Abstract
Family Medicine residents were videotaped in interviews with a new and a return-visit patient. Two coders recorded nonverbal behavior performed by the residents for two, one-minute segments of each interview. Categories of movement included: proxemic behaviors of distance, orientation, and trunk lean, and head, hand/arm, and leg/foot movement, facial expression, and direction of gaze.
Each of the 36 video segments were rated by a group of psychiatric nurses using bipolar adjective scales assessing dimensions of rapport. Significant differences in nonverbal behavior were found between high and low rapport doctors. Physicians were rated more positively when they sat directly facing the patient, with uncrossed legs, and arms in symmetrical, side-by-side positions. High rapport doctors also engaged in moderate, but less extensive eye contact, with the patient than low rapport doctors. Discussion focuses on the impact of nonverbal behavior on physician-patient communication and the establishment of rapport.
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References
Argyle, M. & Ingham, R. Gaze, mutual gaze and proximity.Semiotica 1972,6 32–49.
Ben-Sira, Z. Affective and instrumental components in the physician-patient relationship: An additional dimension of interaction theory.Journal of Health and Social Behavior 1980,21 170–180.
Carroll, J. G. & Monroe, J. Teaching medical interviewing: A critique of educational research and practice.Journal of Medical Education 1979,54 498–500.
Davis, M. & Weitz, S. Sex differences in body movements and positions. In C. Mayo and N.M. Henley (Eds.),Gender and Nonverbal Behavior (pp. 81–92). New York: Springer-Verlag, 1981.
Daubenmire, M.J., Searles, S. & Ashton, C.A. A methodological framework to study nursepatient communication.Nursing Research 1978,27 303–310.
D'Augelli, A.R. Nonverbal behavior of helpers in initial helping interactions.Journal of Counseling Psychology 1974,21 360–363.
DiMatteo, M.R. A social-psychological analysis of physician-patient rapport: Toward a science of the art of medicine.Journal of Social Issues 1979,35 2–33 (a)
DiMatteo, M.R. Nonverbal skill and the physician-patient relationship. In R. Rosenthal (Ed.),Skill in Nonverbal Communication (pp. 104–134). Cambridge, Mass.: Oelgeschalager, Gunn & Hain. (b) 1979.
Doyle, B.J. & Ware, J.E. Physician conduct and other factors that affect consumer satisfaction with medical care.Journal of Medical Education 1977,52 793–801.
Duncan, S.D. & Fiske, D.W.Face-to-Face Interaction: Research, Methods, & Theory. Hillsdale, N.J.: Lawrence Erlbaum Assoc., Pub., 1977.
Egbert, L.D., Battit, G.E., Welch, C.E. & Bartlett, M.R. Reduction of postoperative pain by encouragement and instruction of patients: A study of doctor-patient rapport.New England Journal of Medicine 1964,270 825–827.
Eibl-Eibesfeldt, I.Ethology: The Biology of Behavior. N.Y.: Holt, Rinehart & Winston, Inc., 1975.
Ekman, P. & Friesen, W.V. Nonverbal behavior and psychotherapy. In R.J. Friedman & M.M. Katz (Eds.),The Psychology of Depression: Contemporary Theory & Research (pp. 203–232). Washington, D.C.: Winston & Sons, 1974.
Exline, R.V., Ellyson, S.L. & Long, B. Visual behavior as an aspect of power role relationships. In P. Pliner, L. Krames & T. Alloway (Eds.),Nonverbal Communication of Aggression (pp. 21–52). New York: Plenum, 1975.
Friedman, H. Nonverbal communication between patients and medical practitioners.Journal of Social Issues 1979,35 82–99.
Friesen, W.V., Ekman, P. & Wallbott, H. Measuring hand movements.Journal of Nonverbal Behavior 1979,4 22–29.
Gillum, R.F. & Barsky, A.J. Diagnosis and management of patient noncompliance.Journal of the American Medical Association 1974,228 1563–1567.
Goffman, E.Asylums. Garden City, NY: Anchor Books, 1961.
Guenther, R.W. & Moughan, J. Introverts' and extroverts' responses to nonverbal attending behavior.Journal of Counseling Psychology 1977,24 144–146.
Haase, R.F. & Tepper, D.T. Nonverbal components of empathic communication.Journal of Counseling Psychology 1972,19 417–424.
Harrigan, J.A. The relationship between the auditors' nonverbal behavior and turn-taking in social conversation. (Doctoral Dissertation, University of Cincinnati, 1979.Dissertation Abstracts International, 1980,40, 5867B, University Microfilm No. 8012231.)
Jensen, P. The doctor-patient relationship: Headed for impasse or improvement?Annals of Internal Medicine 1981,95 769–771.
Kasteler, J., Kane, R.L., Olsen, D.M. & Thetford, C. Issues underlying prevalence of “doctor shopping” behavior.Journal of Health and Social Behavior 1976,17 328.
Kendon, A. Some functions of gaze direction in social interaction.Acta Psychologica 1967,26 1–47.
Korsch, B.M. & Negrete, V.F. Doctor-patient communication.Scientific American 1974,227 66–74.
LaFrance, M. & Mayo, C. A review of nonverbal behavior in women and men.Western Journal of Speech Communication 1979,43 96–107.
Langer, E.J., Janis, I.L. & Wolfer, J.A. Reduction of psychological stress in surgical patients.Journal of Experimental Social Psychology 1975,11 159–165.
Larsen, K.M. & Smith, C.K. Assessment of nonverbal communication in the patient-physician interview.Journal of Family Practice 1981,12 481–488.
Ley, P. Psychological studies of doctor-patient communication. In S. Rackman (Ed.),Contributions to Medical Psychology, Vol. 1. (pp. 9–42). New York: Pergammon Press, 1977.
Mansfield, E. Empathy: Concept and identified psychiatric nursing behavior.Nursing Research 1973,22 525–530.
Mehrabian, A.Nonverbal Communication. Chicago: Aldine-Atherton, 1972.
Nielson, G.Studies in Self Confrontation. Copenhagen: Monksgaard, 1962.
Rosenfeld, H. Measurement of body motion and orientation. In K.R. Scherer & P. Ekman (Eds.),Handbook of Methods in Nonverbal Behavior Research (pp. 199–286). Cambridge: Cambridge University Press, 1982.
Smith-Hanen, S. Effects of nonverbal behaviors on judged levels of counselor warmth and empathy.Journal of Counseling Psychology 1977,24 87–91.
Stetler, C.B. Relationship of perceived empathy to nurses' communication.Nursing Research 1977,26 432–438.
Tepper, D.T. & Haase, R.F. Verbal and nonverbal communication of facilitative conditions.Journal of Counseling Psychology 1978,25 35–44.
Truax, C.B. & Carkhuff, R.R.Toward Effective Counseling and Psychotherapy. Chicago: Aldine Press, 1967.
Wolinsky, F.D. & Steiber, S.R. Salient issues in choosing a new doctor.Social Science and Medicine 1982,16 759–767.
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This research was supported in part by a grant from the Department of Health and Human Services.
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Harrigan, J.A., Oxman, T.E. & Rosenthal, R. Rapport expressed through nonverbal behavior. J Nonverbal Behav 9, 95–110 (1985). https://doi.org/10.1007/BF00987141
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DOI: https://doi.org/10.1007/BF00987141