Application of the verona coding definitions of emotional sequences (VR-CoDES) on a pediatric data set

Patient Educ Couns. 2010 Sep;80(3):399-404. doi: 10.1016/j.pec.2010.06.026.


Objective: Adult patients present concerns as defined in the Verona Coding Definitions of Emotional Sequences (VR-CoDES), but we do not know how children express their concerns during medical consultations. This study aimed to evaluate the applicability of VR-CoDES to pediatric oncology consultations.

Methods: Twenty-eight pediatric consultations were coded with the Verona Coding Definitions of Emotional Sequences (VR-CoDES), and the material was also qualitatively analyzed for descriptive purposes. Five consultations were randomly selected for reliability testing and descriptive statistics were computed.

Results: Perfect inter-rater reliability for concerns and moderate reliability for cues were obtained. Cues and/or concerns were present in over half of the consultations. Cues were more frequent than concerns, with the majority of cues being verbal hints to hidden concerns or non-verbal cues. Intensity of expressions, limitations in vocabulary, commonality of statements, and complexity of the setting complicated the use of VR-CoDES. Child-specific cues; use of the imperative, cues about past experiences, and use of onomatopoeia were observed.

Conclusion: Children with cancer express concerns during medical consultations. VR-CoDES is a reliable tool for coding concerns in pediatric data sets.

Practice implications: For future applications in pediatric settings an appendix should be developed to incorporate the child-specific traits.

Publication types

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

MeSH terms

  • Adult
  • Child
  • Cues*
  • Emotions*
  • Female
  • Humans
  • Male
  • Neoplasms / psychology*
  • Norway
  • Pediatrics*
  • Physician-Patient Relations*
  • Psychological Tests
  • Referral and Consultation
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Surveys and Questionnaires / standards