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

Authors

  • Ruud Uitterhoeve,

    1. Ruud Uitterhoeve MScN RN Researcher Centre for Quality of Care Research, Nursing Science, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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  • Jacqueline De Leeuw,

    1. Jacqueline de Leeuw MScN RN Researcher Neurosensoric Cluster, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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  • Jozien Bensing,

    1. Jozien Bensing PhD Professor of Clinical and Health Psychology Department of Health Psychology, Utrecht University and Netherlands Institute for Health Services Research, Utrecht, The Netherlands
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  • Cathy Heaven,

    1. Cathy Heaven PhD RN Researcher and Communication Skills Tutor Maguire Communication Skills Training Unit, Christie Hospital, Manchester, UK
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  • George Borm,

    1. George Borm PhD Associate Professor in Statistics Department of Epidemiology and Biostatistics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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  • Pieter DeMulder,

    1. Pieter deMulder (deceased) MD PhD Professor Medical Oncology Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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  • Theo Van Achterberg

    1. Theo van Achterberg PhD RN Professor Nursing Science Centre for Quality of Care Research, Nursing Science, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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R. Uitterhoeve: e-mail: r.uitterhoeve@cis.umcn.nl

Abstract

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

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.

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