Verbal and non-verbal behaviour and patient perception of communication in primary care: an observational study
Verbal and non-verbal behaviour and patient perception of communication in primary care: an observational study
Background
Few studies have assessed the importance of a broad range of verbal and non-verbal consultation behaviours.
Aim
To explore the relationship of observer ratings of behaviours of videotaped consultations with patients’ perceptions.
Design and setting
Observational study in general practices close to Southampton, Southern England.
Method
Verbal and non-verbal behaviour was rated by independent observers blind to outcome. Patients competed the Medical Interview Satisfaction Scale (MISS; primary outcome) and questionnaires addressing other communication domains.
Results
In total, 275/360 consultations from 25 GPs had useable videotapes. Higher MISS scores were associated with slight forward lean (an 0.02 increase for each degree of lean, 95% confidence interval [CI] = 0.002 to 0.03), the number of gestures (0.08, 95% CI = 0.01 to 0.15), ‘back-channelling’ (for example, saying ‘mmm’) (0.11, 95% CI = 0.02 to 0.2), and social talk (0.29, 95% CI = 0.4 to 0.54). Starting the consultation with professional coolness (‘aloof’) was helpful and optimism unhelpful. Finishing with non-verbal ‘cut-offs’ (for example, looking away), being professionally cool (‘aloof’), or patronising, (‘infantilising’) resulted in poorer ratings. Physical contact was also important, but not traditional verbal communication.
Conclusion
These exploratory results require confirmation, but suggest that patients may be responding to several non-verbal behaviours and non-specific verbal behaviours, such as social talk and back-channelling, more than traditional verbal behaviours. A changing consultation dynamic may also help, from professional ‘coolness’ at the beginning of the consultation to becoming warmer and avoiding non-verbal cut-offs at the end.
communication, consultation, general practice, non-verbal communication
e357-e365
Little, Paul
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White, Peter
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Kelly, Joanne
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Everitt, Hazel
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Gashi, Shkelzen
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Bikker, Annemieke
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Mercer, Stewart
e6f2116e-6556-4f7f-b894-bf8b07e8c379
1 June 2015
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
White, Peter
536aaa93-447f-4103-ba6b-d424b51a5572
Kelly, Joanne
b7094829-aeb1-4bc1-b64c-7b7c716f73b5
Everitt, Hazel
80b9452f-9632-45a8-b017-ceeeee6971ef
Gashi, Shkelzen
40fc3450-5688-4cb7-91f1-0d675cd2daaa
Bikker, Annemieke
c0adc13d-aa6e-495f-b616-9ffe34efe4f8
Mercer, Stewart
e6f2116e-6556-4f7f-b894-bf8b07e8c379
Little, Paul, White, Peter, Kelly, Joanne, Everitt, Hazel, Gashi, Shkelzen, Bikker, Annemieke and Mercer, Stewart
(2015)
Verbal and non-verbal behaviour and patient perception of communication in primary care: an observational study.
British Journal of General Practice, 65 (635), .
(doi:10.3399/bjgp15X685249).
(PMID:26009530)
Abstract
Background
Few studies have assessed the importance of a broad range of verbal and non-verbal consultation behaviours.
Aim
To explore the relationship of observer ratings of behaviours of videotaped consultations with patients’ perceptions.
Design and setting
Observational study in general practices close to Southampton, Southern England.
Method
Verbal and non-verbal behaviour was rated by independent observers blind to outcome. Patients competed the Medical Interview Satisfaction Scale (MISS; primary outcome) and questionnaires addressing other communication domains.
Results
In total, 275/360 consultations from 25 GPs had useable videotapes. Higher MISS scores were associated with slight forward lean (an 0.02 increase for each degree of lean, 95% confidence interval [CI] = 0.002 to 0.03), the number of gestures (0.08, 95% CI = 0.01 to 0.15), ‘back-channelling’ (for example, saying ‘mmm’) (0.11, 95% CI = 0.02 to 0.2), and social talk (0.29, 95% CI = 0.4 to 0.54). Starting the consultation with professional coolness (‘aloof’) was helpful and optimism unhelpful. Finishing with non-verbal ‘cut-offs’ (for example, looking away), being professionally cool (‘aloof’), or patronising, (‘infantilising’) resulted in poorer ratings. Physical contact was also important, but not traditional verbal communication.
Conclusion
These exploratory results require confirmation, but suggest that patients may be responding to several non-verbal behaviours and non-specific verbal behaviours, such as social talk and back-channelling, more than traditional verbal behaviours. A changing consultation dynamic may also help, from professional ‘coolness’ at the beginning of the consultation to becoming warmer and avoiding non-verbal cut-offs at the end.
Text
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Accepted/In Press date: 13 November 2014
Published date: 1 June 2015
Keywords:
communication, consultation, general practice, non-verbal communication
Organisations:
Primary Care & Population Sciences
Identifiers
Local EPrints ID: 378261
URI: http://eprints.soton.ac.uk/id/eprint/378261
ISSN: 0960-1643
PURE UUID: fc4d04c7-c686-4382-b05e-db7bf71b81c5
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Date deposited: 22 Jun 2015 15:31
Last modified: 12 Jul 2024 01:38
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Contributors
Author:
Peter White
Author:
Shkelzen Gashi
Author:
Annemieke Bikker
Author:
Stewart Mercer
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