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Relational Satisfaction

Research Rationale & Method Paper

Examining the nature and effects of Nonverbal Behavior
Aarti Venugopal
Arizona State University

Relational Satisfaction

The Use of Nonverbal Cues in Social & Doctor-Patient Interactions

Nonverbal communication is comprised of several aspects including facial expressions,
eye contact, and gestures. These factors are important to every communication interaction
because people are more likely to believe a persons nonverbal cues than their words. Relational
satisfaction is impacted by the proper use of nonverbal cues. This communication research needs
to have more focus on it because it is a key factor in day-to-day life. Researchers believe: the
two hemispheres of the brain process different types of information, but each hemisphere does
not process each type exclusively. (Knapp, Hall, & Horgan, 2010). Therefore, more research on
this area would be beneficial because it would give the individuals a better understanding of
what exactly are nonverbal messages and cues. Previous research has shown that there are
specific cues that doctors use based on whether the results of the patient are positive or negative.
(Knapp, Hall, Horgan, & Terrance 2013). The purpose of this paper is to further determine the
role of nonverbal communication in both social interactions and doctor-patient interactions in
regards to relational satisfaction.
Nonverbal communication is essential to every human interaction that is present. Due to
the fact that this is so important, people should have an understanding of how their nonverbal
communication appears to other individuals. According to the articles, there has not been
substantial research done on doctor-patient interactions. (Knapp, et al., 2013). Previous research
of nonverbal communication focuses on sex and age but fails to focus on the particular groups
that this study will focus on. Doctor-patient relationships are becoming more common with the
aging population (Mast, 2007). Research shows that in an interpersonal interaction, people are
more likely to believe a persons nonverbal cues as opposed to their verbal cues. (Jokinen,
Nishida, Yamaoto., 2009). Many people are unaware of their nonverbal communication that they

Relational Satisfaction
are showing to others. Therefore, if people understood the true importance on nonverbal
communication, they would better understand how to use their nonverbal communication

properly. This study will focus on nonverbal cues in social interactions as well as nonverbal cues
in doctor-patient relationships.
Literature Review
This literature review of the research performed on nonverbal communication will look
at: nonverbal cues in social interactions, nonverbal cues in doctor-patient relationships and
nonverbal cues overall. Nonverbal cues in social interactions are vitally important because they
give more insight towards the meaning of your message. (Argyle, 2013). Nonverbal cues in
doctor patient relationships are important to the overall satisfaction of the patient. Regardless of
whether the diagnosis is positive or negative, if the doctor gives off positive nonverbal cues then
the patient handles the situation better. (Knapp, et al., 2013). Studies show that there are several
types of nonverbal cues that are more readily noticeable. This study will attempt to find the role
of nonverbal communication. Further in this paper, a hypothesis will be proposed that will look
at the relationship between nonverbal communication and these different types of interactions.
Nonverbal Communication in Social Interactions
Nonverbal communication is present in every human interaction that an individual will
have with another individual. In social interactions, nonverbal communication plays a larger role
than most people understand (Balconi, 2010). These cues make up a large portion of the
messages that are conveyed during any conversation. Facial expressions are one of the most
important aspects of nonverbal communication within social interactions (Siegman & Feldstein,
2009). Nonverbal cues can determine the direction a conversation will go. If too many negative
nonverbal cues are present, the conversation will have a negative tone to it. These cues can also

Relational Satisfaction

make a person question the others integrity (Knapp et al., 2010). Social interactions occur every
day in a typical life. According to Balconi (2010), facial expressions are the central feature of
nonverbal communication in humans. They play the largest role within the social aspect of
society and are communicative signals. Facial expressions can also impact the interaction
because they are readily apparent to the other person in the conversation.
According to Knapp et al. (2010) and Balconi (2010), nonverbal cues are more likely to
negatively impact a social interaction than verbal cues are. Their findings were similar in regards
to importance of these two ideas. Relational satisfaction can be performed by using positive
nonverbal cues (Balconi, 2010). Relational satisfaction is important to interpersonal
communication because it creates a positive interaction. Siegman and Feldstein (2009) argued
that nonverbal cues were vitally important because many times peoples nonverbal
communication and verbal contradict each other. They also argued that without a persons
understanding of their own facial expressions, it would continue to create negative interactions.
This is also important within the doctor-patient relationships.
Types of Nonverbal Cues
There are many different types of nonverbal cues including facial expressions, eye
contact, gestures, and postures. All of these cues are regularly used in every day-to-day
interactions with friends, professors, and once in a while doctors. Facial expressions include eye
movement, mouth movement, and nose movements. (Jokinen, et, al., 2009). Eye contact is
defined as the extent to which one gazes into another individuals eyes. Gestures include hand
movement, body movement, basically the use of lower and upper body. (Argyle, 2013). Overall,
these types of nonverbal cues contribute to our communication on different levels.
Doctor-Patient Relationships

