social communication


Friends of the Nonverbal Communication Blog, this week we present the paper “Conditions Influencing Effective Nurse Nonverbal Communication With Hospitalized Older Adults in Cameroon”, by Wanko-Keutchafo, E. L.; Kerr, J.; Baloyi, O. B. and Duma, S. E. (2022), in which authors carry out a study in Cameroonian hospitals to know which factors affect the quality of nonverbal communication between elder patients and nurses that are in charge of their care. 

Elder adults make up a very significant proportion of the population worldwide, and are often the forgotten ones.

These adults have reached the figure of more than 32 million people in sub-Saharan Africa in 2019 (the context of this article), and are projected to reach 101 million by 2050, which is an increase of 218%.

This rapid growth means that, over time, there will be a greater need for medical care for the elderly, and nurses are expected to interact with these patients more than with any other. 

However, patients have a wide range of personal experiences that influence their perceptions, which increase in diversity as they age. 

In addition, elder adults may experience auditory deficits, changes in attention and information encoding, which can restrict their interaction, participation and effective communication. All this indicates that good communication skills will be essential in nursing. 

As we have said on numerous occasions, communication is the core of human society and sustains community life. 

In healthcare settings, effective communication is the foundation of any relationship. It is important for understanding patients’ needs and supporting the improvement of their health and well-being. 

Communication, as we already know, has both verbal and nonverbal components and is therefore more complicated than the simple transmission of information. 

The nonverbal aspect refers to facial expressions, how we behave in general, the use of touch, space and distances, how we move our body, physical appearance, silences and the tone of our voice… among many other elements. 

The factors that influence communication between nurses and patients seem to be divided into those related to the nurse, the patient, the environment, the physical or the psychological aspects. 

Authors have identified some within these groups. For example, nurse-related factors could be job dissatisfaction, a high workload or insufficient time. Regarding the environment, we could point out the fact that it is a busy, hectic place. Within the physical factors we could mention the space in the rooms, the noise or the lack of privacy. And in the psychological factors, anxiety, level of self-esteem, disorders, and even religion. 

When communication is effective, patients feel taken care of, respected and more able to describe their concerns. 

Age discriminatory attitudes, prejudices and stereotypes based on age, such as condescending speech, are also worth investigating. 

In this article, authors aim to describe the conditions that influence nurses’ effective nonverbal communication with hospitalized elder adults in the Cameroonian context. 

The study was conducted in two public referral and teaching hospitals in Cameroon. Ten female nurses, four students, two managers and one nursing assistant participated, allowing their behavior in dealing with elderly patients to be observed. Data were collected between July 2018 and January 2020. 

The findings revealed that the most influential factors were those related to nurses. 

It appears that the most determinant ones are beliefs and prejudices, their personality traits, personal experiences, and their love and vocation for their work. 

On the other hand, it appears that religious beliefs facilitate positive verbal communication between nurses and patients; however, this is not always the case, as a 2019 study reported that some Muslim patients expected nurses to bow to them when caring for them and, if they did not, they were perceived as insolent. 

Nurses’ awareness of their nonverbal behavior is also very important, since the more they seem to be mindful of conveying positive feelings, the more effective they appear to be. This point is, of course, influenced by experience. 

It is suggested that, in order to increasingly improve nonverbal communication between nurses and patients, educational programs for health professionals should be created, promoting mainly empathy.

If you want to know more about nonverbal behavior and how it affects personal relationships, visit our Master of Science in Nonverbal and Deceptive Behavior, which you can take in English or Spanish, with special grants for readers of the Nonverbal Communication Blog.

Friends of the Nonverbal Communication Blog, this week we present the paper “‘You never get a second chance’: First impressions of Physicians depend on their Body Posture and Gender” by Grün, F. C.; Heibges, M.; Westfal, V. and Feufel, M. A. (2022), in which authors carry out a study to know whether open and/or closed postures influence the perception we have about doctors, as well as their gender. 

The way a patient perceives his or her physician influences a multitude of factors that determine the success of treatment, such as the information shared between the two, patient-physician communication, patient satisfaction, medication adherence and, ultimately, health outcomes. 

First impressions lay the foundation for successful patient-physician interactions, particularly when encounters are brief, which is often the case for many health care visits. 

Recently, empirical research has begun to ask how nonverbal behavior, related to body postures, can affect patients’ first impressions of physicians. 

A 2019 study, demonstrated that physicians who adopt high power postures, put another way, open postures (for instance, arms on hips), are more likely to be perceived as competent, than when they assume low power postures, that is, closed postures (arms crossed), however, it did not take gender into account. This same study also concluded that empathic ability was also related to perceived physician competence. 

The quality of the doctor-patient interaction is not only influenced by the communication of information about the patient’s health, but also by other elements, including the nonverbal one. 

The influence of physicians’ physical appearance has recently been studied in relation to their clothing, the ethnic group to which they belong or their gender, but the authors focus in this case on postures and, moreover, on these related to gender.

In 2002, a study reported that nodding the head, leaning forward, and uncrossed legs and arms lead to greater patient satisfaction. 

With respect to the clinical setting, there is also research showing that physician-patient interaction is influenced by gender, and patients appreciate behavior that fits stereotypes, such as women who speak in a soft voice. 

