By Morgan Wilson Earlier this month, I discussed the effects eye contact and social touch can have on patient perceptions of clinicians’ empathy. In this same study, one of the practice implications determined by the researchers was that clinical environments designed for patient and clinician interaction should be designed to facilitate positive nonverbal interactions, such as eye contact and social touch. They are right that our surroundings can influence our interactions with others, as I have learned in my nonverbal communication course. Both the physical environment and spatial environment are part of nonverbal communication, but for this post, I will focus on explaining the impact that the physical environment alone has on communication and apply it to healthcare settings.
There are three major components of each physical environment, one of which that is the most relevant to this study is the architectural design and movable objects. Montague, Chen, Xu, Chewning, and Barrett referenced results from another study reported by Gorawara-Bhat and colleagues to support their conclusion regarding practice implications – an environment that contains no desk, no height difference, and optimal interaction distance could lead to more eye contact. While the latter concerns proxemics and is considered part of the spatial environment, the
talk more softly, sit closer together, and presume that more personal communication will take place. According to a study by Miwa and Hanyu in 2006, students reported feeling more relaxed in dimly lit counseling rooms compared to those that had brighter lighting. Additionally, an environment’s design or structure may determine how much and what kind of interaction takes place. A 1971 study by Drew included in our text describes how three different designs for nursing stations within a mental hospital yielded very different types of interactions. It was found that the more inaccessible setting decreased the frequency of the interaction and increased the amount of task-oriented messages, while the more accessible setting increased the frequency of the interaction as well as the amount of small talk. Our perceptions of our environment affect our reactions. There are six dimensions central to our perceptions, which consequently influence how we send and receive messages. One of these six dimensions is our perceptions of warmth. We are more likely to relax and feel comfortable in environments that make us feel psychologically warm. Semi-fixed features that can contribute to a space’s warmth are the color of drapes or walls, paneling, carpeting, texture of the furniture, and softness of the chairs, just to name a few. The environment is clearly a significant influencing factor in our communication; however, we must remember that its impact is only one source of influence on our perceptions. Sometimes, other factors can offset any negative effects from a displeasing environment. There are certain healthcare settings wherein the environment may be more important than others. Patients would probably appreciate warmer environments in counseling rooms, oncology treatment rooms, or a physician’s office when receiving major news. Sources:
Montague E, Chen P, Xu J, Chewning B, Barrett B. Nonverbal interpersonal interactions in clinical encounters and patient perceptions of empathy. J Participat Med. 2013 Aug 14; 5:e33. Knapp, Mark L, Judith A. Hall, and Terrence G. Horgan. Nonverbal Communication in Human Interaction. Boston, MA: Wadsworth, 2014. Print.
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