Background & Aims
PURPOSE To explore how we can make health care providers (HCP) more conscious of their gaze and to encourage HCPs to make more eye contact with their patients, making them better suited to promote meaningful lives for them, thus strengthening the patient-provider relationship.
Methods
METHODS Mixed quantitative and qualitative descriptive experimental design with narrative data analysis. 40 participants (23 HCPs and 17 chronic pain patients) viewed standardized videos depicting a patient-provider interaction in which the HCP did not look at the patient. Self-assessments and reflections were obtained.
Results
RESULTS Most HCPs recognized the clinical approach in the videos as cold, whereas 41% of patients recognized it as “normal”. When looking into patient’s eyes, 44% of HCPs were unable to identify the patients’ emotions, nor their own feelings. Powerlessness and vulnerability were emotions often felt by the HCP. Patients and HCPs agree that better addressing meaningful activities in a patient’s life, as well as looking at the patient more, would positively impact patient outcomes and pain management. At the one-month follow-up, 74% of HCPs had increased the amount of eye-contact made during their encounters and paid more attention to the relational aspect of their care.
Conclusions
CONCLUSION We succeeded in making HCPs more aware of the gaze they hold onto their patients, thus encouraging them to change their actions. We attributed the lack of eye contact and lack of focus on meaningful activities to a sense of vulnerability felt by HCPs. We believe that non-verbal communications skills should be more overtly taught in medical school.
References
1.Le T.T.H., Dumas M, Lafrenaye S. Exploration of physician-specific relationship factors influencing management of chronic pain patients. Pain Res Manag. 2014;19(3), e84.
2.Gulbrandsen P, Madsen HB, Benth JS, Lærum E. Health care providers communicate less well with patients with chronic low back pain–a study of encounters at a back pain clinic in Denmark. Pain. 2010 Sep;150(3):458-461.
3.Agledahl KM, Gulbrandsen P, Førde R, Wifstad Å. Courteous but not curious: how doctors’ politeness masks their existential neglect. A qualitative study of video-recorded patient consultations. J Med Ethics. 2011 Nov;37(11):650-4.
4.Gorawara-Bhat R, Cook MA. Eye contact in patient-centered communication. Patient Educ Couns. 2011 Mar;82(3):442-7.
5.Silverman J, Kinnersley P. Doctors’non-verbal behaviour in consultations: look at the patient before you look at the computer. Br J Gen Pract. 2010 Feb;60(571):76-8.
6.Gulbrandsen P, Jensen BF, Finset A, Blanch-Hartigan D. Long-term effect of communication training on the relationship between physicians’ self-efficacy and performance. Patient Educ Couns. 2013 May;91(2):180-5.
7.Mast MS. On the importance of nonverbal communication in the physician-patient interaction. Patient Educ Couns. 2007 Aug;67(3):315-8.
8.Asan O, D Smith P, Montague E. More screen time, less face time – implications for EHR design. J Eval Clin Pract. 2014 Dec;20(6):896-901.
9.Duke P, Frankel RM, Reis S. How to integrate the electronic health record and patient-centered communication into the medical visit: a skills-based approach. Teach Learn Med. 2013;25(4):358-65.
10.Ambady N, Koo J, Rosenthal R, Winograd CH. Physical therapists’ nonverbal communication predicts geriatric patients’ health outcomes. Psychol Aging. 2002 Sep;17(3):443-452.
11.Dysvik E, Furnes B. Living a meaningful life with chronic pain – further follow-up. Clin Case Rep. 2018 Mar 22;6(5):896-900.
12.Milders M, Hietanen JK, Leppänen JM, Braun M. Detection of emotional faces is modulated by the direction of eye gaze. Emotion. 2011 Dec;11(6):1456-61.
13.Gulbrandsen P. The possible impact of vulnerability on clinical communication: Some reflections and a call for empirical studies. Patient Educ Couns. 2018 Nov;101(11):1990-1994.
14.Beege M, Schneider S, Nebel S, Rey GD. Look into my eyes! Exploring the effect of addressing in educational videos. Learn Instr. 2017;49:113-120. 04
15.Paul-Savoie E, Bourgault P, Potvin S, Gosselin E, Lafrenaye S. The Impact of Pain Invisibility on Patient-Centered Care and Empathetic Attitude in Chronic Pain Management. Pain Res Manag. 2018 Sep 24;2018:
Presenting Author
Amanda Vignone
Poster Authors
Sylvie Lafrenaye
MD
University of Sherbrooke
Lead Author
Isabella Depani
University of Sherbrooke.ca
Lead Author
Amanda Vignone
University of Sherbrooke.ca
Lead Author
Helene Guay MD
University of Montreal
Lead Author
Ismael Labbe
University of Sherbrooke.ca
Lead Author
Guillaume Leonard PT PhD
University of Sherbrooke
Lead Author
Topics
- Trial Design