Table 2 Response categories by GPs according to VR-CODES-P
Non-explicit, reducing space | ||
|---|---|---|
Ignore | No reference is made whatsoever to the concern | |
Shutting down | Denying patient’s concern | “Oh don’t be silly” |
Information advice | Giving information or advice in a way that does not open space for further disclosure | “Headaches are very common” |
Non-explicit, providing space | ||
Silence | Silence to invite patient to talk about the concern | |
Back channel | Minimal prompt to invite patient to talk about the concern | “Hmm” “Ok…” |
Acknowledgement | Implicit comment beyond the minimal back channel | “I can see that” |
Active invitation | Clearly inviting, but implicit in relation to the concern | “Would you like to tell me more?” |
Implicit empathy | Expression of feeling or understanding, without explicit reference to the concern | “It must be hard” |
Explicit, reducing space | ||
Switching | Response that changes the frame of reference of the concern | “Did you have similar symptoms in the past?” |
Postponing | Reducing space for talking about the concern at this moment | “I would like to talk with you about this in a minute” |
Information advice | Acknowledging concern, but giving information or advice that does not open space for further disclosure | “You do not need to worry, headaches are very common” |
Active blocking | Mentioning concern and explicitly refusing to talk about it | “Worrying does not do you any good” |
Explicit, providing space | ||
Content acknowledgement | Echoing, reflecting back, giving paraphrases or summarizing content of concern | “You’ve been experiencing headaches for a week now” |
Content exploration | Asking about content | “How long have You’ve been experiencing headaches?” |
Affect acknowledgement | Echoing, reflecting back, giving paraphrases or summarizing emotional aspects of concern | “You’ve worried” |
Affect exploration | Asking about emotional aspects | “Why are you worried?” |
Empathy | Expression of feeling or understanding, with explicit reference to the concern | “I understand that the pain is worrying you” |