Communicating emotional distress during registered nurse-led primary care consultations: from recognition to exploration of health concerns.

Objective
To explore patients' expressions of emotional distress and subsequent Registered Nurses' (RNs') responses in primary care consultations.

Methods
This observational study included a consecutive sample of 147 audio recorded RN-led consultations with adult patients seeking primary care for a new health problem. Expressions of emotional distress were analysed using the Verona Coding Definitions of Emotional Sequences.

Results
Patients expressed emotional distress in one-third of the recorded consultations. A total of 165 expressions of emotional distress were identified, comprising 140 cues and 25 concerns. The RNs' responses primarily provided space for further disclosure of the emotional expressions (125, 75.8%). No statistically significant differences in RNs' response types, such as providing or reducing space, were found based on patients' sex, age, or native language.

Conclusion
RNs demonstrated proficiency in recognising patients' expressions of emotional distress and in facilitating further disclosure in an inclusive manner that aligns with principles of person-centred care.

Practice implications
Encouraging recognition of emotional distress through active listening and an engaged communication approach may enhance RN communication and optimise conditions for person-centred care.