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Many patients feel anxious when entering the consultation room, but seldom verbalize their emotions explicitly in the medical encounter. The authors designed a study to analyse the visibility of patient pre‐consultation (state) anxiety in their communication during the consultation. In an attempt to learn more about how general practitioners' (GPs') communication can help patients to express their worries, the paper also aims to explore the relationship between physicians' communication and patients' articulation of concerns and worries during the consultation.

From a representative sample of videotaped consecutive consultations of 142 Dutch GPs with 2,095 adult patients, 1,388 patients (66.3 per cent) completed the pre‐consultation questionnaire, including state anxiety (STAI), subjective health (COOP‐WONCA‐charts) and the reason for encounter (ICPC). GPs assessed the psychosocial background of patients' presented problems on a five‐point Likert scale. The videotaped consultations were coded with RIAS, including global affect measures. GPs' patient‐directed gaze was measured as a time‐measure.

The results show that, on average, the patients had slightly elevated anxiety levels and one‐third of the patients were highly anxious. As expected, the anxious patients seldom expressed emotional concerns directly, but did show a nonverbal and verbal communication pattern which was distinctively different from that of non‐anxious patients. Whether or not patients expressed concerns verbally was significantly related to GPs' affective communication and partnership building. Nonverbal communication seemed to play a dominant role both in sending and receiving emotional signals

In more than half of the consultations worries were not openly expressed, even by patients with high levels of anxiety. Patients tended to express their concerns in a more indirect way, partly by verbal, partly by nonverbal signals. GPs can facilitate patients to express their concerns more openly, not by direct questioning, but by showing verbal and nonverbal affect to the patient.

Focuses on the important role of verbal and nonverbal affect in physicians' communication.

What makes employees feel well within an organization? The aim of the present chapter is to start from a paradigm that emphasizes human relationality, affectivity, and intersubjective systems, and accordingly focuses on how well-being is emerging from contextual interrelations between employees. Applying this perspective to a qualitative study of nurses in a nursing home, I came to see the work community as a well-being-generating system in which the well-being of individual members is constructed together as an ongoing social accomplishment. In addition, I identified four systemic processes within the work community that greatly influence the well-being-generating capacity of the system.

This study set out to examine whether personal religiosity was in any way associated with adolescents’ propensity to seek out formal mental health care.

Using the National Longitudinal Study of Adolescent Health (Add Health), this study uses logistic regression models to test for an association between personal religiosity and mental health services use net of depressive symptomology and demographic controls.

Results showed a negative, statistically significant relationship between personal religiosity and mental health services use. Highly religious adolescents had lower odds of having seen a mental health professional compared to their less religious counterparts even after controlling for depressive symptomology.

Data restrictions required that we limit our analysis to one specific form of mental health services: talk therapy. Nevertheless, this study suggests that religiosity represents a potentially important consideration in addressing the mental health needs of adolescents.

To our knowledge, this is the first study in which a nationally representative sample of adolescents is used to examine the relationship between personal religiosity and mental health services use.

The methods of coping and their relationship to disease severity, cognitive function, depression and health‐related quality of life (HRQoL) were examined in 79 Parkinson's disease (PD) patients and their carers. The coping methods of the PD patients were not associated with disease severity, cognitive function, or depression. In general the majority of correlations were weak. However, patients who used avoidance and cognitive coping methods reported improved HRQoL. Impaired cognitive function, poorer HRQoL and increased disease severity were associated with depression in patients. In carers, avoidance coping was associated with depression and cognitive impairment in the patient being cared for. These findings demonstrate the complex relationship in PD between impairment, quality of life, depression, cognitive function and the coping styles adopted by patients and carers. The study also highlights the difficulties in measuring these interactions with quantitative outcome measures.

This paper offers an exploration of contextual factors that influence carer-to-resident talk in Australian residential aged care.

A qualitative exploratory multiple case study methodology and a theoretical framework of service language were applied to explore the perspectives of 21 registered nurses, assistants in nursing, leisure and lifestyle officers, general managers and care managers at three residential aged care homes in Australia.

The findings demonstrate contextual factors related to the care home environment, the carer and the relationship between carers and residents that impede or enable carer-to-resident talk in residential aged care. Multiple factors related to the care home environment were found to impede carer-to-resident talk, including time pressures, staffing levels, team culture and the prioritisation of tasks. Factors related to carers had potential to either impede or enable talk, including carers' awareness of the importance of communication, level of experience and individual characteristics, values and attitudes. A strong relationship between a carer and resident built on knowledge of individuals was a key enabling factor.

The paper advances an understanding of factors that influence talk and interaction in residential aged care in Australia from carers' and care home leaders' perspectives. The findings can be used to support verbal communication management strategies aligned with a person-centred care approach, including training and development of staff, cultural change interventions and a review of care delivery procedures.

This study aims to explore the role of interactants' nonverbal sensitivity, anxiety and sociodemographic characteristics in learning and satisfaction within the genetic counseling context.

This is a combined simulation and analogue study. Simulations were videotaped with 152 prenatal and cancer genetic counselors and nine simulated clients. The videotapes were shown to 559 subjects recruited to act as analogue clients (ACs) with the instruction to imagine themselves as the client in the simulation. The profile of nonverbal sensitivity (PONS), a video and audio test of accuracy in the interpretation of nonverbal cues, was administered to both the genetic counselors and ACs. In addition, the ACs completed a literacy screen and post session measures of learning and session satisfaction.

