Emotional concerns in follow-up consultations between paediatric oncologists and adolescent survivors: a video-based observational study

Psychooncology. 2014 Dec;23(12):1365-72. doi: 10.1002/pon.3568. Epub 2014 May 5.

Abstract

Objective: The present study aimed to explore (a) to what extent adolescent cancer survivors express emotional concerns during follow-up consultations, (b) the content of these expressions, and (c) the responses to their concerns by the paediatric haemato-oncologists (oncologists).

Methods: Sixty-six follow-up consultations between adolescent patients (aged 12-20 years old; mean = 16) and oncologists (n = 10) were video recorded. Emotional concerns were coded using the Verona coding definitions of emotional sequences (VR-CoDES). The content of the concerns was analysed using thematic analysis.

Results: Emotional concerns (n = 115) were identified in 50% of the consultations. Of the concerns, 87% were expressed implicitly as hints to the underlying emotion (cues) rather than explicitly (concerns). The oncologists elicited 66.9% of these expressions. Four main categories of emotional concerns were identified in the thematic analysis: physical (31%), psychological (29%), social (17%), and cancer related (23%). The majority (76.5%) of the oncologists' responses to the cues and/or concerns provided space for further disclosure. The oncologists responded less explicitly to the emotional aspects of physical and cancer-related issues in comparison with the cues or concerns of psychological origin. More cues and concerns were expressed when parents were not present in the consultation.

Conclusions: In this study, almost half of the adolescent patients presented emotional concerns, and a subgroup presented many concerns; these were mainly expressed when initiated by the oncologists. Oncologists should therefore be attentive to hints to underlying emotions to help the adolescent bring forward his or her concerns.

Keywords: cancer; clinician-patient relationship; communication; emotion; oncology.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Cues
  • Emotions*
  • Female
  • Humans
  • Leukemia / psychology*
  • Lymphoma / psychology*
  • Male
  • Medical Oncology*
  • Middle Aged
  • Physician-Patient Relations*
  • Qualitative Research
  • Survivors / psychology*
  • Video Recording
  • Young Adult