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Participants' ratings of male physicians who vary in race and communication style.

Research has shown minorities receive lower quality health care than White persons even with socioeconomic conditions controlled. This difference may partially be related to racially biased attitudes and impaired communication in interracial relationships between physicians and patients. This study investigated the effect of physicians' race and nonverbal communication style on participants' evaluations. Patients at a local health clinic were participants (N = 116: 84% Black, 16% White). Each participant viewed one of four videotapes showing varied race of a physician (Black or White) and the physician's nonverbal behavior (expressing concern or distance), and then completed a questionnaire evaluating the depicted physician. Overall, participants did not give significantly different preferences for physicians of the same race. However, participants' evaluations were significantly associated with physicians' nonverbal style. Nonverbal concern was associated with highest satisfaction, trust, self-disclosure, recall of information, likelihood of recommending the physician, and intent to comply with the physician's recommendations. When male and female participants were compared, preference for a physician of the same race was found only among male participants who viewed verbally distant physicians. Results suggest that social skills are more important than race in shaping patients' perceptions of physicians.

Black or African American↗

Resistance and modes of communication.

The recognition that there are three modes of thinking and communicating--iconic, enactive, and symbolic--clarifies and simplifies many issues in psychoanalytic theory and technique. Although this concept is applicable to all communication, it is particularly important in understanding and interpreting various types of resistance. The author uses a number of vignettes to illustrate the forms and functions of various types of nonverbal communication within the psychoanalytic process.

Adult↗

Facial expressions of emotion: a cognitive neuroscience perspective.

Facial expressions are one example of emotional behavior that illustrate the importance of emotions to both basic survival and social interaction. Basic facial responses to stimuli such as sweet and bitter taste are important for species fitness and governed by simple rules. Even at this basic level, facial responses have communicative value to other species members. During evolution simple facial responses were extended for use in more complex nonverbal communications; the responses are labile. The perception and production of facial expressions are cognitive processes and numerous subcortical and cortical areas contribute to these operations. We suggest that no specific emotion center exists over and above cognitive systems in the brain, and that emotion should not be divorced from cognition.

Affect↗

Female juvenile delinquents' pragmatic awareness of conversational interactions.

Standardized testing has shown that juvenile delinquents have a high incidence of communication problems; however, discourse analyses have failed to confirm pragmatic deficits. This study's purpose was to explore, using qualitative procedures, the pragmatic awareness of female juvenile delinquents concerning conversational interactions. The 45 participants engaged in small-group conversations about communication during multiple class periods. On-line field notes served as the data and were used to determine emerging patterns of verbal and nonverbal communication behaviors. Identified themes included (a) active listening; (b) body position; (c) eye contact, facial expressions, and gestures; (d) utterance types; (e) topics of conversation; (f) politeness and honesty; and (g) conversational management. Results suggested that juvenile delinquents can state many conventions governing conversational interactions; however, some do not always display interactional behaviors consistent with their pragmatic awareness. Discrepancies about pragmatic awareness are discussed in terms of the underlying nature of communication challenges in delinquent populations.

Adolescent↗

Neuropsychological servosystems, consciousness, and the problem of embodiment.

Recent work in neurophysiology has begun to close the paradigmatic gap between neurophysiology and the psychology of embodied behavior and movement. The present paper surveys these developments, traces the origins of the split between neurophysiology and neuropsychology and suggests that recent work by Pribram may provide a link between the psychology of consciousness, the neurophysiology of movement, and the growing body of work on nonverbal communication.

Behavior↗

[Problematic communication between physicians and oncological patients].

Verbal and nonverbal communication between oncological patients and physicians and other medical staff has a major effect on the emotional state of the patients. The intensive course of the illness and the therapy makes the medical environment a most central and significant factor in patient's life, both in time spent and emotional reaction to illness and treatment. Members of the medical staff are perceived by patients as having almost magical powers, and communication with them acquires a highly suggestive value. The effect of communication between them is similar to that of hypnotic processes. 4 cases are described in which the patient's emotional distress remarkably increased after an encounter with a physician. We discuss the negative suggestive effects of such communication. They originate in the physician's attempt to defend himself against the patient's feelings of anxiety, depression and impotence while being treated intensively when seriously ill.

Communication↗

Sensorimotor functioning and communication in mute autistic children.

There were two purposes underlying this study: to describe the sensorimotor functioning of mute autistic children and to relate their sensorimotor performance to nonverbal communication. Twelve mute children, diagnosed autistic, ranging from 4 years 9 months to 12 years of age, were administered four scales of sensorimotor development from the Uzgiris and Hunt (1975) series: object permanence, gestural imitation, means for obtaining environmental events, and causality. Subjects performed most poorly on the imitation scale with 9 of 12 performing below Piaget's fifth sensorimotor stage. In contrast, performance was highest on the object permanence scale: No child scored below Stage V. Regarding the subjects' non-scales and Stage III on the imitation scale appeared to form minimal prerequisites for intentional communication in a variety of situations. Finally, none of the subjects, even those with relatively complete sensorimotor development, spontaneously used what Bates (1976) has called "protodeclarative" gestures to point out or show objects to adults. The absence of protodeclarative gestures may represent a qualitatively distinct pattern of prelinguistic development in certain autistic children.

