Patient-directed gaze as a tool for discovering and handling psychosocial problems in general practice

Abstract

In this study, one particular form of nonverbal behavior -- patient-directed gaze -- was examined in relation to the general practitioner's performance in psychosocial care. Data were available from a random sample of 337 videotaped consultations and accompanying questionnaires from both general practitioner and patient. The relevance of general practitioners' gaze in psychosocial care was demonstrated in several ways: (1) general practitioners' gaze was associated with affective verbal behavior and with instrumental behavior on psychosocial topics; (2)general practitioners' gaze was related to patients' share Of talking and the number of health problems presented, especially as regards psychological and social health problems; (3) in consultations with a relatively high degree of patient-directed gaze, general practitioners were found to be more aware of patients' psychosocial history and were better at identifying patients suffering mental distress. Patient-directed gaze appears to be a useful technique, both for decoding people's mental problems and for showing interest in the patient's story. This may encourage the patient to talk about worries that would otherwise remain concealed. In medical education, nonverbal techniques should be taught as distinct from verbal communication strategies.