Communication in Health Care

Communication & Metacommunication Communication is about sharing

information

Metacommunication is about communicating something about the communication, itself. Examples:

A Study on Metacommunication Patch, et al (1997) Research Terminology

Independent Variable ________________________ Dependent Variable _________________________ Experimental condition _______________________ Control condition ____________________________

Psychology Terminology Door-in-the-face (DIFT) technique

A persuader tries to get compliance from others by making a large request, while knowing that the request will likely be rejected; so that the person will agree to a smaller request, since the smaller request seems very reasonable compared with the large one.

A Study on Metacommunication Participants: U.S. men and women (students and non-students) Procedures: Each participant was approached by a single requester when he

or she was alone. 4 Conditions:

MC/DITF DITF MC/Control Control moderate request

Results: Greater compliance in MC/DITF than DITF. Greater Compliance in MC/Control than Control.

Explanation: Metacommunication strategy is effective in facilitating compliance.

Limitation:

Questions about research terminology In the above study:

What are the independent variables? Which is the dependent variable? Which conditions are the experimental

conditions? In each condition, what is the dependent variable? What is/are the independent variable(s)?

Which is the control condition?

Verbal Communication Denotation & Connotation

Example: ______________________ English as a Second Language

Factors to consider: ______________________________ Slang and Jargon

Examples ______________________________

Nonverbal Communication Why is nonverbal communication important in healthcare? What are the functions of verbal and nonverbal communication?

Please give examples to illustrate the functions. In your view, what are the differences between verbal and

nonverbal communication? Can you give examples of nonverbal communication? In your view, are facial expressions universal? What are the kinds of messages that can be conveyed by

touch? Please provide examples.

Why are nonverbal communication important in healthcare?

Why and when do patients rely on nonverbal cues? ___________________________________

Why and when do HCPs rely on nonverbal cues? ____________________________________

What are the functions of verbal and nonverbal communication?

replace verbal communication Examples:

express feelings Examples:

regulate interaction Examples:

validate verbal messages Examples:

maintain self-image Examples:

maintain relationships Examples:

What are some of the differences between verbal and nonverbal communication?

Without words Less voluntary

Examples of Non-Verbal Communication Body Language (gestures, facial

expression, gaze) Proxemics (Distance) Touch Paralinguistics Physical and environmental factors

Body Language Facial Expressions

Six basic expressions1. ______________2. ______________3. ______________4. ______________5. ______________6. ______________

Are they universal?

Are Facial Expressions universal? Ekaman & Friesen (1975)

Participants People who lived in isolated areas of New Guinea

Procedure Asked individuals to imagine different situations, I.e., you friend comes to visit

and you are happy, a dead animal laying in the hot sun for many days and it smelled bad.

Participants were asked to show how they would express their feelings. Results

Participants show similar facial expressions that North Americans might show in those situations

Conclusion _____________________________

Are Facial Expressions universal? Ekman (1973) Procedure

Individuals who lived in widely separate countries were shown facial expressions of strangers from other countries and asked to classify those emotions into these categories:_______________________________________

Results Participants classified the emotions accurately

Conclusion ________________________________________

Are Facial Expressions universal? Russell (1994)

Limitations to Ekman’s studies (1973, 1975)

__________________________________ __________________________________

Are Facial Expressions universal? Russell (1994)

Compare Western, non-western literate, and non-western isolated

Results: _______________________________________

happy Surprise Sadness Fear Disgust Anger

Western 96.4 87.5 80.5 77.5 82.6 81.2

Non-Western Literate

89.2 79.2 76.0 65.0 65.0 63.0

Non-Western Illiterate Isolated

92.0 36.0 52.0 46.0 29.0 56.0

Are Facial Expressions universal? Instinct versus socialization

Cross cultural research suggested substantial agreement in recognition of facial expression

Socialization also is an important factor; facial expressions are not totally universal; contextual differences do exist with respect to precise meanings.

Body Language

Gesture Can you think of some gestures that help to

regulate the flow of conversations?

Eye Contact Can you give examples of how eye contact carry

out the functions of nonverbal communication?

ProxemicsHall’s study on distance

Participants were from the Northeastern United States

1. Intimate 1.5 feet

2. Personal 1.5 and 2.5 feet (arm’s length)

3. Social 4 to 12 feet

4. Public 12-25 feet

How may this study be relevant to you as a dental hygienist? What is the physical distance you maintain with your clients?

What kinds of messages are expressed by touch?

Positive effect Playful (humor) Control Ritualistic Task related, functional

A Study on Touch Crusco & Wetzel (1984)

Procedure Ask a group of servers to greeted customers in 3 ways: a)

refrained from touching in any manner, b) touched briefly on the hand, c) touched them for a longer period on the shoulder.

Results Situation (b) and (c) significantly increased tipping over the no-

touch control condition. Conclusion

Being touched in an innocuous, non-threatening way seemed to generate positive rather than negative reactions among participants

Studies on Touch Aguilera (1967)

Procedures Experimental Group: patients received touch and

verbal communication Control Group: patients received only verbal

communication Results

Patients in the experimental groups had more verbal interaction and more rapport with the nurse

Studies on Touch Patterison (1973)

In counseling session, the therapist’s touch contact has been related to increased amount of self-exploration

What are the limitations of Aguilera and Patterison’s studies Not a double blind situation May not be generalized to other contexts

Touch in Health Care What are some of the factors that affect people’s

receptivity to touch? Gender Socio-cultural Factors Nature of the Relationship