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Continue to app. In addition, the division between instrumental and affective communication is somewhat artificial and not always evident, i. Secondly, we focused on positive expressions by HCPs. We did not code a lack of expressions, e. Moreover, as we only coded verbal affective communication, the HCPs may possibly have used affective expressions non-verbally. Their reactions also depend on the non-verbal expressions of their patients, who were not visible.
This could have influenced their behavior. They were, however, unaware of the specific focus on instrumental and affective communication. This might be related to the fact that patients with limited health literacy often hide the fact that they do not understand health information because they are ashamed [ 12 , 38 ].
These patients were included based on the opinion of the HCP, which could have biased our population. Fifthly, the coded video-recorded consultations were snapshots of daily practice.
It is possible that topics that were not discussed in the recorded consultation had already been discussed in a previous consultation or would be discussed in a future one. Because of the small sample size, it was not possible to look at differences between male and female patients, between the individual HCPs, between first and follow-up consultations, or between patients with cancer or COPD.
However, these differences could have influenced the instrumental and affective communication of the HCPs. For instance, previous research has shown that oncologists think the definitions of reassurance and hope overlap to some extent [ 39 ]. Future research could focus on the appropriate amount and quality of information provision and affective communication according to both LHL patients in palliative care and HCPs.
To adapt the communication to LHL patients in palliative care, HCPs could reduce their wordiness and simplify their language, reduce the amount of information, use the teach-back technique and pay attention to affective communication. Health promoting effects of the physician-patient encounter. Psychol Health Med. Article Google Scholar. J Clin Oncol.
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We also thank Wietske van der Hoeven for collecting the video-recordings and Tessera Translations Mike Wilkinson for the language editing. You can also search for this author in PubMed Google Scholar. JN and LS contributed equally. JN participated in the design of the study, carried out the reliability analysis and the interpretation of the data and wrote the first draft of the paper.
LS carried out the coding and analysis, the modeling of the data and wrote the first draft of the paper. RR collected the data, helped interpret the data and helped draft the paper. SvD participated in the design of the study, the interpretation of the data and helped draft the paper.
All authors read and approved the final manuscript. Correspondence to Janneke Noordman. The Arnhem-Nijmegen Medical Research Ethics Committee — ruled that no formal ethics approval was required in this particular case.
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Reprints and Permissions. Noordman, J. Instrumental and affective communication with patients with limited health literacy in the palliative phase of cancer or COPD. BMC Palliat Care 19, Download citation. Received : 03 June Accepted : 24 September Published : 07 October Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative.
Skip to main content. Search all BMC articles Search. Download PDF. Methods In , consultations between LHL patients in the palliative phase of cancer or COPD and their healthcare providers were video-recorded in four hospitals in the Netherlands. Tubular Bells entered the Top 10 and stayed in the album charts for five years straight, and went on to sell over 20m albums. With nine musicians re-creating the studio album recorded with 20 instruments to a click-track, synchronised to acrobats, the DiGiCo SD7 fader banks had over input channels including — naturally — a massive array of percussion instruments.
With so many instrument changes, all the band were provided with stereo IEM mixes from the monitor DiGiCo SD7, except for pianist Dominic Ferris, who preferred to hear his piano acoustically so sported one mono, hard-wired earpiece plus a Genelec speaker to augment his sound.
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