School of Nursing, University of Wollongong, BEGA, NSW, Australia.
Department of Health Services Research and Policy, Research School of Population Health, College of Medicine, Biology and the Environment, Australian National University, ACTON, ACT, Australia.
J Clin Nurs. 2020 Jul;29(13-14):2378-2387. doi: 10.1111/jocn.15249. Epub 2020 Apr 13.
This study explores nonverbal communication behaviours between general practice nurses and patients during chronic disease consultations.
Nonverbal communication is an important aspect of nurse-patient lifestyle risk reduction conversations. Despite the growing role of general practice nurses in lifestyle risk modification when managing chronic disease, few studies have investigated how this communication occurs.
Observational study within a concurrent mixed methods project.
Thirty-six consultations by 14 general practice nurses were video-recorded between August 2017 and March 2018. Video analysis used the Nonverbal Accommodation Analysis System. The STROBE checklist was used to guide this paper.
Joint convergence of nurse-patient behaviours such as laughing, smiling and eye contact was most common (44%; n = 157). Patient-nurse eye contact time decreased significantly across the consultation, while nurse gesturing increased significantly. No significant relationship between consultation length and convergent to divergent behaviour categorisation or nurse-computer use across the consultation was found.
The high levels of convergent behaviours are promising for person-centred care. However, scope exists to enhance nonverbal interactions around lifestyle risk reduction. Supporting nurses with skills and improved environments for lifestyle risk communication has potential to improve therapeutic relationships and patient outcomes.
These results indicate that nurses support patients through nonverbal interactions during conversations of lifestyle risk reduction. However, there are opportunities to improve this practice for future interventions.
本研究探讨了全科护士与慢性病患者在就诊期间的非言语交流行为。
非言语交流是护士与患者进行生活方式风险降低对话的一个重要方面。尽管全科护士在管理慢性病时在生活方式风险改变方面的作用越来越大，但很少有研究调查这种沟通是如何发生的。
在一项同时进行的混合方法项目中进行观察性研究。
2017 年 8 月至 2018 年 3 月，14 名全科护士的 36 次就诊被录制成视频。视频分析使用了非言语适应分析系统。STROBE 清单用于指导本文。
护士和患者行为的共同趋同，如大笑、微笑和眼神接触，最为常见（44%；n=157）。患者与护士的眼神接触时间在整个咨询过程中显著减少，而护士的手势显著增加。没有发现咨询时间长短与咨询过程中趋同到趋异行为分类或护士与计算机使用之间存在显著关系。
高水平的趋同行为对以患者为中心的护理是有希望的。然而，在围绕生活方式降低风险的交流中，还有改进非言语互动的空间。通过技能支持和改善生活方式风险沟通的环境，有可能改善治疗关系和患者的结果。
这些结果表明，护士在生活方式风险降低的谈话中通过非言语互动来支持患者。然而，为了未来的干预，还有改进这种实践的机会。
