Brandes, K., Van der Goot, M.J., Smit, E.G., Van Weert, J.C.M., & Linn, A.J. (2017). Understanding the interplay of cancer patients’ instrumental concerns and emotions. Patient Education and Counseling, 100, 839-845. doi 10.1016/j.pec.2017.02.002

Objectives: 1) to assess patients’ descriptions of concerns, and 2) to inform a conceptual framework in which the impact of the nature of concerns on doctor-patient communication is specified.
Methods: Six focus groups were conducted with 39 cancer patients and survivors. In these focus groups participants were asked to describe their concerns during and after their illness.
Results: Concerns were described as instrumental concerns (e.g., receiving insufficient information) and emotions (e.g., sadness). Patients frequently explained their concerns as an interplay of instrumental concerns and emotions. Examples of the interplay were “receiving incorrect information” and “frustration”, and “difficulties with searching, finding and judging of information” and “fear”.
Conclusion: Instrumental concerns need to be taken into account in the operationalization of concerns in research. Based on the interplay, the conceptual framework suggests that patients can express instrumental concerns as emotions and emotions as instrumental concerns. Consequently, providers can respond with instrumental and emotional communication when patients express an interplay of concerns.
Practice implications: The results of this study can be used to support providers in recognizing concerns that are expressed by patients in consultations.

Keywords: Concerns; Emotions; Cancer patients; Doctor-patient communication; Focus groups; Stress-coping model

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