Conversational analysis of medical discourse in rehabilitation: A study in Korea

Objective: The purpose of this study is to conduct an analysis of actual communicative behaviors, including nonverbal ones, between physicians and patients in rehabilitation. Design: Sixteen videotaped physician-patient interactions in a rehabilitation center in Korea were transcribed. And three coders placed utterances in transcripts into categories while watching the videotapes. Results: Consistent with results of previous studies, patient active communicative behaviors varied considerably depending on individual patients. The findings revealed that, on average, patients' active communicative behaviors were less than 9% of patients' total utterances. In particular, almost half of the patients (N = 7) did not even ask one single question. The results also showed that physicians' empathic communicative acts averaged less than 3% of physicians' total utterances. In addition, among physicians' nonverbal behaviors, eye-contact showed significant correlation with physician empathic listening and supportive talks. Conclusions: The findings of this study indicated a considerable lack of empathic communicative behaviors of physicians in Korea. This might have led to infrequent use of active communicative behaviors by patients. In addition, the importance of physician's partnership for enhancement of active communicative behaviors of patients was demonstrated. To better serve patients, physicians who wish to improve their communication should first identify components of their empathic communicative behaviors that need improvement and then attempt to refine their skills.