Patient validation of cues and concerns identified according to Verona coding definitions of emotional sequences (VR-CoDES): a video- and interview-based approach

Patient Educ Couns. 2011 Feb;82(2):156-62. doi: 10.1016/j.pec.2010.04.036. Epub 2010 Jun 8.


Objective: A challenging but main task for clinicians is to identify patients' concerns related to their medical conditions. The study aim was to validate a new coding scheme for identifying patients' cues and concerns.

Methods: 12 videotaped consultations between nurses and pain patients were coded according to the Verona Coding Scheme for Emotional Sequences (VR-CoDES). During a metainterview each patient watched his/her own video interview with the researcher to confirm or disconfirm the identified cues and concerns. A directive or an open format was applied. Quantitative and qualitative data analyses were performed.

Results: Patients' confirmation in relation to the coding gave a sensitivity of 0.95 and specificity of 0.99 in the directive format and a sensitivity of 0.99 and specificity of 0.70 applying the open format. Through a qualitative analysis 83% of researcher-identified cues and concerns were validated. 17% were not confirmed or uncertain.

Conclusion: The VR-CoDES seems to capture what are experienced as real concerns to patients, and proves to be a coding scheme with a high degree of ecological validity.

Practice implications: The VR-CoDES provides a valid framework for detecting patients' cues and concerns, and should be explored as a training tool to develop clinicians' empathic accuracy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Anxiety / psychology
  • Communication*
  • Cues*
  • Emotions*
  • Empathy
  • Female
  • Humans
  • Interview, Psychological
  • Male
  • Middle Aged
  • Physician-Patient Relations*
  • Psychometrics
  • Qualitative Research
  • Referral and Consultation*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Verbal Behavior / physiology*
  • Videotape Recording