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Table 1 Items for coding HCPs’ instrumental communication (a) and affective communication (b) during consultations with LHL patients in the palliative phase of cancer or COPD

From: Instrumental and affective communication with patients with limited health literacy in the palliative phase of cancer or COPD

a. Instrumental communication Definition Examples (as defined a priori)
1. Assessment of patients’ understanding of their disease The HCP asks questions about the provided information, to see if the patient understood. Including the teach-back method. “Do you understand what I just said?”
“Could you maybe explain …”
2. Assessment of patient priorities The HCP assesses and/or mentions the priorities and preferences of the patient. “I’d like to know what’s important for you.”
“I can imagine that you’d like to continue your swimming, wouldn’t you?”
3. Provision of information about current medical status The HCP gives medical information and explains it to the patient. “As we can see on the CT scan …”
“Comparing these results with the last time …”
4. Discussion of information about treatment options The HCP suggests one or more possible treatment options and explains them. “Starting chemotherapy would be one possibility.”
“I’ll explain the treatment options to you.”
5. Discussion of information about treatment consequences The HCP discusses the consequences of a treatment, e.g. the side effects. “It’s possible that you will feel nauseous after taking these medicines.”
6. Discussion of prognosis The HCP discusses the expectations of the course of the disease within a certain time frame. “The illness will probably become more active over time.”
“These medicines will have an effect within three weeks.”
7. Giving information about emotional distress The HCP gives information about the effect on emotions. “It’s possible that you will feel lonely.”
“Your situation may also influence your mental wellness.”
b. Affective communication Definition Example
1. Hope The HCP sheds highlights the positive aspects of the situation. “That looks very good!”
2. Support The HCP emphasizes that the patient is not alone. “We’ll do this together.”
3. Reassurance The HCP tries to make the patient feel at ease. “Don’t worry about that.”
4. Empathy The HCP shows that he or she understands the patients’ situation. “I can imagine that you are afraid, going through all this.”
5. Appreciation The HCP shows that he or she appreciates the patient as a person/being. “I really do respect the way you’re keeping going.”
6. Emotional coping The HCP asks how the patient deals with their emotional distress. “And what’s your response to this unpleasant situation?”
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