Emotional distress and compassionate responses in palliative care decision-making consultations

Stewart C. Alexander, Susan Ladwig, Sally A. Norton, David J Gramling, J. Kelly Davis, Maureen Metzger, Jane Deluca, Robert Gramling

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Seriously ill hospitalized patients and their loved ones are frequently faced with complex treatment decisions laden with expressions of emotional distress during palliative care (PC) consultations. Little is known about these emotional expressions or the compassionate responses providers make and how common these are in PC decision-making conversations. Objectives: To describe the types and frequency of emotional distress that patients and loved ones express and how providers respond to these emotions during PC decision-making consultations with seriously ill hospitalized patients. Methods: We used a quantitative descriptive approach to analyze 71 audio-recorded inpatient PC decision-making consultations for emotional distress and clinicians' responses to those emotions using reliable and established methods. Results: A total of 69% of conversations contained at least one expression of emotional distress. The per-conversation frequency of expressions of emotional distress ranged from 1 to 10. Anxiety/fear were the most frequently encountered emotions (48.4%) followed by sadness (35.5%) and anger/frustration (16.1%). More than half of the emotions related to the patient's feelings (53.6%) and 41.9% were related to the loved ones' own emotions. The majority of emotions were moderate in intensity (65.8%) followed by strong (20.7%) and mild (13.5%). Clinicians responded to a majority of emotions with a compassionate response (75.7%) followed by those with medical content (21.9%) and very few were ignored (1.3%). Conclusions: Expressions of emotional distress are common during PC consultations and are usually met with compassionate responses by the clinician.

Original languageEnglish (US)
Pages (from-to)579-584
Number of pages6
JournalJournal of Palliative Medicine
Volume17
Issue number5
DOIs
StatePublished - May 1 2014

Fingerprint

Palliative Care
Decision Making
Emotions
Referral and Consultation
Frustration
Anger
Fear
Inpatients
Anxiety

ASJC Scopus subject areas

  • Medicine(all)
  • Anesthesiology and Pain Medicine
  • Nursing(all)

Cite this

Emotional distress and compassionate responses in palliative care decision-making consultations. / Alexander, Stewart C.; Ladwig, Susan; Norton, Sally A.; Gramling, David J; Davis, J. Kelly; Metzger, Maureen; Deluca, Jane; Gramling, Robert.

In: Journal of Palliative Medicine, Vol. 17, No. 5, 01.05.2014, p. 579-584.

Research output: Contribution to journalArticle

Alexander, SC, Ladwig, S, Norton, SA, Gramling, DJ, Davis, JK, Metzger, M, Deluca, J & Gramling, R 2014, 'Emotional distress and compassionate responses in palliative care decision-making consultations', Journal of Palliative Medicine, vol. 17, no. 5, pp. 579-584. https://doi.org/10.1089/jpm.2013.0551
Alexander, Stewart C. ; Ladwig, Susan ; Norton, Sally A. ; Gramling, David J ; Davis, J. Kelly ; Metzger, Maureen ; Deluca, Jane ; Gramling, Robert. / Emotional distress and compassionate responses in palliative care decision-making consultations. In: Journal of Palliative Medicine. 2014 ; Vol. 17, No. 5. pp. 579-584.
@article{78216ad424934d2d8e3471e484403935,
title = "Emotional distress and compassionate responses in palliative care decision-making consultations",
abstract = "Background: Seriously ill hospitalized patients and their loved ones are frequently faced with complex treatment decisions laden with expressions of emotional distress during palliative care (PC) consultations. Little is known about these emotional expressions or the compassionate responses providers make and how common these are in PC decision-making conversations. Objectives: To describe the types and frequency of emotional distress that patients and loved ones express and how providers respond to these emotions during PC decision-making consultations with seriously ill hospitalized patients. Methods: We used a quantitative descriptive approach to analyze 71 audio-recorded inpatient PC decision-making consultations for emotional distress and clinicians' responses to those emotions using reliable and established methods. Results: A total of 69{\%} of conversations contained at least one expression of emotional distress. The per-conversation frequency of expressions of emotional distress ranged from 1 to 10. Anxiety/fear were the most frequently encountered emotions (48.4{\%}) followed by sadness (35.5{\%}) and anger/frustration (16.1{\%}). More than half of the emotions related to the patient's feelings (53.6{\%}) and 41.9{\%} were related to the loved ones' own emotions. The majority of emotions were moderate in intensity (65.8{\%}) followed by strong (20.7{\%}) and mild (13.5{\%}). Clinicians responded to a majority of emotions with a compassionate response (75.7{\%}) followed by those with medical content (21.9{\%}) and very few were ignored (1.3{\%}). Conclusions: Expressions of emotional distress are common during PC consultations and are usually met with compassionate responses by the clinician.",
author = "Alexander, {Stewart C.} and Susan Ladwig and Norton, {Sally A.} and Gramling, {David J} and Davis, {J. Kelly} and Maureen Metzger and Jane Deluca and Robert Gramling",
year = "2014",
month = "5",
day = "1",
doi = "10.1089/jpm.2013.0551",
language = "English (US)",
volume = "17",
pages = "579--584",
journal = "Journal of Palliative Medicine",
issn = "1096-6218",
publisher = "Mary Ann Liebert Inc.",
number = "5",

