title: Applying the Verona coding definitions of emotional sequences (VR-CoDES) in the dental context involving patients with complex communication needs: An exploratory study.
abstract: OBJECTIVE
  The VR-CoDES has been previously applied in the dental context. However, we know little about how dental patients with intellectual disabilities (ID) and complex communication needs express their emotional distress during dental visits. This is the first study explored the applicability of the VR-CoDES to a dental context involving patients with ID.
  
  
  METHODS
  Fourteen dental consultations were video recorded and coded using the VR-CoDES, assisted with the additional guidelines for the VR-CoDES in a dental context. Both inter- and intra-coder reliabilities were checked on the seven consultations where cues were observed.
  
  
  RESULTS
  Sixteen cues (eight non-verbal) were identified within seven of the 14 consultations. Twenty responses were observed (12 reducing space) with four multiple responses. Cohen's Kappa were 0.76 (inter-coder) and 0.88 (intra-coder).
  
  
  CONCLUSIONS
  With the additional guidelines, cues and responses were reliably identified. Cue expression was exhibited by non-verbal expression of emotion with people with ID in the literature. Further guidance is needed to improve the coding accuracy on multiple providers' responses and to investigate potential impacts of conflicting responses on patients.
  
  
  CONCLUSIONS
  The findings provided a useful initial step towards an ongoing exploration of how healthcare providers identify and manage emotional distress of patients with ID.
authors.affiliation: School of Medicine, University of St Andrews, St Andrews, UK. Electronic address: yz10@st-andrews.ac.uk.
authors.forename: Yuefang
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: School of Computing, University of Dundee, Dundee, UK.
authors.forename: Rolf
authors.initials: R
authors.lastname: Black
authors.affiliation: School of Dentistry, University of Dundee, Dundee, UK.
authors.forename: Ruth
authors.initials: R
authors.lastname: Freeman
authors.affiliation: School of Computing, University of Dundee, Dundee, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Herron
authors.affiliation: School of Medicine, University of St Andrews, St Andrews, UK.
authors.forename: Gerry
authors.initials: G
authors.lastname: Humphris
authors.affiliation: School of Computing, University of Dundee, Dundee, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Menzies
authors.affiliation: School of Dentistry, University of Dundee, Dundee, UK.
authors.forename: Sandra
authors.initials: S
authors.lastname: Quinn
authors.affiliation: School of Computing, University of Dundee, Dundee, UK.
authors.forename: Lesley
authors.initials: L
authors.lastname: Scott
authors.affiliation: School of Computing, University of Dundee, Dundee, UK.
authors.forename: Annalu
authors.initials: A
authors.lastname: Waller
mesh_terms: D000293:Adolescent; D000328:Adult; D059019:Clinical Coding / Q000379:methods; D003142:Communication; D003463:Cues; D003812:Dentist-Patient Relations; D004644:Emotions; D005260:Female; D006801:Humans; D008607:Intellectual Disability; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012017:Referral and Consultation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014743:Videotape Recording; D055815:Young Adult
keywords: Dental patients; Emotional distress; Intellectual disabilities; The VR-CoDES