Other studies show conflicting results on gender regarding the latter idea. One meta-analysis showed that patients generally prefer to interact with male physicians, but there is other research indicating that gender does not exist, and others saying that women prefer to be seen by female gynecologists. 

In a nutshell, the inconsistent findings of the effects of gender on physicians’ perceptions call for further research on the topic. 

In the research at hand, authors focused on open postures and closed postures, and introduced gender as an additional variable, to study patients’ perceptions of physicians.

They gathered a total of 200 North American adults and conducted an online survey. The survey material consisted of photographs of doctors in open and closed postures, so that there were male doctors with open and closed postures, and the same for female doctors. In the online survey, participants were asked to rate their perceptions of these physicians. 

The results obtained showed that male physicians tend to be perceived as more professionally competent when they assume open body postures and, in addition, seem to encourage patients to take an active role in the patient-physician interaction.

On the other hand, female physicians who assumed open postures were perceived as more professionally competent than those with closed postures, but no more so than male physicians. And, interestingly, female physicians were rated more positively in social competencies when they had closed postures. 

Plus, male physicians in open postures and showing empathy tended to be perceived as warm, as well as competent. 

In other words, it seems that women tend to have high scores in competence when they show open postures, but low scores in warmth; this would not be the case with male physicians, who would have high scores in both. 

Body postures influence patients’ perceptions. Therefore, in addition to training the verbal aspects of interaction, medical professionals should be aware of the nonverbal dimensions and incorporate them into their day-to-day work, in order to have greater control of their patients’ perceptions of them.  

If you want to know more about nonverbal behavior and how it affects personal relationships, visit our Master of Science in Nonverbal and Deceptive Behavior, which you can take in English or Spanish, with special grants for readers of the Nonverbal Communication Blog.

Friends of the Nonverbal Communication Club, this week we present the paper “Does Teacher Immediacy Affect Students? A Systematic Review of the Association Between Teacher Verbal and Non-verbal Immediacy and Student Motivation”, by Liu, W. (2021), in which the author carries out a revision of some previous studies about whether teacher immediacy affects students behavior.

The study of the teacher immediacy in the field of educational communication is attracting more and more the attention of experts.

But what is immediacy?

It was first introduced by Mehrabian, who defined the concept as “communication behaviors that enhance closeness and non-verbal interaction with others.” Furthermore, considering the “approach-avoidance theory”, this author proposed that people are likely to approach those who they like and away from those who they do not like.

Regarding the importance of immediacy in educational environments, other authors have proposed that the verbal and non-verbal behaviors that teachers use in their interactions with their students can be considered as a reward by them. That is, teachers could inspire students to be more motivated, attentive, and engaged, minimizing anxiety, stress, and negative reactions from students, by exhibiting verbal and non-verbal actions.

It has been pointed out that this could be especially useful for foreign/second languages classes, although it could also affect all training activities in general.

Some research has studied the satisfaction of students regarding the immediacy of the teacher. In these investigations, reached conclusions point in the direction that students who have an immediate teacher are more satisfied with their learning experience than those who do not.

Although numerous studies have sought to examine the association between immediacy and factors such as academic engagement, participation, or learning, there is less research on immediacy and motivation.

For this reason, the author decides to carry out a systemic review of the existing literature on this matter.

What would be the teacher’s behaviors of immediacy? We can classify them into verbal ones and non-verbal ones.

The verbal ones can be: calling the students by their names, asking for comments on the lessons, referring to the class as “we/us”, engaging in conversations with the students before and after class, etcetera.

The non-verbal ones can be: having close proxemics, a direct body orientation, smiles and vocal varieties, using physical gestures, making eye contact, having a relaxed body position, among others.

How was this study conducted? The author carried out a bibliographic search in different databases about the subject. After filtering numerous articles, the sample was finally reduced to 30 investigations.

Of these 30, only 5 empirical studies (17%) were carried out in foreign/second languages classes; the rest examined the interaction between teacher immediacy and student motivation in general educational contexts (science, communication, business, etc.).

Among the results obtained, it was found that students perceive the immediate behaviors of teachers as an important motivating factor in teaching-learning environments.

Regarding the role of teacher non-verbal immediacy, the findings indicated that these behaviors improve students’ motivation. In other words, it was revealed that the teacher’s non-verbal immediacy is a strong predictor of their students’ motivation.

A positive relationship was also found between the verbal immediacy of the teacher and the motivation of the students.

That is, students instructed by a teacher who uses both verbal and non-verbal immediacy behaviors are more motivated than those instructed by teachers who do not use them.

This can be explained by the fact that getting students’ attention is the most crucial factor when it comes about motivating them. Moving around the class, making eye contact, and, in general, calling them by name, etcetera, also strongly influence.

These teachers, in addition to improving the state of their students’ motivation, contribute to strengthening their interaction with them, and therefore, the relationship between them.

There are also signs that immediacy would also influence the learning outcomes of students, with higher achievements. It can be explained because these behaviors would inspire students to be more attentive and therefore improve their performance.

Among the limitations of this research, we point out the small number of studies that have been examined and, furthermore, that the vast majority of them were carried out in university and non-school contexts.

For future research, the importance of conducting more empirical studies in these settings, especially in foreign/second languages classes, is pointed out.

NonVerbal Communication Blog