BACKGROUND: Seriously ill hospitalized patients and their loved ones are frequently faced with complex treatment decisions laden with expressions of emotional distress during palliative care (PC) consultations. Little is known about these emotional expressions or the compassionate responses providers make and how common these are in PC decision-making conversations. OBJECTIVES: To describe the types and frequency of emotional distress that patients and loved ones express and how providers respond to these emotions during PC decision-making consultations with seriously ill hospitalized patients. METHODS: We used a quantitative descriptive approach to analyze 71 audio-recorded inpatient PC decision-making consultations for emotional distress and clinicians' responses to those emotions using reliable and established methods. RESULTS: A total of 69% of conversations contained at least one expression of emotional distress. The per-conversation frequency of expressions of emotional distress ranged from 1 to 10. Anxiety/fear were the most frequently encountered emotions (48.4%) followed by sadness (35.5%) and anger/frustration (16.1%). More than half of the emotions related to the patient's feelings (53.6%) and 41.9% were related to the loved ones' own emotions. The majority of emotions were moderate in intensity (65.8%) followed by strong (20.7%) and mild (13.5%). Clinicians responded to a majority of emotions with a compassionate response (75.7%) followed by those with medical content (21.9%) and very few were ignored (1.3%). CONCLUSIONS: Expressions of emotional distress are common during PC consultations and are usually met with compassionate responses by the clinician.
BACKGROUND: Seriously ill hospitalized patients and their loved ones are frequently faced with complex treatment decisions laden with expressions of emotional distress during palliative care (PC) consultations. Little is known about these emotional expressions or the compassionate responses providers make and how common these are in PC decision-making conversations. OBJECTIVES: To describe the types and frequency of emotional distress that patients and loved ones express and how providers respond to these emotions during PC decision-making consultations with seriously ill hospitalized patients. METHODS: We used a quantitative descriptive approach to analyze 71 audio-recorded inpatient PC decision-making consultations for emotional distress and clinicians' responses to those emotions using reliable and established methods. RESULTS: A total of 69% of conversations contained at least one expression of emotional distress. The per-conversation frequency of expressions of emotional distress ranged from 1 to 10. Anxiety/fear were the most frequently encountered emotions (48.4%) followed by sadness (35.5%) and anger/frustration (16.1%). More than half of the emotions related to the patient's feelings (53.6%) and 41.9% were related to the loved ones' own emotions. The majority of emotions were moderate in intensity (65.8%) followed by strong (20.7%) and mild (13.5%). Clinicians responded to a majority of emotions with a compassionate response (75.7%) followed by those with medical content (21.9%) and very few were ignored (1.3%). CONCLUSIONS: Expressions of emotional distress are common during PC consultations and are usually met with compassionate responses by the clinician.
Authors: Stewart C Alexander; Kathryn I Pollak; Perri A Morgan; Justine Strand; Amy P Abernethy; Amy S Jeffreys; Robert M Arnold; Maren Olsen; Keri L Rodriguez; Sarah K Garrigues; Justin R E Manusov; James A Tulsky Journal: Support Care Cancer Date: 2010-09-04 Impact factor: 3.603
Authors: Sarah L Kennifer; Stewart C Alexander; Kathryn I Pollak; Amy S Jeffreys; Maren K Olsen; Keri L Rodriguez; Robert M Arnold; James A Tulsky Journal: Patient Educ Couns Date: 2008-11-28
Authors: Wendy G Anderson; Stewart C Alexander; Keri L Rodriguez; Amy S Jeffreys; Maren K Olsen; Kathryn I Pollak; James A Tulsky; Robert M Arnold Journal: Support Care Cancer Date: 2007-10-25 Impact factor: 3.603
Authors: Kathryn I Pollak; Robert M Arnold; Amy S Jeffreys; Stewart C Alexander; Maren K Olsen; Amy P Abernethy; Celette Sugg Skinner; Keri L Rodriguez; James A Tulsky Journal: J Clin Oncol Date: 2007-12-20 Impact factor: 44.544
Authors: Katharine L Cheung; Samantha Smoger; Manjula Kurella Tamura; Renee D Stapleton; Terry Rabinowitz; Michael A LaMantia; Robert Gramling Journal: J Palliat Med Date: 2022-03-04 Impact factor: 2.947
Authors: Elise C Tarbi; Robert Gramling; Christine Bradway; Elizabeth G Broden; Salimah H Meghani Journal: J Palliat Med Date: 2021-02-02 Impact factor: 2.947
Authors: Shane Sinclair; Jill M Norris; Shelagh J McConnell; Harvey Max Chochinov; Thomas F Hack; Neil A Hagen; Susan McClement; Shelley Raffin Bouchal Journal: BMC Palliat Care Date: 2016-01-19 Impact factor: 3.234
Authors: Robert Gramling; Elizabeth Gajary-Coots; Susan Stanek; Nathalie Dougoud; Heather Pyke; Marie Thomas; Jenica Cimino; Mechelle Sanders; Stewart C Alexander; Ronald Epstein; Kevin Fiscella; David Gramling; Susan Ladwig; Wendy Anderson; Stephen Pantilat; Sally A Norton Journal: BMC Palliat Care Date: 2015-08-19 Impact factor: 3.234