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Objective: Apply Chinese VR-CoDES in ophthalmic setting and describe patients' worries and the doctor's responses. Explore cultural differences in coding., Methods: 102 audio-taped consultations of 84 patients were coded by Chinese version of VR-CoDES. The intra-class correlation coefficient (ICC) was used to test inter/intra-rater reliability, and inductive content analysis was conducted., Results: The ICCs of inter-rater reliability for cues/concerns and responses were 0.78 and 0.81, and intra-rater reliability were 0.87 and 0.99, respectively. Cues were more frequent than concerns and elicited often by patients. Explicit Reduce Space (ER) was the most frequent response. Interruptions and the doctor's repetitions were evident. Some expressions were not specified in the coding manual. Patients concerned about treatment effect (22 %), expenses (18 %), risk of operation (14 %), and pain (10 %)., Conclusion: The Chinese VR-CoDES can be applied to clinical consultations in China. Ophthalmic patients often expressed cues which were frequently elicited by themselves. The ophthalmologist preferred to give ER response. Interruptions and the ophthalmologist's repetitions were difficult to code. More Chinese expressions should be collected to reduce cultural difference when coding., Practice Implication: VR-CoDES will be helpful in doctor-patient communication and medical education. VR-CoDES should undergo cultural adaptions in China., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objective: To investigate the reliability and validity of the Chinese version of VR-CoDES., Methods: The VR-CoDES was translated into Chinese, and a focus group was held to discuss its cultural adaptation. Video consultations between 75 fourth-year medical students and 2 standardized patients (SPs) were coded by two raters with the Chinese VR-CoDES. Inter-rater reliability was tested by using ICC. To obtain validity, the SPs reviewed the video consultations to confirm the cues and concerns., Results: ICC was 0.79. Specificity and sensitivity were 0.99 and 0.96 respectively. The SPs expressed considerably more cues (mean = 7.00) than concerns (mean = 0.32). Half of the responses of medical students were explicit reducing space. Focus group participants raised some cultural considerations, and some interactions were difficult to code due to cultural differences., Conclusion: The Chinese VR-CoDES obtained good reliability and validity. Due to differences in the expression of emotions and other differences such as different medical systems between China and Western countries, the Chinese VR-CoDES needs further cultural adaptation., Practice Implication: More consultations in real clinical settings need to be gathered to further support the Chinese VR-CoDES both on validation and cultural adaptation., (Copyright © 2019 Elsevier B.V. All rights reserved.)

This study aimed to examine the direct relationship between negative family expressiveness and internalizing problems, as well as the mediating roles of emotional clarity and emotion dysregulation. A sample of Chinese families (N = 499) comprising adolescents and their parents was included. Parents completed the Family Expressiveness Questionnaire, while adolescents completed the Strengths and the Difficulties Questionnaire, the Trait Meta-Mood Scale, and the Difficulties in Emotion Regulation Scale. The results indicated that negative family expressiveness had a direct connection with internalizing problems. Moreover, negative family expressiveness had an indirect association with internalizing problems through the sequential mediating roles of emotional clarity and emotion dysregulation. These findings enhanced the understanding of the mechanism of internalizing problems and provided new perspectives for the prevention and treatment of internalizing problems among adolescents. [ABSTRACT FROM AUTHOR]

Emotion reactivity and emotion dysregulation have been implicated in risk for suicidality. However, it remains unclear whether emotion reactivity and emotion dysregulation are predictive factors of suicide ideation, the progression from suicide ideation to suicide attempt, or both. The present study explored the relationship among emotion reactivity, emotion dysregulation, suicide ideation, and suicide attempt within a sample of Chinese undergraduates (n = 1596). According to lifetime suicidality, the current sample was divided into three groups: (a) non-ideators (no lifetime suicide ideation and no lifetime suicide attempts), (b) suicide ideators (with lifetime suicide ideation and no lifetime suicide attempts), and (c) suicide attempters (with lifetime suicide ideation and lifetime suicide attempts). Results of multinomial logistic regression suggested that compared to non-ideators, suicide ideators reported greater problems with emotion reactivity, and greater difficulties in emotion dysregulation, especially for emotion regulation strategies and emotional clarity. Compared to suicide ideators, suicide attempters reported greater difficulties in emotion dysregulation, especially for controlling impulses of negative emotions and emotional awareness. Emotion reactivity and emotion dysregulation are differentially associated with lifetime suicidality, and these findings provide preliminary guidance for suicide prevention and intervention. [ABSTRACT FROM AUTHOR]