}

TY - JOUR

T1 - Emotional distress and compassionate responses in palliative care decision-making consultations

AU - Alexander, Stewart C.

AU - Ladwig, Susan

AU - Norton, Sally A.

AU - Gramling, David J

AU - Davis, J. Kelly

AU - Metzger, Maureen

AU - Deluca, Jane

AU - Gramling, Robert

PY - 2014/5/1

Y1 - 2014/5/1

N2 - Background: Seriously ill hospitalized patients and their loved ones are frequently faced with complex treatment decisions laden with expressions of emotional distress during palliative care (PC) consultations. Little is known about these emotional expressions or the compassionate responses providers make and how common these are in PC decision-making conversations. Objectives: To describe the types and frequency of emotional distress that patients and loved ones express and how providers respond to these emotions during PC decision-making consultations with seriously ill hospitalized patients. Methods: We used a quantitative descriptive approach to analyze 71 audio-recorded inpatient PC decision-making consultations for emotional distress and clinicians' responses to those emotions using reliable and established methods. Results: A total of 69% of conversations contained at least one expression of emotional distress. The per-conversation frequency of expressions of emotional distress ranged from 1 to 10. Anxiety/fear were the most frequently encountered emotions (48.4%) followed by sadness (35.5%) and anger/frustration (16.1%). More than half of the emotions related to the patient's feelings (53.6%) and 41.9% were related to the loved ones' own emotions. The majority of emotions were moderate in intensity (65.8%) followed by strong (20.7%) and mild (13.5%). Clinicians responded to a majority of emotions with a compassionate response (75.7%) followed by those with medical content (21.9%) and very few were ignored (1.3%). Conclusions: Expressions of emotional distress are common during PC consultations and are usually met with compassionate responses by the clinician.

AB - Background: Seriously ill hospitalized patients and their loved ones are frequently faced with complex treatment decisions laden with expressions of emotional distress during palliative care (PC) consultations. Little is known about these emotional expressions or the compassionate responses providers make and how common these are in PC decision-making conversations. Objectives: To describe the types and frequency of emotional distress that patients and loved ones express and how providers respond to these emotions during PC decision-making consultations with seriously ill hospitalized patients. Methods: We used a quantitative descriptive approach to analyze 71 audio-recorded inpatient PC decision-making consultations for emotional distress and clinicians' responses to those emotions using reliable and established methods. Results: A total of 69% of conversations contained at least one expression of emotional distress. The per-conversation frequency of expressions of emotional distress ranged from 1 to 10. Anxiety/fear were the most frequently encountered emotions (48.4%) followed by sadness (35.5%) and anger/frustration (16.1%). More than half of the emotions related to the patient's feelings (53.6%) and 41.9% were related to the loved ones' own emotions. The majority of emotions were moderate in intensity (65.8%) followed by strong (20.7%) and mild (13.5%). Clinicians responded to a majority of emotions with a compassionate response (75.7%) followed by those with medical content (21.9%) and very few were ignored (1.3%). Conclusions: Expressions of emotional distress are common during PC consultations and are usually met with compassionate responses by the clinician.

UR - http://www.scopus.com/inward/record.url?scp=84900318335&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84900318335&partnerID=8YFLogxK

U2 - 10.1089/jpm.2013.0551

DO - 10.1089/jpm.2013.0551

M3 - Article

C2 - 24588656

AN - SCOPUS:84900318335

VL - 17

SP - 579

EP - 584

JO - Journal of Palliative Medicine

JF - Journal of Palliative Medicine

SN - 1096-6218

IS - 5

ER -