Eye contact in patient-centered communication

The University of Chicago, Department of Medicine, Chicago, IL 60637, USA.
Patient Education and Counseling (Impact Factor: 2.2). 03/2011; 82(3):442-7. DOI: 10.1016/j.pec.2010.12.002
Source: PubMed


To understand the relationship between eye contact and patient-centered communication (PC) in physician-elder patient interactions.
Two instruments-Patient-centered Behavior Coding Instrument (PBCI) and Eurocommunication Global Ratings Scale-were used to measure PC in 22 National Institute of Aging videotapes. Eye contact was measured using a refined eye contact scale in NDEPT. Qualitative observational techniques were used to understand how eye contact can implicate communication.
'High' eye contact tapes were found to be 'high' in PC using both instruments. However, the majority of 'low' tapes were also found to be 'high' in PC. Physicians' behavior distinctly differed in two ways: (1) high tapes were characterized by more 'sustained' eye contact episodes; low tapes consisted of a greater number of 'brief' episodes; (2) brief episode tapes showed a greater focus on 'charts', i.e. 'listening' was bereft of 'looking'; sustained episodes showed a focus on 'patients', i.e. 'listening' was accompanied by 'looking' indicating patient-centered communication.
A comprehensive understanding of elder patient-physician interaction needs to include both-'listening' and 'looking'-components of patient-centered communication.
Eye contact serves as a salient factor in the expression of PC, making it imperative to incorporate as a nonverbal dimension in PC instruments.

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Available from: Rita gorawara-bhat, Apr 16, 2015
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    • "We calculated the percentage of client-directed gaze, by dividing the time a midwife looked at the client by the total duration of the counseling session  100%. In line with other research, we used percentages of time rather than the absolute length of time spent to client-directed gaze during counseling [20] [23] [44] "
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    ABSTRACT: This study focuses on facilitation of clients' psychosocial communication during prenatal counseling for fetal anomaly screening. We assessed how psychosocial communication by clients is related to midwives' psychosocial and affective communication, client-directed gaze and counseling duration. During 184 videotaped prenatal counseling consultations with 20 Dutch midwives, verbal psychosocial and affective behavior was measured by the Roter Interaction Analysis System (RIAS). We rated the duration of client-directed gaze. We performed multilevel analyses to assess the relation between clients' psychosocial communication and midwives' psychosocial and affective communication, client-directed gaze and counseling duration. Clients' psychosocial communication was higher if midwives' asked more psychosocial questions and showed more affective behavior (β=0.90; CI: 0.45-1.35; p<0.00 and β=1.32; CI: 0.18-2.47; p=0.025, respectively). Clients "psychosocial communication was not related to midwives" client-directed gaze. Additionally, psychosocial communication by clients was directly, positively related to the counseling duration (β=0.59; CI: 0.20-099; p=0.004). In contrast with our expectations, midwives' client-directed gaze was not related with psychosocial communication of clients. In addition to asking psychosocial questions, our study shows that midwives' affective behavior and counseling duration is likely to encourage client's psychosocial communication, known to be especially important for facilitating decision-making. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
    Patient Education and Counseling 07/2015; DOI:10.1016/j.pec.2015.07.020 · 2.20 Impact Factor
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    • "Expressive touch (on hand and/or forearm) has been suggested as a means for improving interaction between general practitioners and patients [11]. Eye-contact has been identified as one of the most salient dimensions of nonverbal communication in doctor–elder-patient interactions [12] [13] [14]. In the spirit of continuing this trend, I look "
    Patient Education and Counseling 03/2014; 94(3):289-90. DOI:10.1016/j.pec.2014.01.006 · 2.20 Impact Factor
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    • "It is mostly taken as a sign of respect, care, and attention from a doctor [1]. However, if eye contact is coupled with attentive listening it inclines the interaction towards more patient-centered communication [14]. Nowadays, the use of computers and especially the electronic health records (HER), during medical interviews, is a big obstacle in using eye contact as an effective way to communicate [15]. "
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    ABSTRACT: Background. Nonverbal behaviors have a significant impact on patients during consultations. This study was undertaken to find out the attitudes and preferences of the patients regarding nonverbal communication during consultations with physicians, in a tertiary care hospital. Methods. A questionnaire based cross-sectional study was carried out at the Aga Khan University Hospital, Karachi, Pakistan, during the months of January to March 2012. All patients (>18 years of age) coming for consultancy in the family medicine clinics were approached; out of 133, 120 agreed to participate. The subjects were asked questions regarding physician's comforting touch and eye contact and their responses were noted. The data were analyzed using SPSS and chi-square test was used to identify corelations. Results. Overall, 120 patients were enrolled. About 58.3% were men and 41.7% were women with a mean age of 34.9 ± 10.9 years. 95.8% were Muslims and 57.6% had more than 12 years of education. Among females 74% wanted supportive touch from doctors, used to comfort the patient (45%) or to show respect (27.5%) or as healing (30%). 86.1% of the respondents believe that establishing eye contact with the patient shows that the doctor is attentive towards his/her patient. The eye contact should be brief but regular (54.1%) and prolonged staring (36.7%) makes them uncomfortable. Conclusion. Nonverbal communication helps to strengthen the doctor-patient relation as patients do appreciate positive touch and eye contact from their physicians.
    02/2014; 2014:473654. DOI:10.1155/2014/473654
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