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
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?” |