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Objective: To explore whether negative emotions expressed by adolescent cancer survivors during follow-up consultations were associated with potential late effects (persisting disease or treatment-related health problems).Methods: We video-recorded 66 follow-up consultations between 10 pediatricians and 66 adolescent survivors of leukemia, lymphoma or stem-cell transplantations. In transcripts of the recordings, we identified utterances coded as both 1) expressions of negative emotions (VR-CoDES), and 2) late effect-related discussions. Principles of thematic content analysis were used to investigate associations between the two.Results: Of the 66 video-recorded consultations, 22 consultations contained 56 (49%) utterances coded as both emotional concerns and discussions of potential late effects. Negative emotions were most commonly associated with late effects such as fatigue ("I'm struggling with not having energy"), psychosocial distress ("When I touch this (scar) I become nauseous"), pain ("I'm wondering how long I am going to have this pain?"), and treatment-related effects on physical appearance ("Am I growing?").Conclusions: Negative emotions expressed by adolescent cancer survivors during follow-up consultations were frequently associated with potential late effects. These late effects were not the medically most serious ones, but reflected issues affecting the adolescents' daily life.Practice Implication: Eliciting and exploring patients' emotional concerns serve as means to obtain clinically relevant information regarding potential late effect and to provide emotional support. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine how emotional cues/concerns are expressed and responded to in medical consultations with adolescent and young adults (AYA), an understudied patient group, at the time of cancer diagnosis.Methods: Nine consultations in which AYA patients aged 12-25 years were informed about their cancer diagnosis and treatment plans were audio recorded. Expressions of emotional cues/concerns and physicians' responses were identified and coded using The Verona Coding Definitions of Emotional Sequences (VR-CoDES).Results: A total of 135 emotional cues/concerns (range: 2-26, median: 13) were identified. Cues or concerns that were expressed by patients and relatives following questions from physicians were more often explicit than patient-initiated cues/concerns. Questions about medical and practical issues could often be understood as ways of expressing emotional cues. When patients or relatives expressed less explicit verbal cues about underlying concerns, physicians often responded by presenting medical information without commenting on the emotional aspect indicated by the cue.Conclusion: The communication was dominated by information-giving, but the questions from patients and relatives and their responses to the information often had emotional connotations.Practice Implications: Patients' requests for information may include an emotional aspect. These preliminary findings should be tested in a larger sample. [ABSTRACT FROM AUTHOR]

• Various interventions lead to reduced reporting of conflicts and restraints. • More studies of youth experiences of physical restraint are needed. • Research on interventions to reduce aggression, conflicts and restraints are needed. • More research is needed into how staff prevent and manage conflicts in practice. • More research on how various interventions affects youth is needed. Conflict and aggression are well-known concerns in youth inpatient and residential facilities, frequently affecting both the quality of children/youth (hereafter, youth) care and the well-being of staff. Responses, such as restraint and seclusion (R&S), also pose challenges and can threaten the safety of youth and staff. Various educational and training programs have been implemented to improve practice and create safer places to live and work for both youth and staff. This article reviews the research on the results of measures taken in response to conflict and aggression in youth facilities. Because very little on this topic was published before 2015, we searched for both systematic reviews and original studies published between January 2015 and November 2020 in a total of 7 databases. Our aims in this article are to 1) describe and review the literature related to the effects of interventions to prevent and manage aggression and violence in inpatient and residential youth facilities, 2) describe and review the literature on the effects of R&S and experiences of youth and staff, related to youth violence, R&S, and 3) identify potential gaps in knowledge about these issues that future research could narrow or close. The literature search retrieved 4,698 potentially relevant publications. A total of 14 publications—2 reviews and 12 individual case studies—met our inclusion criteria. Most of the 14 studies were conducted in residential-care and hospital/psychiatric facilities; a small number were conducted in juvenile justice facilities. Our review indicates that interventions that contributed to a reduction in episodes of R&S differed from those that led to a reduction in conflicts and aggression. The review also indicates that both youth and staff have negative experiences of physical restraint. Results also show that further studies are needed of both the effects and experiences of physical restraint and the effectiveness of de-escalation measures in preventing violence and aggression. [ABSTRACT FROM AUTHOR]

