By Emma Greijn This is a very interesting study which looks at nonverbal communication between patients and doctors, similar to everything else on this blog, but in a different way. These researchers wanted to come up with a way to analysis nonverbal communication between the two groups, particularly with new patients, and see if there were ways to improve this encounter. The study points out that there are currently ways in which to analysis these encounter, but none that focus solely on nonverbal communication and accommodation. D'Agostino and Bylund say "Accommodation within an interaction is the product of many factors. Given that an individual may have multiple goals during an interaction, he or she may variously accommodate different behaviors." [34]. What they mean by accommodation is two fold, between convergence and divergence. The two concepts are important to understand and implement when dealing with patients. Convergence, matching the persons communication style which shows similarity, and divergence, which emphasizes differences in style and show those differences. Both of these concepts are important and using nonverbal communication cues to understand which to use in health care are very important. The researchers looked at previous research and found that the outline of the Communication Accommodation Theory (CAT) was something to work off of. Some interesting findings from the previous research fits with what many other nonverbal communication research says about eye gaze. For example, the CAT studies showed that high rapport physicians engaged in less eye contact than low rapport physicians. Not only this but they found that eye contact was the best predictor of patient distress, empathy, questions, and patient-centeredness. [D'Agostino et.al. 34]. The issue they found with this theory was that is focused on "physician behavior, relied on analysis methods not specifically developed for rating accommodation and neglected the role of nonverbal communication." [34]. To expound on this research they created the NAAS, which took many of the testing strategies from CAT but tweaked them to focus more on nonverbal communication and to better suit their study. To test their NAAS they consulted with and video recorded 45 patients and had two independent coders view and rate each consultation. The results for this study showed promise for the NAAS "as a tool for systematically analyzing the process of nonverbal accommodation within physician-patient interactions." [37] The NAAS aided in rating the rapport of patients and physicians and patient satisfaction, understanding and compliance. [37]. Some aspects the system looks for is pauses in conversation, eye gaze, and looking away to what direction etc. These are very important things when dealing with healthcare workers and patients. With NAAS it could help to show how the patient-physician interaction moves closer or furthur from one another using nonverbal behaviors. They note that the system "results demonstrate that the NAAS method can be taught and mastered with little intervention." [38], so in reference to the previous post, maybe physicians can be taught! Of course NAAS is not a comprehensive coding method and future research should be done to improve on the system to be able to implement it and better the patient-physician interaction experience. So what do you think?Source:
D’Agostino, T. A., & Bylund, C. L. (2011). The nonverbal accommodation analysis system (NAAS): Initial application and evaluation. Patient education and counseling, 85(1), 33-39.
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