A sociolinguistic study of doctor-patient interaction in healthcare settings : a Jordanian perspective

Communication is a crucial component of clinical practice for both doctors and patients. The effectiveness of verbal and non-verbal communication between doctors and patients has a significant impact on health outcomes for patients. Previous studies have shown that language and socio-cultural factors can have a negative impact on the doctor-patient relationship, patients’ satisfaction, patients’ adherence to treatment and other related outcomes. The purpose of this study was to examine the verbal, non-verbal and socio-cultural barriers that preclude effective doctor-patient (D-P) communication in Jordan leading to poor health outcomes and identifying the strategies used for effective communication. This study drew conceptually on Interactional Sociolinguistics Theory (IST) and Communication Accommodation Theory (CAT) to describe and analyse Jordanian D-P interaction in clinical consultations. It sought to 1) analyse the factors that hinder doctor-patient verbal interaction, 2) explore the non-verbal communication benefits and barriers in doctor-patient clinical interaction, and 3) critically examine the socio-cultural barriers that cause ineffective doctor-patient communication and misunderstanding. A thematic, qualitative approach was employed to interpret the phenomena under study. Doctor-patient clinical interaction was video-recorded and interviews with doctors (n=9) and patients (n=18) were audio-recorded. The analysis of audio and video data revealed that several factors influenced doctor-patient communication, and were divided into three major dimensions. The verbal dimension included language barriers, health literacy and disclosure of sensitive information. The non-verbal dimension includes haptic, paralinguistic, and kinesic cues. Socio-cultural dimension includes gender roles, traditional medicine, and cultural beliefs. The study also found that participants used a set of strategies for effective communication, including doctors’ affective and convergent behaviours such as: codeswitching, and positive non-verbal behaviours, such as eye contact and smiling. While some patients used a story-based interaction style to explain their medical needs, others were affected by socio-cultural taboo practices. The findings of the study supported the need for Jordanian doctors and patients to make extra effort to further develop their verbal and non-verbal communication competence, and socio-cultural awareness during clinical consultations