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. Author manuscript; available in PMC: 2010 Mar 18.
Published in final edited form as: Patient Educ Couns. 2009 Mar 24;77(1):90–96. doi: 10.1016/j.pec.2009.02.010

Table 2.

Sample cells from SCOPE intervention development grid.

Theoretical construct Concept Visual/audio image Voiceover wording
Barriers (Module 2: Responding to Patient Emotion) Oncologists’ own emotions make it hard to deal with patients’ Video clips from:

  • - On being: (segment 29) We feel constant loss; (segment 35) If I am struggling hard, it’s because it is hard, feel like I failed

  • - On edge of being: (segment 22.5) Cannot accept patient has to die

  • - Moyers, different kind of care: (segment 10) Doctors are afraid, family is afraid, patient is afraid

 In situations like this oncologist just described, it’s sometimes easier to avoid engaging patients’ emotions all together. That’s because your own emotions, in response, may feel overwhelming. As painful as your own feelings may be, they are a window to understanding what your patient feels. With this awareness of your own emotions comes the ability to empathize and comfort. The bottom line is that paying attention to your own emotion can help you manage patient distress
Skill building (Module 3: Responding to Empathic Opportunities) Recognizing empathic opportunities Video clips from:

  • - EPEC: (segment 22) I just don’t care anymore (patient)

  • - EPEC: (segment 23.3) I’m too young to die anyway

  • - EPEC: (segment 50) I’m worried, can’t eat, getting worse

 Here are some examples of empathic opportunities that sound similar to things you have heard in your own practice [video clip]
Now, here are actual examples from your conversations [audio clip from MD/patient recordings]
Skill building (Module 4: Conveying Prognosis) Use the Ask-Tell-Ask Method Video clip from:

  • - Moyers: Different kind of care: (segment 27:4) (MD) Let me know if I am pushing you too far (Patient) No, you’re not, I need it

 There is almost no more important time to use Ask-Tell-Ask then when conveying prognosis. First, Ask what the patient knows or believes about the prognosis. This can help you know where they are emotionally and cognitively. It helps you understand how they’re doing. Some patients know about survival statistics for their type of cancer. Some have different belief systems to help them understand their prognosis. Knowing this going in will help you communicate most effectively