title: Coding patient emotional cues and concerns in medical consultations: the Verona coding definitions of emotional sequences (VR-CoDES).
abstract: OBJECTIVE
  To present the Verona Coding Definitions of Emotional Sequences (VR-CoDES CC), a consensus based system for coding patient expressions of emotional distress in medical consultations, defined as Cues or Concerns.
  
  
  METHODS
  The system was developed by an international group of communication researchers. First, consensus was reached in different steps. Second, a reliability study was conducted on 20 psychiatric consultations.
  
  
  RESULTS
  A Cue is defined as a verbal or non-verbal hint which suggests an underlying unpleasant emotion that lacks clarity. A Concern is defined as a clear and unambiguous expression of an unpleasant current or recent emotion that is explicitly verbalized with or without a stated issue of importance. The conceptual framework sets precise criteria for cues and concerns and for whom (health provider or patient) elicits the cue/concern. Inter-rater reliability proved satisfactory (agreement 81.5%, Cohen's Kappa 0.70).
  
  
  CONCLUSIONS
  The VR-CoDES CC will facilitate comparative research on provider-patient communication sequences in which patients express emotional distress.
  
  
  CONCLUSIONS
  The VR-CoDES CC may be used to help clinicians in recognizing or facilitating cues and concerns, thereby improving the recognition of patients' emotional distress, the therapeutic alliance and quality of care for these patients.
authors.affiliation: Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy. christa.zimmermann@univr.it
authors.forename: Christa
authors.initials: C
authors.lastname: Zimmermann
authors.forename: Lidia
authors.initials: L
authors.lastname: Del Piccolo
authors.forename: Jozien
authors.initials: J
authors.lastname: Bensing
authors.forename: Svein
authors.initials: S
authors.lastname: Bergvik
authors.forename: Hanneke
authors.initials: H
authors.lastname: De Haes
authors.forename: Hilde
authors.initials: H
authors.lastname: Eide
authors.forename: Ian
authors.initials: I
authors.lastname: Fletcher
authors.forename: Claudia
authors.initials: C
authors.lastname: Goss
authors.forename: Cathy
authors.initials: C
authors.lastname: Heaven
authors.forename: Gerry
authors.initials: G
authors.lastname: Humphris
authors.forename: Young-Mi
authors.initials: YM
authors.lastname: Kim
authors.forename: Wolf
authors.initials: W
authors.lastname: Langewitz
authors.forename: Ludwien
authors.initials: L
authors.lastname: Meeuwesen
authors.forename: Matthias
authors.initials: M
authors.lastname: Nuebling
authors.forename: Michela
authors.initials: M
authors.lastname: Rimondini
authors.forename: Peter
authors.initials: P
authors.lastname: Salmon
authors.forename: Sandra
authors.initials: S
authors.lastname: van Dulmen
authors.forename: Larry
authors.initials: L
authors.lastname: Wissow
authors.forename: Linda
authors.initials: L
authors.lastname: Zandbelt
authors.forename: Arnstein
authors.initials: A
authors.lastname: Finset
mesh_terms: D001007:Anxiety / Q000523:psychology; D003142:Communication; D003210:Concept Formation; D032921:Consensus; D003463:Cues; D004644:Emotions; D004645:Empathy; D006801:Humans; D010817:Physician-Patient Relations; D010865:Pilot Projects; D012017:Referral and Consultation; D015203:Reproducibility of Results; D014743:Videotape Recording