Differences in verbal and nonverbal communication between depressed and non-depressed elderly patients

ABSTRACT

Introduction: Doctor-patient communication is a complex process where verbal and nonverbal interactions happen simultaneously. We systematically evaluated and compared these behaviors in geriatric clinical visits with depressed and non-depressed elderly patients using communication accommodation theory (CAT).

Method: A cross-sectional analysis of doctor-patient interactions during 43 videotaped primary care geriatric sessions was conducted. Twenty-one of the patients had symptoms of depression, while 22 were not depressed. These sessions originated from a subset of 70 videos from the National Institute on Aging and were obtained for the purpose of studying doctor-patient communication.

Results: Our study showed that for nonverbal communication, non-depressed elderly patients had longer eye gaze at the doctor than the group of depressed patients. Doctors gazed at the chart longer while seeing depressed versus non-depressed patients. For verbal communication, treatment discussion in seconds was significantly different between depressed elderly patients (420.30 s) and non-depressed elderly patients (468.58 s). The average duration in seconds of patient talking, doctor talking, symptom discussion, and silence time, were different between the two populations.

Discussion: Elderly patients with depression have different communication patterns with providers than patients without depression. Different communication strategies need to be implemented to better accommodate these patients’ different needs and expectations during their clinic visits. Our findings provide practical implications for facilitating better patient-centered care by educating healthcare providers about communication accommodation strategies.

KEYWORDS:

• Nonverbal communication
• health communication
• depression
• geriatrics
• patient-centered care

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Disclosure statement

No potential conflict of interest was reported by the authors.

Acknowledgement

We thank to Edith Burns for her critical feedback and support for this study. We also thank Mary Ann Cook for providing access to the archive of the video data. Finally, we thank to Rabia Copuroglu for her assistance with video data coding.

Notes on contributors

Onur Asan is an Assistant Professor at the Department of Medicine at Medical College of Wisconsin. His interest is in doctor-patient communication and health information technologies.

Sojung Claire Kim is an assistant professor at the School of Communication at George Mason University. Her research interests mainly lie on intersections of new interactive media, health communication and social marketing.

Paul Iglar is a 2nd year medical student at Medical College of Wisconsin.

Alice Yan is an associate professor of Community & Behavioral Health Promotion. Her research focuses on eliminating health disparities in minority populations through Community-Based Participatory Research (CBPR) and applied translational research.

ORCID

Onur Asan http://orcid.org/0000-0002-9239-3723

Sojung Claire Kim http://orcid.org/0000-0002-9622-3035