Relational Satisfaction

Doctor-patient relationships have become more important than ever with the aging
population. Nonverbal aspects have been found to be vitally important in this field (Mast, 2007).
Eye contact, gestures, and body position have been found to be important in Mast (2007) along
with Gorawara-Bhat and Cook (2010). They both found that there is greater patient satisfaction
when there are positive nonverbal cues used. Eye gaze and proximity to patients is especially
important according to Mast (2007). Patient satisfaction is impacted significantly when doctors
fail to exhibit positive nonverbal cues. Patients receiving a negative prognosis need this type of
communication in order to have a more positive view of their situation (Gorawara-Bhat & Cook,
2010).
Patients have been found to have one of two approaches to a doctors visit. They are
either certain their doctor is incompetent or that they must rely on their doctor for all the
information (Gorawara-Bhat & Cook, 2010). Any comprehensive understanding of physicianpatient interaction needs to include an analysis of verbal as well as nonverbal aspects of
communication (Gorawara-Bhat & Cook, 2010, p. 442). Communication is comprised of both
verbal and nonverbal, which explains the importance of both in this type of interaction. Mast
(2007) also emphasizes the importance of understanding the relationship between verbal and
nonverbal communication. Eye contact is important no matter what the patient does and
encompasses the extent to which a doctor looks into the patients eyes. Eye contact can influence
the understanding and the tone of the visit.
Doctor-patient interactions can be different based upon the age of the individual. Older
patients tend to require more eye contact because of possible hearing impairments (GorawaraBhat & Cook, 2010). Older patients rely more upon the nonverbal communication than the
verbal in many instances. It is important for doctors to understand the patients needs based upon

Relational Satisfaction

their age. Younger patients may be able to understand the doctor more clearly than older patients
because they do not typically have the same types of hearing and cognitive impairments.
Younger patients also tend to be healthier and experience less doctor interactions than older
patients (Gorawara-Bhat & Cook, 2010).
Doctor-patient communication is also impacted by the types of disorders that the patient
currently has. According to Robins, Dautenhahn, and Dickerson (2009), children with Autism
required specific type of communication. In many cases, children with Autism cannot
communicate verbally so they rely on the nonverbal communication. This can be compared to
the findings from Mast (2007) in regards to older patients. Older patients exhibit diseases such as
Alzheimers or dementia. These can also impact the amount of verbal communication that can be
used during a doctor-patient interaction. It is important to the satisfaction of the patients with
communication difficulties that the doctors treat them as individuals instead of as a member of a
group. Doctor-patient interactions can be improved when they view individuals as such because
every person has different communication needs.
In summary this literature review has focused on nonverbal communication and
specifically nonverbal communication in doctor-patient relationships. Nonverbal communication
and social interaction and the types of nonverbal cues helped to support the ideas behind doctorpatient relationships. Considering the previous research studies performed, the following
hypothesis is proposed in an attempt to bridge the gap in research in regards to doctor-patient
relationships:
H: Doctor-patient relationships are improved by the use of positive nonverbal cues.
Method
Overview

Relational Satisfaction

This study will have a hundred participants who each complete a survey. The more
participants there are, the more diverse can I expect the results to be different and diverse. This
method will be the most effective way to collect quantitative data because it produces numbers
that can easily be analyzed. The independent variable is nominal level and includes the presence
or absence of the positive nonverbal cues. The dependent variable is interval level because it is a
rating on a Likert scale of relational satisfaction. Following the collection of data, an independent
sample t-test will be used to analyze the data.
Participants
A sample will be collected from the Phoenix metropolitan area. This will include the
cities of Tempe, Scottsdale, Phoenix, Mesa, and Chandler. There will be 100 people sampled by
selecting from lists of patients from the doctors offices in these areas. The list will be obtained
after the patients sign off on their information being released for a study. There will be people
selected that fall into the age range of 25 to 65. This will allow for the different age populations
to be represented. In previous studies, having a difference in age groups has proven to give a
more wide variety of results. Doctor-patient relationships occur more frequently among the
elderly as opposed to the younger children and kids. As individuals age, the visits to the doctors
office will increase because there may be more problems as individuals age. Going to the
doctors office will give the elderly that doctor-patient interaction more frequently. Therefore,
having participants that are elderly will tend to give off more information during the survey
questions because of their experience of going to the doctor offices a lot more than the age of
younger adults. All of the participants will take this survey in a room.
Variables

