恐惧的频率多于愤怒或悲伤；披露的严重程度通常是中等的。肿瘤学家用共情语言对 35% 的负面情绪表露做出了回应。当患者表现出强烈的情绪时，他们最具同理心。对患者的情绪表露做出同理心的反应使讨论时间平均仅延长了 21 秒。 结论：对严重情绪的反应率较高，这表明当患者更强烈地表达负面情绪时，肿瘤学家可能会更好地识别负面情绪。肿瘤科医生对患者的恐惧反应最不敏感，而对悲伤的反应则表现出最大的同理心。实践意义：肿瘤科医生可能会从额外的识别负面情绪的培训中受益，即使负面情绪的表现并不强烈。教导癌症患者更好地表达他们的情感担忧也可以增强患者与肿瘤科医生的沟通。 (c) 2008 Elsevier Ireland Ltd. 保留所有权利。
Objective: To examine how type and severity of patients' negative emotions influence oncologists' responses and subsequent conversations.Methods: We analyzed 264 audio-recorded conversations between advanced cancer patients and their oncologists. Conversations were coded for patients' expressions of negative emotion, which were categorized by type of emotion and severity. Oncologists' responses were coded as using either empathic language or blocking and distancing approaches.Results: Patients presented fear more often than anger or sadness; severity of disclosures was most often moderate. Oncologists responded to 35% of these negative emotional disclosures with empathic language. They were most empathic when patients presented intense emotions. Responding empathically to patients' emotional disclosures lengthened discussions by an average of only 21 s.Conclusion: Greater response rates to severe emotions suggest oncologists may recognize negative emotions better when patients express them more intensely. Oncologists were least responsive to patient fear and responded with greatest empathy to sadness.Practice implications: Oncologists may benefit from additional training to recognize negative emotions, even when displayed without intensity. Teaching cancer patients to better articulate their emotional concerns may also enhance patient-oncologist communication. (c) 2008 Elsevier Ireland Ltd. All rights reserved.