Background: Little is known about family members' and patients' expression of negative emotions among high‐risk preoperative conversations. Objectives: This study aimed to identify the occurrence and patterns of the negative emotions of family members and patients in preoperative conversations, to investigate the conversation themes and to explore the correlation between the negative emotions and the conversation themes. Methods: A retrospective study was conducted using the Chinese version of Verona Coding Definitions of Emotional Sequences (VR‐CoDES‐C) to code 297 conversations on high‐risk procedures. Inductive content analysis was used to analyse the topics in which negative emotions nested. The χ2 Test was used to test the association between the cues and the conversation themes. Results: The occurrence rate of family members' and patients' negative emotions was very high (85.9%), much higher when compared to most conversations under other medical settings. The negative emotions were mainly expressed by cues (96.4%), and cue‐b (67.4%) was the most frequent category. Cues and concerns were mostly elicited by family members and patients (71.6%). Negative emotions were observed among seven themes, in which 'Psychological stress relating to illness severity, family's care and financial burden' (30.3%) ranked the top. Cue‐b, cue‐c and cue‐d had a significant correlation (p <.001) with certain themes. Conclusions: Family members and patients conveyed significantly more negative emotions in the high‐risk preoperative conversations than in other medical communications. Certain categories of cues were induced by specific emotional conversation contents. Patient Contribution: Family members and patients contributed to data. [ABSTRACT FROM AUTHOR]

Objective: To investigate physicians' responses to negative emotions in high-risk preoperative conversations; and to explore the influencing factors of these responses.Methods: One hundred and sixty-two audio recordings were coded using the Chinese Verona Coding Definition of Emotional Sequences (VR-CoDES). Big Five Personality Inventory Brief Version and Emotional Intelligence Scale were administered to explore the influencing factors of physicians' responses. SPSS 24.0 and R 3.6.3 LME4 Package were used for data analysis.Results: Reduce Space (83%), referring to physicians' responses reducing the opportunities of patients to disclose emotions, was physicians' most frequent response to patients or families' emotions. The main responses were Information-advice (ERIa) and Ignoring (NRIa). Younger age, female, Agreeableness and Openness were factors positively associated with Explicit Provide Space (EP); Neuroticism was negatively correlated with EP. Extroversion was negatively correlated with Explicit Reduce Space (ER); Conscientiousness was negatively correlated with both EP and ER responses. Emotional intelligence had no significant influence on physicians' responses.Conclusion: The majority of physicians were inclined to reduce space by providing information advice or ignoring. Physicians' responses were correlated with their gender, age and personality traits.Practice Implications: The trainees' gender, age and personality should be considered when conducting doctor-patient communication skills training. [ABSTRACT FROM AUTHOR]

Background/Purpose: Maladaptive emotion regulation is a strong predictor of depression or anxiety. Behavioral emotion regulation has a direct influence on coping with negative emotion. Although it is interesting to explore more about the behavioral emotion regulation, most of the existing measures can not assess it separately. The Behavioral Emotion Regulation Questionnaire (BERQ) has made important gain in addressing conceptual confusion between cognitive and behavioral emotion regulation. As there is a lack of single and stable measure to assess behavioral emotion regulation in mainland China, we translated the BERQ into Chinese to fit this gap. Methods: We evaluated the psychometric properties of the Chinese version of the BERQ (BERQ-C) based on a sample of Chinese university students (n=816). Factor analysis was performed to assess the construct validity of the BERQ-C. To test its reliability and validity, all the participants were invited to complete BERQ-C, GAD-7, PHQ-9, and CERQ-C. Of the initial samples, 138 students participated in the second measurement with completing BERQ-C twice. Results: Confirmatory factor analysis supported the five-factor model. The internal consistence (Cronbach's α = 0.71 ∼ 0.85), the split-half reliability (Spearman-Brown coefficient = 0.66 ∼ 0.85), and the test–retest stability (ICC = 0.55 ∼ 0.67) are all acceptable. The criterion-related validity is good. Conclusion: The BERQ-C is a promising instrument to assess behavioral emotion regulation among the Chinese university students. Future studies are needed to explore the questionnaire's psychometric properties among wider range of population especially for patients. [ABSTRACT FROM AUTHOR]

Background: Workplace violence is a widely-reported phenomenon among healthcare providers and negatively affects quality of care and treatment. This study aims to understand the potential factors related to HCV through the experiences of women who have undergone a pregnancy termination due to fetal anomaly. Methods: Qualitative interview was used to collect data in this case study. Forty-one pregnant women who decided to terminate their pregnancy due to fetal anomaly were recruited from four Chinese hospital facilities, including three general hospitals and one specialty hospital in Changsha, Hunan, China. In-depth interviews were conducted from May to September 2017. Content analysis was used to analyze the data. Results: Several potential factors related to violence in healthcare facilities were identified, including preventive factors, which possibly relieve healthcare violence; and negative experiences, which potentially related to healthcare violence. Preventive factors include healthcare providers gaining patient trust with detailed observation, expressing patient-centered care through discreet behavior, and showing patience and professionalism. Factors related to violence include busy work schedules, hurried visits, mechanized process, patients’ scant medical knowledge and mental distress. Conclusions: This study highlights potential factors related to healthcare violence. The results will be submitted to the Chinese government’s policy making department in order to improve the healthcare system. We also suggest several important strategies to prevent HCV in a healthcare setting, both in China and globally. [ABSTRACT FROM AUTHOR]