Table 1. Thematic Categories of Family Responses to Physician Empathetic Statements.
| Category of Family Response | Definition of Category | Sample Quotea |
|---|---|---|
| Alliance response | ||
| Deepen emotional discussion | Family shares their hopes and fears | Physician: This is not making sense, I understand. It is no one’s intent to have such a thing happen…and it’s a nightmare. Family: It is, and it’s never going to end because my son won’t be leaving out here with me. I don’t know what to do. |
| Express gratitude | Family expresses thanks for the care or concern from the physician | Physician: He’s so lucky to have you guys…he has an amazing family—you all are amazing. Are there any questions we haven’t answered? Family: No questions. I really, really appreciate it. He wouldn’t have survived without you, so I really appreciate the doctors and the hospital. |
| Agreement with physician | Family statement aligns with the physician’s statement | Family: I agree. I think that talking to the tracheostomy nurse would be a good idea. |
| Express mourning | Family becomes tearful or asks for a moment to collect themselves | Family: [family crying] |
| Cognitive response | Family asks a medical question or makes a statement continuing the medical talk, ignoring the empathetic statement | Physician: Believe me, we want to do that. We want to do what’s best for him as fast as possible. We thought about removing the kidneys first, but it’s a big surgery. He won’t make any urine anymore. His kidney function is declining, but still the kidneys are doing at least a little bit, and that helps even a little bit. So that’s why we want to try this peritoneal dialysis first. Family: That would be a drastic change, removing the kidney. |
| No response | Conversation ends without a response from the family because the physician asked closed-ended question or a member of the health care team interrupted prior to a family response | Physician: I think you guys did a great job. You expressed your thoughts very clearly and we had a good 2-way conversation. We’ll come in separately for the week and touch base with you. Alright? Family: Mmhmm. |
a
The empathetic physician statement is italicized in the sample quotes.