Linking Nonverbal Rapport to Health Outcome: Testing an Organizational Pathway Model

ABSTRACT

A growing body of research on medical communication indicates that nonverbal rapport (e.g., smiling, eye contact, closer proximity) is central to productive health care delivery. However, mechanisms integral to the process by which nonverbal rapport influences health improvement remain under-researched. This study breaks new grounds in proposing and testing mediation pathways that take into account organizational factors. We conducted a cross-sectional survey in a private hospital in Singapore among 417 patients to examine their communication with physicians and nurses. Results indicated that nonverbal rapport did not have a significant direct relationship with perceived health outcome in both the patient-physician dyad and the patient-nurse dyad. Instead, communication satisfaction and organizational identity completely mediated this relationship. In addition, respect positively moderated the relationship between nonverbal rapport and communication satisfaction in both dyads, while health literacy was not a significant moderator. The findings suggest that the organizational context should be considered in pathways research.

Disclosure of potential conflicts of interest

The authors declare that they have no conflict of interest.

Ethics statement

Survey respondents provided informed consent. The study protocol was approved by the Institutional Review Boards in authors’ institution.

Notes

1. By saying “adapted”, we mainly changed words such as “physician” for “doctor”, because in Singapore, patients do not often use the term “physician”. We also swapped the term “physician” for “nurse” in the patient-nurse survey, to keep the survey parallel to the patient-physician version. We also removed some items that were not relevant to the context of this study.

Additional information

Funding

Singapore Academic Research Fund Tier 1 [Project number: FY2019-FRC4-002].