Verona Coding Definitions of Emotional Sequences (VR-CoDES)

Christa Zimmermann, Lidia Del Piccolo, Jozien Bensing, Svein Bergvik, Hanneke De Haes, Jesús Deveugele · 2011

The Verona consensus system for coding patient emotional cues and concerns and the way providers respond to them in clinical consultations.

Work in progress — this scale ships domain definitions while its curated agent skills are still being authored. Domains may change as it is completed.

VR-CoDES is a consensus-based system for coding the emotional sequences of a medical consultation: the patient's expressions of emotional distress (cues and concerns) and the way the provider responds to them. It has two linked parts — VR-CoDES-CC for patient cues/concerns and VR-CoDES-P for provider responses — and models each response along a "providing space" vs "reducing space" dimension.

Work in progress. This scale currently ships domain definitions only — the curated per-domain agent skills are still being authored and need source verification against the Verona consensus manuals. Domains and their groupings may change as the scale is completed.

Domains (6)

CueCUE

A verbal or nonverbal hint that suggests an underlying, not clearly expressed, unpleasant emotion.

—
ConcernCON

A clear, explicit verbal expression of an unpleasant current or recent emotion.

—
Provide-space Explicit EmpathyEMP

A provider response that explicitly names or validates the emotion and gives the patient space to elaborate.

—
Reduce-space BlockingBLK

A provider response that reduces space, shutting down or moving away from the emotional expression.

—
AcknowledgeACK

A provider response that acknowledges the cue or concern (backchannel or active acknowledgment) without further exploration.

—
ExploreEXP

A provider response that actively explores the cue or concern, inviting the patient to say more about its content or affect.

—
Zimmermann C, Del Piccolo L, Bensing J, et al. Coding patient emotional cues and concerns in medical consultations: the Verona coding definitions of emotional sequences (VR-CoDES). Patient Educ Couns. 2011;82(2):141-148. (Provider responses: Del Piccolo L, et al. Patient Educ Couns. 2011;82(2):149-155.)

Definitions published in Patient Educ Couns 2011; reproducible with citation. Cite Zimmermann/Del Piccolo et al.