Background Communication is a cornerstone in nursing. Research on nurse–patient communication faces well-known challenges, as encounters are dynamic, context-dependent, and shaped by subtle verbal and non-verbal cues. Capturing this complexity requires rigorous observational approaches, of which audio and video recordings are key methods, enabling documentation of communication as it unfolds in practice. However, collecting such data in clinical settings involves significant methodological and ethical considerations. Objective The aim of this paper is to provide guidance for methodological rigor in data collection using audio or video recordings when observing clinical communication in patient encounters. Information sources This discussion paper draws on theory and previous empirical research on communication in clinical patient encounters using data collected with audio and video recordings. Results The practical guidance is structured into five key areas spanning the data collection process: (1) planning and preparation, (2) audio versus video recordings, (3) ethical and legal concerns, (4) information and recruitment, and (5) procedures for collecting recordings. Each area includes methodological considerations related to the design and conduct of data collection, as well as recommendations for transparent reporting to support rigor. Conclusions This guidance supports researchers in addressing key methodological challenges in data collection using audio and video recordings in studies of clinical communication. It highlights considerations relevant to the design and conduct of the research process, including issues of ecological validity and generalizability, and emphasizes the importance of transparent reporting of methodological decisions. In light of previous inconsistencies in reporting, such guidance is essential to strengthen methodological rigor. By adopting more robust methodological strategies, ethical and scientific standards in study design and data collection can be strengthened.

Objective

To explore patients’ expressions of emotional distress and subsequent Registered Nurses’ (RNs’) responses in primary care consultations.

Methods

This observational study included a consecutive sample of 147 audio recorded RN-led consultations with adult patients seeking primary care for a new health problem. Expressions of emotional distress were analysed using the Verona Coding Definitions of Emotional Sequences.

Results

Patients expressed emotional distress in one-third of the recorded consultations. A total of 165 expressions of emotional distress were identified, comprising 140 cues and 25 concerns. The RNs’ responses primarily provided space for further disclosure of the emotional expressions (125, 75.8%). No statistically significant differences in RNs’ response types, such as providing or reducing space, were found based on patients’ sex, age, or native language.

Conclusion

RNs demonstrated proficiency in recognising patients’ expressions of emotional distress and in facilitating further disclosure in an inclusive manner that aligns with principles of person-centred care.

Practice implications

Encouraging recognition of emotional distress through active listening and an engaged communication approach may enhance RN communication and optimise conditions for person-centred care.

This study explores emotional communication in registered nurse (RN)-led consultations in Swedishprimary care, as part of the PINPOINT project. In this setting, RNs often serve as the first point ofcontact, in parallel to general practitioners (GPs), for patients seeking help with new healthproblems, playing a key role in initial assessment, decision-making, and patient guidance.Previous findings from the PINPOINT project indicate that patients generally hold high expectationsfor communication and report positive experiences with RNs who mostly meet their expectations(Östensson et al., 2025). Preliminary results also suggest that RNs tend to follow a naturalconsultation structure when exploring patients’ health problems. However, essential componentssuch as eliciting medical concerns, exploring social history, and confirming patient understandingare sometimes omitted (manuscript).The current study investigates whether and how patients’ emotional concerns, expressed throughnegative emotional cues or explicit concerns, are addressed during RN-led consultations in primarycare.Data were collected from 148 routine RN-led consultations across 10 primary care centers, involving30 RNs and 148 patients. Emotional communication was analyzed using the Verona CodingDefinitions of Emotional Sequences (VR-CoDES).

Research questions:

• What emotional cues and concerns do patients express during consultations, and what aspects ofcare do these relate to (e.g., current health problems, treatment, self-care, referrals)?

• How do RNs respond to or address these cues and concerns?

• Do RNs tailor their responses to patients’ emotional cues and concerns or follow a standardizedresponse pattern?

We aim to discuss both our research questions and the planned analysis for the study

Background

Internationally, interest in the expanding role of registered nurse–led consultations in primary care is increasing. This role requires effective communication to support triage and clinical decision-making. While physician‒patient communication has been extensively studied, research on registered nurse‒patient communication remains limited, particularly in primary care. Therefore, the aim of this scoping review was to map and describe how registered nurse–patient communication and decision-making in primary care consultations are characterised in the existing literature, based on observations of clinical practice.

Methods

This scoping review included a systematic literature search conducted in March 2025 in the PubMed, CINAHL, Web of Science and Scopus databases. A total of 12,066 records were identified and screened. The review followed the methodological framework of Arksey and O’Malley and adhered to the PRISMA-ScR reporting guidelines.

Results

A total of 16 studies were included. Registered nurse‒patient communication was observed using audio- and video-recorded observations and participant observations during telephone consultations (n = 5), chronic disease management consultations (n = 3), mental health consultations (n = 1) and walk-in clinic consultations (n = 7). Findings on communication and decision-making were organised into four themes related to the key characteristics of exploring patients’ concerns, observing and assessing patients’ health status, tailoring communication, and facilitating decision-making with patients.

Conclusion

The findings indicate that registered nurses use various communication skills during different phases of consultations. However, comprehensive studies on registered nurse–patient communication and decision-making in primary care are lacking. This highlights the need for future in-depth and comprehensive studies on registered nurse–patient communication in primary care to inform both clinical practices and nursing education.

