Nonverbal communication in doctor-elderly patient transactions (NDEPT): development of a tool

Patient Educ Couns. 2007 May;66(2):223-34. doi: 10.1016/j.pec.2006.12.005. Epub 2007 Feb 26.


Objective: There are several measurement tools to assess verbal dimensions in clinical encounters; in contrast, there is no established tool to evaluate physical nonverbal dimensions in geriatric encounters. The present paper describes the development of a tool to assess the physical context of exam rooms in doctor-older patient visits.

Method: Salient features of the tool were derived from the medical literature and systematic observations of videotapes and refined during current research.

Results: The tool consists of two main dimensions of exam rooms: (1) physical dimensions comprising static and dynamic attributes that become operational through the spatial configuration and can influence the manifestation of (2) kinesic attributes.

Conclusion: Details of the coding form and inter-rater reliability are presented. The usefulness of the tool is demonstrated through an analysis of 50 National Institute of Aging videotapes. Physicians in exam rooms with no desk in the interaction, no height difference and optimal interaction distance were observed to have greater eye contact and touch than physicians' in exam rooms with a desk, similar height difference and interaction distance.

Practice implications: The tool can enable physicians to assess the spatial configuration of exam rooms (through Parts A and B) and thus facilitate the structuring of kinesic attributes (Part C).

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Validation Study

MeSH terms

  • Adult
  • Aged* / physiology
  • Aged* / psychology
  • Aged, 80 and over
  • Data Collection / methods*
  • Data Collection / standards
  • Female
  • Humans
  • Interior Design and Furnishings* / methods
  • Interior Design and Furnishings* / statistics & numerical data
  • Male
  • Middle Aged
  • Midwestern United States
  • Nonverbal Communication* / physiology
  • Nonverbal Communication* / psychology
  • Observation / methods
  • Observer Variation
  • Office Visits*
  • Personal Space
  • Physician-Patient Relations*
  • Qualitative Research
  • Southwestern United States
  • Spatial Behavior
  • Touch
  • Videotape Recording