caa a22 4500 60618354X CHVBK 20210128100821.0 cr unu---uuuuu 210128e20150901xx s 000 0 eng 10.1007/s00405-014-3209-x doi (NATIONALLICENCE)springer-10.1007/s00405-014-3209-x How head and neck consultants manage patients' emotional distress during cancer follow-up consultations: a multilevel study [Elektronische Daten] [Yuefang Zhou, Gerry Humphris, Naseem Ghazali, Simon Friderichs, David Grosset, Simon Rogers] Head and neck cancer (HNC) patients suffer substantial emotional problems. This study aimed to explore how utterance-level variables (source, type and timing of emotional cues) and patient-level variables (e.g. age, gender and emotional well-being) relate to consultants' responses (i.e. reducing or providing space) to patient expressions of emotional distress. Forty-three HNC outpatient follow-up consultations were audio recorded and coded, for patients' expressions of emotional distress and consultants' responses, using the Verona Coding Definitions of Emotional Sequence. Multilevel logistic regression modelled the probability of the occurrence of consultant-reduced space response as a function of patient distress cue expression, controlling for consultation and patient-related variables. An average of 3.5 cues/concerns (range 1-20) was identified per consultation where 84 out of 152 total cues/concerns were responded by reducing space. Cue type did not impact on response; likewise for the quality of patient emotional well-being. However, consultants were more likely to reduce space to cues elicited by patients, as opposed to those initiated by themselves. This reduced space response was more pronounced as the consultation continued. However, about 6min into the consultation, this effect (i.e. tendency to block patients) started to weaken. Head and neck consultants' responses to negative emotions depended on source and timing of patient emotional expressions. The findings are useful for training programme development to encourage consultants to be more flexible and open in the early stages of the consultation. Springer-Verlag Berlin Heidelberg, 2014 Head and neck cancer nationallicence Emotional distress nationallicence The VR-CoDES nationallicence Multilevel nationallicence HNC : Head and neck cancer nationallicence NICE : National Institute for Clinical Excellence nationallicence OSCE : Objective and structured clinical examination nationallicence VR-CoDES : Verona Coding Definitions of Emotional Sequence nationallicence QoL : Quality of life nationallicence PCI : Patient concerns inventory nationallicence Zhou Yuefang School of Medicine, University of St Andrews, St Andrews, Fife, KY16 9TF, St Andrews, Scotland, UK aut Humphris Gerry School of Medicine, University of St Andrews, St Andrews, Fife, KY16 9TF, St Andrews, Scotland, UK aut Ghazali Naseem Oral and Maxillofacial Surgery, Aintree University Hospital, L9 7AL, Liverpool, UK aut Friderichs Simon School of Medicine, University of St Andrews, St Andrews, Fife, KY16 9TF, St Andrews, Scotland, UK aut Grosset David School of Medicine, University of St Andrews, St Andrews, Fife, KY16 9TF, St Andrews, Scotland, UK aut Rogers Simon Oral and Maxillofacial Surgery, Aintree University Hospital, L9 7AL, Liverpool, UK aut European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/9(2015-09-01), 2473-2481 0937-4477 272:9<2473 2015 272 405 https://doi.org/10.1007/s00405-014-3209-x text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00405-014-3209-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Zhou Yuefang School of Medicine, University of St Andrews, St Andrews, Fife, KY16 9TF, St Andrews, Scotland, UK aut NATIONALLICENCE 700 1- Humphris Gerry School of Medicine, University of St Andrews, St Andrews, Fife, KY16 9TF, St Andrews, Scotland, UK aut NATIONALLICENCE 700 1- Ghazali Naseem Oral and Maxillofacial Surgery, Aintree University Hospital, L9 7AL, Liverpool, UK aut NATIONALLICENCE 700 1- Friderichs Simon School of Medicine, University of St Andrews, St Andrews, Fife, KY16 9TF, St Andrews, Scotland, UK aut NATIONALLICENCE 700 1- Grosset David School of Medicine, University of St Andrews, St Andrews, Fife, KY16 9TF, St Andrews, Scotland, UK aut NATIONALLICENCE 700 1- Rogers Simon Oral and Maxillofacial Surgery, Aintree University Hospital, L9 7AL, Liverpool, UK aut NATIONALLICENCE 773 0- European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/9(2015-09-01), 2473-2481 0937-4477 272:9<2473 2015 272 405