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Communicating emotional distress during registered nurse-led primary care consultations: From recognition to exploration of health concerns
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0002-0530-9408
Research, Education, Development & Innovation, Primary Health Care, Region Västra Götaland, Sweden; General Practice / Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. The Swedish Red Cross University, Stockholm, Sweden.ORCID iD: 0000-0002-9194-3244
Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands; Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, the Netherlands.
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2026 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 151, article id 109776Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2026. Vol. 151, article id 109776
Keywords [en]
Communication, Concerns, Cues, Emotional expressions, Person-centred care, Registered Nurse, Primary Care
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
URN: urn:nbn:se:hb:diva-35993DOI: 10.1016/j.pec.2026.109776ISI: 001827598200001PubMedID: 42468442Scopus ID: 2-s2.0-105044907895OAI: oai:DiVA.org:hb-35993DiVA, id: diva2:2089408
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2022-00850Available from: 2026-08-03 Created: 2026-08-03 Last updated: 2026-08-12Bibliographically approved

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Bergman, KarinSundler, Annelie J.Hedén, Lena

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