The study finds that ACs' post‐session knowledge score was positively associated with both their own and the counselors' audio PONS scores. Also related to knowledge were clients' literacy, younger age and non‐minority ethnicity. Ratings of session satisfaction were inversely related to ACs' and counselors' video PONS scores and ACs' literacy and anxiety.

While based on the performance of a large number of practicing genetic counselors, simulated and analogue clients are used to explore study questions.

The nonverbal sensitivity of both providers and ACs plays a role in medical communication and its cognitive and affective consequences. These findings warrant greater attention to nonverbal dynamics in future research and interventions.

No similar studies have investigated the role of nonverbal sensitivity in predicting learning and satisfaction for users of health care services.

The purpose of this paper is to examine how strategic, patient-centred communication plays a part in the discursive management of expectations posed to patients and healthcare organizations.

The paper provides an analysis of four documents collected as part of an ethnographic case study regarding “The Perspective of the Patient” – a Danish Hospital’s patient-centred communication programme. Mapping methods inspired by Grounded Theory are used to qualify the analysis.

The paper shows that strategic patient-centred communication addresses both a care-oriented approach to the patient and deploys market perceptions of patients. Market and care is seen as co-existing organizing modes that entail expectations to the patient. In the communication programme the patient is constructed in six information-seeking patient figures: affective patient; target group patient; citizen with rights; patient as a competent resource; user as active partner; and consumer. As a result, the patient-centred communication programme renders the patient as a flexible figure able to fit organizational demands of both care orientation and market concerns.

This study contributes to qualitative research in organizational health communication by combining two subfields – patient-centredness and health communication – in an empirical study of how market and care are intertwined in a patient-centred communication programme. The argument goes beyond the prevalent prescriptive approaches to patient-centredness and healthcare communication, instead providing a critical analytical perspective on strategic communication and patient-centredness and showing how expectations are posed to both patient and organization.

The medical consultation is one of the requirements in diseases diagnosis and patient treatment. In addition, a high-quality consultation is a fundamental demand of patients, and it is one of the rights of every patient. The purpose of this paper is to identify factors affecting the high-quality consultation in medical communications.

The following electronic databases were searched: MEDLINE (via PubMed), Web of Science, Cochrane, EMBASE, Scopus and ProQuest until December 2018. In addition, the authors searched Google Scholar. Qualitative and quantitative studies were assessed using the Critical Appraisal Skills Programme, Qualitative Checklist and the Center for Evidence-Based Management appraisal checklist, respectively. A stepwise approach was conducted for data synthesis.

Of 3,826 identified studies, 29 met the full inclusion criteria. Overall, after quality assessment of studies, 25 studies were included. The studies were conducted in the USA (n=6), the UK (n=6), the Netherlands (n=4), Canada (n=2), Belgium (n=2), Poland (n=2), Germany (n=1), Iran (n=1), Finland (n=1), Austria (n=1), Qatar (n=1), Denmark (n=1) and China (n=1), and five studies were excluded. Data synthesis showed that high-quality consultation consisted of three main categories: structural (4 main themes with 26 sub-themes), process (2 main themes with 33 sub-themes) and outcome (3 main themes with 12 sub-themes) quality.

Using the indicators of consultation quality improvement can develop physicians’ clinical competence and skills. Decision makers can use them to monitor and evaluate physicians’ performance. A high-quality consultation can be useful in social prescribing that helps patients to manage their disease.

Visit time is a crucial aspect of patient–physician interaction; its inadequacy can negatively impact the efficiency of treatment and diagnosis. In addition, visit time is a fundamental demand of patients, and it is one of the rights of every patient. The purpose of this paper is to determine factors influencing the consultation length of physicians and to compare consultation length in different countries.

MEDLINE (PubMed), Web of Science, Cochrane, ProQuest, Scopus, and Google Scholar were searched. In addition, references of references were checked, and publication lists of individual scholars in the field were examined. We used data sources up to June 2018, without language restriction. We used a random-effects model for the meta-analyses. Meta-analyses were conducted using Comprehensive Meta-Analysis Version (CMA) 3.0.

Of 16,911 identified studies, 189 studies were assessed of which 125 cases (67 percent) have been conducted in the USA. A total of 189 studies, 164 (86.77 percent) involved face-to face-consultations. The effects of three variables, physician gender, patient gender, and type of consultation were analyzed. According to moderate and strong evidence studies, no significant difference was found in the consultation lengths of female and male doctors (Q=42.72, df=8, I²=81.27, p=0.891) and patients’ gender (Q=55.98, df=11, I²=80.35, p=0.314). In addition, no significant difference was found in the telemedicine or face-to-face visits (Q=41.25, df=5, I²=87.88, p=0.170).

In this systematic review and meta-analysis, all of physicians’ visits in 34 countries were surveyed. The evidence suggests that specified variables do not influence the length of consultations. Good relationship is essential to a safe and high-quality consultation and referral process. A high-quality consultation can improve decisions and quality of visits, treatment effectiveness, efficiency of service, quality of care, patient safety and physician and patient satisfaction.