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Cue-responding behaviours of oncology nurses in video-simulated interviews.

Uitterhoeve R, de Leeuw J, Bensing J, Heaven C, Borm G, Demulder P, van Achterberg T

Centre for Quality of Care Research, Nursing Science, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. r.uitterhoeve@cis.umcn.nl

AIM: This paper is a report of a study to describe nurse-patient interactions, i.e. nurses' cue-responding behaviour in encounters with actors playing the role of patients. BACKGROUND: Patients with cancer seldom express their concerns directly but express cues instead. Few studies empirically investigated nurses' cue-responding behaviour and the subsequent influence of disclosure of cues and concerns. METHODS: In this descriptive observational study, conducted from April to June 2004, five oncology nurses interviewed an actor playing the role of a patient with cancer. Each nurse performed seven different interviews (n = 35); these were videotaped and subsequently rated for cue-responding using the Medical Interview Aural Rating Scale. Mixed model analysis was used to investigate the relation between cues and cue-responding. FINDINGS: Half of the patients' cues were responded to with distancing behaviours. The other half of the cues were either explored (33%) or acknowledged (17%). In 16% of these responses, nurses used open directive questions. One out of four open directive questions were used as a distancing response, suggesting that open directive questions are not used to explore or acknowledge cues of patients. Cue-responding influenced subsequent expression of concerns and emotions, i.e. disclosure of a concern is two times higher after exploration or acknowledging of a preceding cue than after a distancing response. CONCLUSION: Cue-responding is a valuable concept which can contribute to our understanding of optimal ways of communicating. Cue-responding behaviour facilitates the disclosure of worries and concerns of patients. Further research is needed to assess the clinical relevancy of cue-responding.

Published 4 January 2008 in J Adv Nurs, 61(1): 71-80.
Full-text of this article is available online (may require subscription).

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