Verbal and non-verbal behaviour and patient perception of communication in primary care: an observational study

Little, P., White, P., Kelly, J., Everitt, H., Gashi, S., Bikker, A. and Mercer, S. (2015) Verbal and non-verbal behaviour and patient perception of communication in primary care: an observational study. British Journal of General Practice, 65(635), e357-e365. (doi: 10.3399/bjgp15X685249) (PMID:26009530)

Abstract

<b>Background </b>Few studies have assessed the importance of a broad range of verbal and non-verbal consultation behaviours.<p></p> <b>Aim </b>To explore the relationship of observer ratings of behaviours of videotaped consultations with patients’ perceptions.<p></p> <b>Design and setting </b>Observational study in general practices close to Southampton, Southern England.<p></p> <b>Method </b>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.<p></p> <b>Results </b>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.<p></p> <b>Conclusion </b>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.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Mercer, Professor Stewart and Bikker, Ms Annemieke
• Authors: Little, P., White, P., Kelly, J., Everitt, H., Gashi, S., Bikker, A., and Mercer, S.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: British Journal of General Practice
• Publisher: British Journal of General Practice
• ISSN: 0960-1643
• ISSN (Online): 1478-5242