Developers: Lidia Del Piccolo, Christa Zimmermann, Arnstein Finset, Hanneke de Haes, Cathy Heaven, Jesse Jansen, William Verheul, Jozien Bensing, Svein Bergvik, Myriam Deveugle, Hilde Eide, Ian Fletcher, Claudia Goss, Gerry Humphris, Young-Mi Kim, Wolf Langewitz, Maria Angela Mazzi, Ludwien Meeuwesen, Trond Mjaaland, Francesca Moretti, Matthias NЩbling, Michela Rimondini, Peter Salmon, Tonje Sibbern, Ingunn Skre, Sandra van Dulmen, Larry Wissow, Bridget Young, Linda Zandbelt

Year of publication: 2011

Date of last revision: 21 October 2019

Setting in which the tool was originally developed/validated: primary care, general hospital, oncology, dentistry; pediatric, fibromyalgia, psychiatry, neurology

Restriction to setting(s): None

Target group: Health providers and their patients

Language(s): English

Translations(s): Chinese, German, Italian, Portuguese

Tool topics:

Cues and concerns / emotions
Patient-centered communication
Responding to patients’ requests for information / responding to questions
Socio-emotional focused communication

Specific constructs/behaviours:

Cues/concerns introduced spontaneously or elicited by the health provider and the response by the clinician basically classified as explicit vs. non-explicit, providing vs. reducing room for further disclosure. Responses are then further distinguished in 17 subcategories.

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 basically classified as explicit vs. non-explicit, providing vs. reducing room for further disclosure.

Types of data required to use the tool: Video recordings, Audio recordings, Transcripts

Intended application: Education, Research

Reference(s) to development/validation paper(s):

1. Zimmermann, C., Del Piccolo, L., Bensing, J., Bergvik, S., De Haes, H., Eide, H., . . . Finset, A. (2011). Coding patient emotional cues and concerns in medical consultations: The Verona coding definitions of emotional sequences (VR-CoDES). Patient Education and Counseling, 82(2), 141-148. doi:10.1016/j.pec.2010.03.017
2. Del Piccolo, L., de Haes, H., Heaven, C., Jansen, J., Verheul, W., Bensing, J., . . . Finset, A. (2011). Development of the Verona coding definitions of emotional sequences to code health providers' responses (VR-CoDES-P) to patient cues and concerns. Patient Education and Counseling, 82(2), 149-155. doi:10.1016/j.pec.2010.02.024
3. Del Piccolo, L., Finset, A., Mellblom, A.V., Figueiredo-Braga, M., Korsvold, L., Zhou, Y., Zimmermann, C., Humphris, G. (2017) Verona Coding Definitions of Emotional Sequences (VR-CoDES): Conceptual framework and future directions. Patient Education and Counseling. 100, 2303_2311. doi.org/10.1016/j.pec.2017.06.026

Tool/manual available: Yes.

Tool description by the author:

The Vr-CoDES needs training (one full day) to be used. It is also possible to learn how to use the system on a specific exercise book and then have supervision by the authors.

The Vr-CoDES is a descriptive tool that can be used either for research or education purposes.

The construction of VR-CoDES was based on the assumption that patients' expressions of emotion in medical consultations need to be identified and responded to. Emotional communication is analyzed in terms of ongoing sequences of talk-in-interaction, which includes a basic triad of an eliciting event, an emotional expression by the patient (cue/concern) and the immediate response by the clinician. Sequence analysis is then crucial.

Access: Public

Contact: Lidia Del Piccolo & Gerry Humphris