Addai-Davis, J; (2015) Do pain images used in pain consultations affect clinicians’ and patients’ nonverbal communication, and patient emotional disclosure? Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Background: Patients with chronic pain find it hard to convey their experience of pain in medical consultations. Visual images may communicate experience in a way which language cannot. Aim: To examine the impact of using images of pain on patients’ and clinicians’ nonverbal communication and how personal patients’ emotional disclosures were during pain consultations. Method: Thirty-five video-taped chronic pain consultations were used (17 patients had consultations with images and 18 did not). Ten clinicians conducted consultations in both groups. Using fixed-interval sampling, coders rated perceptions of patients’ and clinicians’ affiliation and dominance behaviours using the Interpersonal Grid (Moskowitz & Zuroff, 2005); how personal patients’ emotional disclosures were; and whether or not the images were actively used in consultations. Results: In consultations with images, behavioural correspondence (mirroring behaviour) between patients’ and clinicians’ positive affiliation behaviours was observed, and patients made more personal emotional disclosures when the images were used compared to when they were not used in the consultation. Behavioural reciprocity (mismatching behaviour indicative of status differences) between patients’ and clinicians’ dominance behaviours was not observed in either consultation. No differences were found between consultations with and without images for rates of patients’ or clinicians’ affiliation and dominance behaviours, and patients’ emotional disclosures over the course of the consultations. Conclusions: Using images in pain consultations largely failed to demonstrate a beneficial impact on the nonverbal communication of patients and clinicians. However, some benefit was found: pain images facilitated patient-clinician behavioural correspondence and patient emotional disclosure. The findings will be used to inform further research on verbal and nonverbal communication in pain consultations and the use of visual images.

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