Non-verbal
communicationConsider:
- the non-verbal behaviour of patients
- the non-verbal behaviour of doctors
Reading the non-verbal cues of patients
- Essential — to understand patient’s feeling
- But need to check them out:
e.g. “You seem upset — would you like to talk about it”
Transmitting your own non-verbal cues
- Remember: non-verbal wins out over verbal cues
- Adopt appropriate eye contact, posture, position, movement, facial expression, timing and voice.
Use of notes, records, computer
May lose eye contact: can cause problems.
Therefore
- postpone using records until the patient has completed their opening statement
- wait for opportune moment before looking at the notes
- separate listening from note reading by verbal signposting
What do we mean by non-verbal communication?
- Posture: sitting, standing; erect, relaxed
- Proximity: use of space, physical distance between communicators
- Touch: handshake, pat, physical contact during physical examination
- Body movements: hand and arm gestures, fidgeting, nodding, foot and leg movements
- Facial expression: raised eyebrows, frown, smiles, crying
- Eye behaviour: eye contact, gaze, stares
- Vocal cues: pitch rate, volume, rhythm, silence, pause, tone, speech errors, affect, responsiveness
- Use of time: early, late, on time, overtime, rushed, slow to respond
- Physical presence: race, gender, body shape, clothing, grooming
- Environmental cues: location, furniture placement, lighting, temperature, colour
Ways to pick up verbal and non-verbal cues
Repetition of cues
- ‘upset...’?’
- ‘something could be done....?’
Picking up and checking out verbal cues
- ‘You said that you were worried that the pain might be something serious; what theories did you have yourself about what it might be?’
- ‘You mentioned that your mother had rheumatoid arthritis; did you think that’s what might be happening to you?’
Picking up and checking out non-verbal cues
- ‘I sense that you’re not quite happy with the explanations you’ve been given in the past. Is that right?’
- ‘Am I right in thinking you’re quite upset about your daughter’s illness'?