Communicating with patients with schizophrenia: characteristics of well functioning and poorly functioning communication

Abstract

Twenty-seven video-recorded interviews, with nine patients diagnosed with schizophrenia, were analysed using qualitative methodology. Sequences of well and of poorly functioning communication were distinguished, and characteristic verbal and nonverbal means of communication were described. In well functioning communication the interviewer asked short open questions, explored the emotional content in the narrative, and showed nonverbal means of communication that invited social interaction. The interviewer confirmed the patient emotionally and the narrative turned into a dialogue. The patient took a more active part and the narrative became extensive and elaborated. In poorly functioning communication the conversations were often fragmented, incoherent and confusing, with long pauses. The interviewer and the patients avoided eye-contact, and the nonverbal communication that was displayed did not accompany verbal utterances, but indicated discomfort and tension instead. Either patient or interviewer was observed dominating the conversation. In order to establish well functioning communication the interviewer's contribution, particularly the willingness to explore and pursue the emotional content in the patient's narrative, was found to be important.

Key words:

• communication
• Grounded Theory
• intersubjectivity nonverbal
• qualitative method
• schizophrenia
• video observation