RT Journal Article
SR Electronic
T1 Verbal and non-verbal behaviour and patient perception of communication in primary care: an observational study
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e357
OP e365
DO 10.3399/bjgp15X685249
VO 65
IS 635
A1 Paul Little
A1 Peter White
A1 Joanne Kelly
A1 Hazel Everitt
A1 Shkelzen Gashi
A1 Annemieke Bikker
A1 Stewart Mercer
YR 2015
UL http://bjgp.org/content/65/635/e357.abstract
AB 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.