Communication and strengthening of relationship between the

Communication is based on a functional behaviour that is influenced by a hierarchy of needs such as primary needs (food, water, safety, etc.), psychological needs (intimate relationships and sense of accomplishment) and self-fulfilment needs (Chambers). With effective communication between a health practitioner and their patient can enhance overall satisfaction and grant towards greater long-term health outcomes (Sheeler). Interactive communication requires a person’s awareness and use of non-verbal communication skills, as well as, verbal skills which require notable ability in eight associated areas such as hearing, sight, memory, attention, turn-taking, eye contact, self-awareness and group awareness. A significant impairment of one or more of these skills will negatively influence the environment which can affect the communication’s appropriateness (Chambers). Thus, Sheeler noted the importance of non-verbal communication’s role not just in mundane activities but especially in promoting the sophistication of medical treatment. In addition, Hybel and Weaver II believed that more than 90 percent of communication is sent through non-verbal, with half of it sent through facial expressions, stance, and gestures and the remaining proportion through prosodic and paralinguistic cues. The significance of understanding non-verbal communication is undeniably paramount for both medical personnel and the patient in delivering effective health care services. Increased understanding of non-verbal communication means a higher likelihood of doctors to become a skilled diagnosticians (Sheeler) and strengthening of relationship between the nurse and patient (Chambers).


Communication is mostly made up of non-verbal communication but it is the neglected part and it is crucial to discern how it works and how individuals can utilize it (Hybels and Weaver II). The solution to regulating and thus improving one’s non-verbal communication is self-awareness. When a person is extensively conscious of the signals that are being sent, that person has a greater chance not just for controlling them but for assessing them as well. It is like using strategic flexibility on an intrapersonal level. An example cited by Sheeler wherein a fervent medical student discussing medical history to a long-term smoker patient fails to recognize the non-verbal cues sent by the patient indicating that he is not comfortable of the recommendations of smoking cessation which heightened to confrontational situation. Should the medical student be sensitive of the non-verbal cues sent by the patient, the consultation will not cause a breakdown in the doctor-patient relationship.

Suprasegmental features of voice, facial expressions, eye contact, and touch are some of the non-verbal communications that have a substantial effect in providing effective health care. The emphasis and volume of the voice are important portions of paralanguage as it intensifies, highlight or alter the meaning of the words delivered verbally (O’Toole). Moreover, another rich source of non-verbal cue that can be utilized by a medical practitioner and patient is facial expression. An analysis conducted that facial muscles can produce more than 10,000 expressions (Hybels and Weaver II). The term micro-expression was coined to describe ultraquick facial movements that signal underlying emotions, though barely noticeable, these expressions are key to determining whether someone is telling the truth. Furthermore, research has shown that doctor-patient eye contact and gestures are key aspects in determining how much information a patient would be willing to reveal. Initiating a face-to-face conversation may indicate that the healthcare professional is genuinely interested in speaking and listening to the patient, reassuring the patient that he or she is being heard. Maintaining eye contact with the patient may also allow the healthcare practitioner to divert the attention of a distracted patient back to the on-going consultation (O’Toole). Haptics is another component of non-verbal communication which has significant importance in providing effective health care. A study in premature babies showed that touch helps them to thrive which releases brain chemicals that promote growth as compared to babies who were left alone in their incubators, these babies also demonstrate much better on tests of mental and motor ability. Developing strategic flexibility amongst medical practitioner will help them to think before emoting as it requires them to anticipate, assess, evaluate, select and properly apply skills and behaviours and is more likely that the strategies will be effective if they can control the initial emotional responses.


Non-verbal communication plays an essential role in nursing care especially to people who have language disability as it has more impact compared to communication controlled by speech, this is in relation to the study made that patients with a severe learning disability are quite capable of expressing themselves using non-verbal communication. With improved nurse-client communication the better care and reduced level of challenging behaviour by clients. Chamber stressed that the key element of non-verbal communication to be effective for this kind of patients is to know the client well so that they will be more efficient in interpreting the messages. Nursing is dependent on effective communication; however, words often prevent optimal interaction.


Non-verbal communication is a quick and effective way of surpassing other forms of communication although it is mostly used in combination with verbal communication. A pre-verbal communication schedule was developed intended for people working with patients who have a severe learning disability, which was found quite effective. Objects of reference were used to enhance non-verbal communication, these objects were shown to clients prior to an activity that has relevance to it and they would know where and what activity they must do. Some examples are swimming trunks for hydrotherapy session, a shoe for walking and seat-belt buckle that means going out in the car. Chamber emphasized that a person with a severe learning disability should learn skills that will be useful in later life, rather than just provided solutions to problems that may not be valid in the future. Many people with limited verbal expression are masters at using facial expressions, other people’s personal space, eye contact and gestures to send powerful messages about themselves, their feelings and their needs. The responsibilities for nurses are to recognize and expand on these communications by sensitive and imaginative responses and to build up a good rapport with them.



A medical practitioner’s potential to interpret nonverbal communication is a solution to advancing the sophistication of medical therapy, especially in instances where patient does not fully disclose a medical condition, consciously or unconsciously to receive a proper cure in a timely and safe manner. Sheeler explains that there are many facets of patient history in which candid and sincere communication does not constantly transpire, like when discussing personally delicate areas involving a psychiatric malady or compliance history to various treatments such as drug rehabilitation and lifestyle adjustment. Competence in the ability of encoding and decoding nonverbal signals yield principal benefits such as high skills in interpersonal situations, organizational communication, teacher-student communication, etc. but most importantly it renders a crucial role in achieving the finest result in medicine (Devito).


Sheeler also notes that people engaged in the medical field lag behind when compared to other professions when it comes to communication since there is little to zero formal education on how to interpret nonverbal communication or sudden micro-expressions of a patient. Mentoring, reading and formal courses of study are all ways that can help a person become more proficient in non-verbal communication. In the practice of medicine, high-level communication skills are of critical import to success. Finding others with similar interest and using your combined commitment can help to bring these elements into the corporate culture and into the larger world to the benefit of all.



In conclusion, health professionals play a central and critical role in improving access and quality health care for the population. They provide essential services that promote health, prevent disease and deliver care services to individuals, families, and communities based on the primary health care approach. Mechanisms of optimizing the strength and skills of health professionals will be essential to achieving this goal and one of which is through effective communication. The delivery of quality medical care entails an effective interpersonal relationship between healthcare givers and receivers. NVC equips healthcare professionals with the ability to engage patients during consultations, as well as providing a positive experience to patients as visits to healthcare centers itself may be a stressful process. Consideration of the non-verbal communication theory is a useful exercise, as it helps health professionals to examine communication more closely; their communication with their clients and the patient’s communication with them. It also helps to see communication in a much wider context than only verbal expression, which is often imprecise about the expression of emotions possible through body language. NVC is not an inherited ability, but one that can be mastered with time and practice.