Background: In Sweden, registered nurses have a key role in initial patient assessments and prioritization in primary care. This assessment is a complex and demanding process. To meet patient and public needs, insight is needed into nurses’ communication and decision-making during these consultations. Therefore, the aim of this PhD project is to explore clinical reasoning and decision-making in patient-nurse consultations in primary care.

Methods: A prospective multicentre study was designed and data were gathered with a purposive sample of audio recorded observations of real-life communication during 150 patient‒nurse consultations, patient reported health status and stimulated recall interviews with nurses.

Findings: This PhD project will investigate communication and decision-making in 150 nurse-patient consultations with a focus on:

1.Patients’ reason-for-encounter and health problems as assessed by patients’ self-reported health concerns and functional health status (COOP-WONCA).

2.Communication of health concerns and needs as observed with the VR-CoDES (Verona Coding Definitions of Emotional Sequences) using the audio recorded consultations

3.Nurses’ clinical reasoning and decision-making using data gathered with stimulated recall interviews and analysed with a qualitative method for thematic analysis.

This project is presented as an example on how to design and gather data in communication research to investigate nurses’ communication and their exploration of health concerns during nurse-patient consultations in primary care.

Discussion: Results from this research are aimed to support nurses in their assessments, communication and clinical decision-making in primary care. In the long term, this research can contribute to increased knowledge on how the competence of registered nurses can be used and enhanced to make the best use of the primary care resources.

Introduction

Communication between older persons and nursing assistants is important in providing high-quality, person-centred home care. While previous research has reported on older persons' emotional concerns during home care conversations, there is a need to gain an in-depth understanding of emotional concerns' role in such conversations and how to support the older persons' comfort and well-being. Therefore, this study aimed to explore the nature and focus of emotional communication between older persons and nursing assistants in home care.

Methods

A descriptive qualitative design using observational data from 83 audio-recorded home care visits was used to identify and analyse sequences of distressing emotional communication, analysed through thematic analysis.

Results

In this study, four themes were described illustrating how emotional communication between older persons and nursing assistants during home care visits creates opportunities for empathy: (1) recognising empathic opportunities, (2) identifying subtle and vague signs of emotional distress, (3) expressing needs for emotional support, and (4) striving to restore comfort in challenging conversations.

Conclusions

Conversations about older persons' emotions and worries can be complex. The findings indicate a fine line between meaningfulness and discomfort in emotional sequences. Expressions of emotional distress provide empathic opportunities that call for attentiveness and sensitivity from nursing assistants, implying a need for education and training in person-centred communication.

Implications for Practice

Emotional communication acknowledging empathic opportunities enhances person-centred care by promoting trust, comfort, and well-being. Ultimately, emotional communication reinforces the importance of empathy in home care and creates space for emotional interactions, leading to more supportive relationships.

Aim

To evaluate child-nurse emotional communication during needle procedures using a child-centered intervention versus a control group.

Methods

A controlled, video-observational study, incorporating 66 children and seven nurses was conducted. Data were collected using video-recordings of child-nurse communication during needle procedures when receiving standard care (control group) or standard care plus the i Can Choose intervention (intervention group).

Findings

Children expressed their unpleasant emotions mostly non-verbally. Compared to children in the intervention group, those in the control group more often expressed vague or unspecified words to describe an emotion (χ2(1) = 14.4, p < 0.001). The nurses' focus and overall communication style varied between the groups. When using i Can Choose, nurses provided more space to children's communication preferences. This seemed to increase children's involvement during the needle procedure.

Conclusion

Communicating with the child, the so-called communicative interaction, instead of to the child, can play a critical role in children's handling of fear and pain related to needle procedures.

Background: Trait emotional intelligence (EI) is often assessed using the 30-item Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF). However, previous research using item response theory (IRT) modelling has identified several underperforming items. This study aimed to psychometrically evaluate, refine, and optimize the TEIQue-SF using IRT, with the goals of identifying and eliminating underperforming items, and examining whether items in the refined version function differently across sexes. Furthermore, the study sought to further validate the Swedish version of the TEIQue-SF.

Methods: This cross-sectional study surveyed 845 first-year students aged 19–59 (87% women) from seven healthcare and social work programs across six universities in southern Sweden. Participants completed the TEIQue-SF and health-related measures for convergent validity. IRT modeling employed the Graded Response Model (GRM) using the 2-Parameter Logistic Model in IRT for Patient-Reported Outcomes (IRTPRO). Marginal reliability and differential item functioning (DIF) were assessed with IRT, internal consistency with Cronbach’s alpha and mean inter-item correlations, and validity through evaluating Direct Discrepancy Dynamic fit index (DDDFI) and bivariate correlations.

Results: The IRT modeling identified underperforming items, leading to a refined 12-item TEIQue-SF that effectively captures trait EI with high-quality items. The item selection process is detailed and supplemented. The shortened measure showed a strong correlation with the original (r = .94), demonstrated good reliability, and exhibited uniform DIF for only one item (Item 15). A comparison of confirmatory factor analysis (CFA) model fit statistics using the DDDFI indicated a fair fit for the TEIQue-SF. Consistent with previous research on the TEIQue-SF, both 30-item and 12 item versions demonstrated strong convergent validity with health-related measures within the Swedish context.

Conclusions: The 12-item TEIQue-SF is a brief, precise, and valid measure for assessing trait EI while preserving its global conceptual structure. IRT modeling and validity testing against health-related measures confirm that 12-item TEIQue-SF effectively captures trait EI.