Relational Satisfaction

The independent variable is the presence or absence of the positive nonverbal cues. This
will be tested using a Likert scale and asking the patients to critique their doctor-patient
interactions. The dependent variable is the level of satisfaction within their doctor-patient
relationships. The Likert scale will use a 1 (Least satisfied) to 5 (Most Satisfied). The variables
will be examined using Likert scale as well as a survey instrument which would be the survey
that is given to each of the hundred participants.
Procedure
For the procedure, all of the participants (from ages 25-65) ended up taking a survey.
Once all of the participants arrive they will be lead to a room to sit and wait until the survey
questionnaire is passed out. The survey consisted of twenty Likert Scale survey questions. All of
the questions will analyze the relational satisfaction. Each participant will take the survey then
after they have taken the survey the data will be collected. After the data is collected, it will run
through an independent sample t-test. The survey test will be very reliable because it is a survey
with 20 questions that are bound to give correct results. The validity of the study instrument will
also be a reliable source because this particular method chosen for this study will give logical
results. After the results arrive from the independent sample t-test then all of the results will be
shared with the participants who took part in this study. It is imperative to include the
participants in the study because they are going to be the ones who take the survey and they
should be able to see the results as well. It will also give them an understanding of what the
results were and how the difference of age played a role in the variety of results. I hope that the
results tell us that besides the elderly the young adults also visit their doctor and that the doctorpatient relationships are vital and of importance as explained in the literature review.
Limitations and Conclusion

Relational Satisfaction
The limitations for this study had external validity and the external validity may be
threatened because the sample is small and I did not use random sampling. I did not use random
sampling because then the results will not be concise and it would be all over the place. The
random sampling was the only threat in the limitations that would have caused different results
within the study. In summary, this research study focused on what nonverbal communication is
and why it is important in social interactions, doctor-patient interactions as well as why
nonverbal cues are imperative in day-to-day life. The research study should be explored in the
future to see what other kinds of methods and limitations are found in various types of
interactions.

References
Argyle, Michael. (2013). Bodily Communication. Books.google.com, (17-19).
Bal, Elgiz, Harden, Emily, Lamb, Damon, Vaughan, Amy Van Hecke, Denver, John W.,
Porges, Stephen W. (2009). Emotion Recognition in Children with Autism
Spectrum Disorders: Relations to Eye Gaze and Autonomic State. Journal
Of Computer Mediated Communication.
Balconi, M. (2010). The Neuropsychology of Nonverbal Communication: The Facial
Expressions of Emotions. Journal of Neuropsychology of Communication.
Bhat, Rita. Gorawara., Cook, Mary-Ann. (2011). Eye contact in patient-centered
Communication. Journal of Patient Education and Counseling.
Jokinen, Kristlina, Nishida, Masafumi, Yamamoto, Selichi. (2009). Eye-gaze
Experiments for conversation monitoring. Journal of Universal
Communication.

Relational Satisfaction
Knapp, L. Mark, Hall, A. Judith, Horgan, G. Terrence. (2013). books.google.com (14-21).
Marcinowics, Ludmilla, Konstantynowicz, Jerzy, Godlewski, Cezary. (2010). Patients
Perceptions of GP non-verbal communication: a qualitative study. British
Journal of General Practice.
Robins, B., Dautenhahn, K., Dickerson, P. (2009). From Isolation to Communication:
A Case Study Evaluation of Robot Assisted Play for Children with Autism
With a Minimally Expressive Humanoid Robot. Journal of Advances in
Computer-Human Interactions.
Seigman, W. Aron, Feldstein, Stanley. (2014). Nonverbal Behavior and Communication
Books.google.com
Swabb, I. Roderick, Swabb, F. Dick. (2009). Sex differences in the effects of visual
Contact and eye contact in negotiations. Journal of Experimental Social
Psychology.

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