Autistic Disorder↗

A Markovian model of adult gaze behavior.

This study was designed to test a proposed Markov chain model of adult gaze behaviors. Hypotheses for an individual's gaze behavior, dyadic visual interaction, and dyadic gaze states within an independent decision model were examined. Subjects were assigned to a same- or mixed-sex dyad and instructed to converse for approximately 5 min about life at the university. Video tapes of the conversations were unobtrusively obtained and scored by an observer of gaze behaviors for 4 1/2 min in 24 pairs of subjects: eight male, eight female, and eight mixed-sex dyads. The results indicate that the occurrence of a gaze behavior is dependent on a 0.6-sec history, but infrequently prolonged Looking behaviors were found to occur slightly more often than Markovian formulations predicted. The mathematical properties of gaze behavior demonstrated in this experiment are congruent with those of dialogic time patterns, suggesting a regularity in the gross temporal organization of nonverbal communications.

Eye Movements↗

[Occurrence and significance of touching between nursing professionals and patients in an ICU and a semi-intensive surgical unit].

This study aims to identify the use of the instrumental and/or emotional touch and its characteristics by nursing professionals in the nonverbal communication with the ICU and Semi Intensive Surgical Unit patients of a school hospital--University of São Paulo; and to identify the professionals and patients feelings and perceptions in relation to the touches experienced. The study was developed with 19 nursing professionals and 19 patients, from October to November 2000, through direct observation of the interaction and individual interview. The feelings and perceptions reported were classified and we noticed that most of the touches were instrumental-emotional.

Attitude of Health Personnel↗

The role of person and object in eliciting early imitation.

The role of person and object in eliciting early imitation was examined in this study. Twenty-seven infants, between 5 and 8 weeks old were assigned randomly to two conditions. In the person condition (N = 12) they were presented with tongue protrusions and mouth openings modeled by an adult, whereas in the object condition (N = 15) they were presented with these gestures simulated by two objects. Two infant behaviors were coded; mouth openings and tongue protrusions. Infants in the person condition selectively reproduced the mouth open and tongue protrusion gestures at significant levels, infants in the object condition did not. Instead of reproducing the congruent gestures (mouth openings and tongue protrusions when they were modeled) infants in the object condition reproduced the incongruent gestures at significant levels. Together, the findings indicate that imitation is a social response, which has implications for the development of nonverbal communication and speech.

Attention↗

[Non-verbal communication in nurse-user interactions in mental health care].

On this exploratory-description study, we analyzed the nurse's nonverbal communication during 11 interactions in mental illness attendance. We came to the conclusion that among nonverbal sins observed, a greater number used to the feelings demonstration, the codified especially, as interest, attention, quietness/relaxing, tension/fear, indifference, anxiety and irritation. We identified also the nonverbal contradicting the verbal, alerting us that the contradictory of sending messages can give a double or distorted understanding of the message sent. In our perception, most of the nurses researched are not enough attentive to realize consciously how much the nonverbal way of communicating can influence on assistance and humanization of attendance.

Communication↗

[The influence of information and communication in the orthodontic consultation and treatment visit. II. The communication style and compliance].

The establishment of a good rapport between dentist and patient is together with providing information a basic prerequisite for successfully motivating the patient to comply with the guidance the dentist provides. Both the style adopted in verbally communicating with the patient and also nonverbal communication play a decisive role in the establishment and maintenance of such a relationship. In the pilot study presented here, which draws on psychological interaction analysis of video recordings taken of the initial consultation with 27 patients and of 28 routine treatment sessions with different patients, the typical interaction patterns between the orthodontist and the patient are objectively assessed and compared. The most important findings of the study were: (1) The mean duration of the chairside sessions was lowest during routine encounters with cooperative patients. (2) During consultations approximately 2/3 of the time was taken up talking to each other. On the other hand, in treatment sessions with uncooperative patients only 1/4 of the time was devoted to verbal communication. (3) The orthodontist dominated the conversation in all groups and especially in conversing with the uncooperative patients. (4) In the consultation sessions the dentist and the patient related relatively strongly to each other. (5) Providing mere information significantly predominated over any discussion of the professional aspects of the treatment. (6) During the consultations eye contact was maintained over almost all of the sessions.(ABSTRACT TRUNCATED AT 250 WORDS)

Communication↗

Older adult performance on the Communication Profile for the Hearing Impaired: gender difference.

Gender difference in auditory function with age is well documented. However, little is known about the influence of interacting sensory, psycho-social, and economic variables on adjustment to hearing loss. Adjustment to acquired, mild-to-moderate hearing loss by advantaged older women and men was examined using the Communication Profile for the Hearing Impaired (CPHI) (Demorest & Erdman, 1987). Correlational analyses revealed relationships between scales to be similar for women and men. Controlling for socio-demographic and hearing variables, group responses for the majority of CPHI scales did not differ significantly. Six scales differed significantly, and those results are discussed. When compared to men, women assigned greater importance to effective social communication, were more likely to use nonverbal communication strategies, reported greater anger and stress, and reported greater problem awareness and less denial associated with hearing loss. The CPHI is a useful tool for specifying parameters of perceived communication handicap for both older men and women. Findings underscore the need to consider gender-specific self-assessment of communication and personal adjustment in clinical management of older adults with age-related hearing loss.

