Non-verbal communication

Consider:

  • the non-verbal behaviour of patients
  • the non-verbal behaviour of doctors

Reading the non-verbal cues of patients

  • Essential — to understand the 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 an 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, the 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’?
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