title: Nonverbal communication and conversational contribution in breast cancer genetic counseling: are counselors' nonverbal communication and conversational contribution associated with counselees' satisfaction, needs fulfillment and state anxiety in breast cancer genetic counseling?
abstract: OBJECTIVE
  The current study aimed to examine how counselors' nonverbal communication (i.e. nonverbal encouragements and counselee-directed eye gaze) and conversational contribution (i.e. verbal dominance and interactivity) during the final visit within breast cancer genetic counseling relate to counselee satisfaction, needs fulfillment and anxiety.
  
  
  METHODS
  Breast cancer counselees (N=85) completed questionnaires measuring satisfaction, needs fulfillment and anxiety after the final consultation and anxiety before the initial visit. Consultations were videotaped. Counselor nonverbal encouragements and counselee-directed eye gaze were coded. Verbal dominance and interactivity were measured using the Roter Interaction Analysis System (RIAS).
  
  
  RESULTS
  More counselor nonverbal encouragements and higher counselor verbal dominance were both significantly related to higher post-visit anxiety. Furthermore, counselor verbal dominance was associated with lower perceived needs fulfillment. No significant associations with eye gaze and interactivity were found.
  
  
  CONCLUSIONS
  More research is needed on the relationship between nonverbal encouragements and anxiety. Given the unfavorable association of counselor verbal dominance with anxiety and needs fulfillment, more effort could be devoted to involve counselees in the dialog and reduce the counselor's verbal contribution during the consultation.
  
  
  CONCLUSIONS
  Interventions focused on increasing counselees' contribution in the consultation may be beneficial to counselees.
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Henriëtta
authors.initials: H
authors.lastname: Dijkstra
authors.forename: Akke
authors.initials: A
authors.lastname: Albada
authors.forename: Christina
authors.initials: C
authors.lastname: Klöckner Cronauer
authors.forename: Margreet G E M
authors.initials: MG
authors.lastname: Ausems
authors.forename: Sandra
authors.initials: S
authors.lastname: van Dulmen
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology*; D001943:Breast Neoplasms / Q000235:genetics* / Q000523:psychology*; D005133:Eye Movements; D005260:Female; D005817:Genetic Counseling / Q000523:psychology*; D006301:Health Services Needs and Demand; D006801:Humans; D008875:Middle Aged; D009633:Nonverbal Communication; D017060:Patient Satisfaction; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014743:Videotape Recording
keywords: Anxiety; Communication; Eye gaze; Familial breast cancer; Genetic counseling; Interactivity; Needs fulfillment; Nonverbal encouragement; Satisfaction; Verbal dominance