Adult↗

Developing an instrument for the observation of touching.

This article describes the development of an instrument for the observation of nonnecessary touching and its purposes in interaction between nursing staff and elderly patients in long-term care. The work took place on three wards of a nursing home. The instrument is based on three main concepts: verbal communication, touch as a form of nonverbal communication, and nursing care situation. In its finalized form, the instrument consists of a single sheet of paper with the human body pictured from the front and from the back.

Aged↗

The education of health care professionals in the year 2000 and beyond: Part 1: The consumer's view.

In summary, consumers desire health care professionals with interpersonal communication skills; with ability to interpret nonverbal communication or body language beyond gross facial gestures; and with effective questioning techniques for taking family histories quickly and accurately yet uncovering some client feelings and life-style difficulties in the process. Consumers want health care professionals who know how to mobilize clients' personal healing resources through greater understanding of how the immune system functions and who know how to deliver difficult diagnoses to clients in a positive, challenging manner and involve the clients in the course of their own body's healing. They desire significantly more information and guidelines about nutrition, weight management, and the complex biochemical interactions associated with food, medication, and the combination of the two. Consumers want health care professionals with greater understanding of sleep and its effect on health and of biofeedback, hypnosis, exercise, meditation, relaxation, and support groups as disease-fighting tools. The genetic components of illness and wellness and how clients cope with some of the built-in genetic weaknesses must receive greater attention. The influence of the environment and pollutants on human health must be addressed. How to maintain health among an aging population, and utilizing norm data that is age specific, gender specific, and developmentally and socioculturally specific is essential to address. An emphasis shift is necessary towards healing and wellness. When we do all this, we still have to make it cost effective. What a challenge! How then can health care professionals be where the consumer wants them to be? How can professionals be responsive to their own human needs as well as those of the consumer? How can the faculty preparing health care professionals incorporate the dimensions outlined by futurists and by consumers by the year 2000? The answer lies in the curriculum solution to be developed in Part II of this presentation. The curriculum solution will explicate a human need theory/process-oriented approach to professional education and practice, assuring the consumer of a person-/family-/community-centered approach to health care and engendering for the carer a healthy, valued self and improved services. Trust your heart ... Never deny it a hearing. It is the kind of house oracle that often foretells the most important.

Attitude to Health↗

Ethological approach to delayed language acquistion.

Language is initially a social or communicative event that develops from the nonverbal communication system existing between caretaker and child. While language in an adult speaker is used for reasons other than social communication, the communication function is the primary source for language acquistion, other language functions being derivatives of this basic function. A few studies were cited which suggest that the normal process of language acquisition may be conceived heuristically in terms of an ethological or psychosoical framework. This ethological approach to language acquisition suggests that noncognitive, interpersonal factors may be major contributors to the slow pace of language development among mentally retarded and autistic children. The implications of this approach were discussed in terms of the design of language-intervention programs.

Autistic Disorder↗

Early recognition of autism. Parental reports vs clinical observation.

OBJECTIVE: To determine which behavioral characteristics of autism are apparent in early childhood and to examine the relative contributions of clinical observation and parental reports to early identification of autism. DESIGN: Blinded comparison of behavioral data obtained through parental reports and clinical observation. SETTING: Child development referral center. PATIENTS: Twenty-six children (23 boys and three girls) younger than age 48 months with a clinical diagnosis of autism. SELECTION PROCEDURES: Consecutive sample. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Social interaction, communication, and activities and interests were evaluated using standard diagnostic criteria for autism. Results suggested that deficits in the areas of social interaction, imitation, play, and nonverbal communication are more prominent than insistence on sameness and routines in young children with autism. Also, parental reports and clinical observation appear to detect different aspects of abnormal behavior patterns in this sample. CONCLUSIONS: Improved awareness of the early signs of autism should help physicians recognize this disorder in a timely manner. Further research may identify how observation of play and parental reports might be incorporated efficiently into a physician's repertoire of developmental and behavioral screening tools.

Age Factors↗

Developmental process: family caregivers of demented Japanese.

1. Developmental process of caring for demented elders: the case of family caregivers consists of the beginning process (stage 1 through 4) and the awakening process (stage 5 through 7). 2. In the beginning process, the caregiver is unaware of the interaction between him/her and the demented family member, relies on conventional, general-purpose methods of care and on verbal communication, and consider care in terms of training and discipline of the person cared for. 3. The caregiver in the awakening process has realized that there is interaction between him/her and the demented family member, reflects on the nonverbal signs shown by the elder in order to improve their care, and provide warm and considerate care by making the most of nonverbal communication.

Aged↗