Objectives: To systematize the scientific knowledge of empirically tested strategies for verbally providing medical information in patient-physician consultations.Methods: A scoping review searching for terms related to physician, information, oral communication, and controlled study. Four pairs of reviewers screened articles. For each selected study, we assessed the quality and summarized aspects on participants, study, intervention, and outcomes. Information provision strategies were inductively classified by types and main categories.Results: After screening 9422 articles, 39 were included. The methodological quality was moderate. We identified four differently used categories of strategies for providing information: cognitive aid (n = 13), persuasive (n = 8), relationship- (n = 3), and objectivity-oriented strategies (n = 4); plus, one "mixed" category (n = 11). Strategies were rarely theoretically derived.Conclusions: Current research of tested strategies for verbally providing medical information is marked by great heterogeneity in methods and outcomes, and lack of theory-driven approaches. The list of strategies could be used to analyse real life communication.Practice Implications: Findings may aid the harmonization of future efforts to develop empirically-based information provision strategies to be used in clinical and teaching settings. [ABSTRACT FROM AUTHOR]

Objective: To discuss the theoretical and empirical framework of VR-CoDES and potential future direction in research based on the coding system.Methods: The paper is based on selective review of papers relevant to the construction and application of VR-CoDES.Results: VR-CoDES system is rooted in patient-centered and biopsychosocial model of healthcare consultations and on a functional approach to emotion theory. According to the VR-CoDES, emotional interaction is studied in terms of sequences consisting of an eliciting event, an emotional expression by the patient and the immediate response by the clinician. The rationale for the emphasis on sequences, on detailed classification of cues and concerns, and on the choices of explicit vs. non-explicit responses and providing vs. reducing room for further disclosure, as basic categories of the clinician responses, is described.Conclusions: Results from research on VR-CoDES may help raise awareness of emotional sequences. Future directions in applying VR-CoDES in research may include studies on predicting patient and clinician behavior within the consultation, qualitative analyses of longer sequences including several VR-CoDES triads, and studies of effects of emotional communication on health outcomes.Practice Implications: VR-CoDES may be applied to develop interventions to promote good handling of patients' emotions in healthcare encounters. [ABSTRACT FROM AUTHOR]

Objective Childhood cancer survivors need information about risks of late effects to manage their health. We studied how and when adult, long-term survivors prefer to receive information about late effects. Methods Five focus-groups with adult survivors of childhood lymphomas who had completed routine follow-up care and participated in a preceding follow-up study ( n = 34, 19 females, mean age = 39). We used thematic analysis to identify themes regarding providing late effects information. Results The survivors wanted information about late effects (symptoms, prevention and treatment), lifestyle and social security rights. Information should be tailored, carefully timed, given “face-to-face” and in written format. Many expressed ambivalence regarding receiving information as adolescents, but it was seen as essential “to know” once a late effect occurred. A “re-information” consultation about late effects around age 25 was suggested as beneficial. Conclusion Although ambivalent, all survivors wanted information about late effects. They preferred individualized information, disclosed “step-by-step” and in a “re-information consultation” when reaching young adulthood. Practice Implications Providing information about late effects should be an on-going process across the cancer care trajectory. (Re-)Informing survivors when older would enhance their understanding of their health risks and could aid better health self-management beyond completion of follow-up care. [ABSTRACT FROM AUTHOR]

Objective: Childhood cancer survivors need information about risks of late effects to manage their health. We studied how and when adult, long-term survivors prefer to receive information about late effects.Methods: Five focus-groups with adult survivors of childhood lymphomas who had completed routine follow-up care and participated in a preceding follow-up study (n = 34, 19 females, mean age = 39). We used thematic analysis to identify themes regarding providing late effects information.Results: The survivors wanted information about late effects (symptoms, prevention and treatment), lifestyle and social security rights. Information should be tailored, carefully timed, given "face-to-face" and in written format. Many expressed ambivalence regarding receiving information as adolescents, but it was seen as essential "to know" once a late effect occurred. A "re-information" consultation about late effects around age 25 was suggested as beneficial.Conclusion: Although ambivalent, all survivors wanted information about late effects. They preferred individualized information, disclosed "step-by-step" and in a "re-information consultation" when reaching young adulthood.Practice Implications: Providing information about late effects should be an on-going process across the cancer care trajectory. (Re-)Informing survivors when older would enhance their understanding of their health risks and could aid better health self-management beyond completion of follow-up care. [ABSTRACT FROM AUTHOR]