title: Clients' psychosocial communication and midwives' verbal and nonverbal communication during prenatal counseling for anomaly screening.
abstract: OBJECTIVE
  This study focuses on facilitation of clients' psychosocial communication during prenatal counseling for fetal anomaly screening. We assessed how psychosocial communication by clients is related to midwives' psychosocial and affective communication, client-directed gaze and counseling duration.
  
  
  METHODS
  During 184 videotaped prenatal counseling consultations with 20 Dutch midwives, verbal psychosocial and affective behavior was measured by the Roter Interaction Analysis System (RIAS). We rated the duration of client-directed gaze. We performed multilevel analyses to assess the relation between clients' psychosocial communication and midwives' psychosocial and affective communication, client-directed gaze and counseling duration.
  
  
  RESULTS
  Clients' psychosocial communication was higher if midwives' asked more psychosocial questions and showed more affective behavior (β=0.90; CI: 0.45-1.35; p<0.00 and β=1.32; CI: 0.18-2.47; p=0.025, respectively). Clients "psychosocial communication was not related to midwives" client-directed gaze. Additionally, psychosocial communication by clients was directly, positively related to the counseling duration (β=0.59; CI: 0.20-099; p=0.004).
  
  
  CONCLUSIONS
  In contrast with our expectations, midwives' client-directed gaze was not related with psychosocial communication of clients.
  
  
  CONCLUSIONS
  In addition to asking psychosocial questions, our study shows that midwives' affective behavior and counseling duration is likely to encourage client's psychosocial communication, known to be especially important for facilitating decision-making.
authors: Department of Midwifery Science, AVAG and the EMGO(+) Institute for Health and Care Research, VU University Medical Centre, Amsterdam, Netherlands. Electronic address: linda.martin@INHOLLAND.nl.
authors: Linda
authors: L
authors: Martin
authors: Department of Midwifery Science, AVAG and the EMGO(+) Institute for Health and Care Research, VU University Medical Centre, Amsterdam, Netherlands; Faculty of Theology, VU University, Amsterdam, Netherlands.
authors: Janneke T
authors: JT
authors: Gitsels-van der Wal
authors: Department of Midwifery Science, AVAG and the EMGO(+) Institute for Health and Care Research, VU University Medical Centre, Amsterdam, Netherlands.
authors: Monique T R
authors: MT
authors: Pereboom
authors: Department of Midwifery Science, AVAG and the EMGO(+) Institute for Health and Care Research, VU University Medical Centre, Amsterdam, Netherlands; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
authors: Evelien R
authors: ER
authors: Spelten
authors: Department of Midwifery Science, AVAG and the EMGO(+) Institute for Health and Care Research, VU University Medical Centre, Amsterdam, Netherlands; Obstetrics & Gynecology, Midwifery Education Program, McMaster University, Hamilton, Ontario, Canada.
authors: Eileen K
authors: EK
authors: Hutton
authors: NIVEL (Netherlands Institute for Health Services Research), Utrecht, Netherlands; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands; Faculty of Health Sciences, Buskerud and Vestfold University College, Drammen, Norway.
authors: Sandra
authors: S
authors: van Dulmen
mesh_terms: D000328:Adult; D000339:Affect; D003142:Communication; D000013:Congenital Abnormalities / Q000175:diagnosis*; D003376:Counseling / Q000379:methods*; D004645:Empathy; D005260:Female; D006801:Humans; D008880:Midwifery / Q000379:methods / Q000592:standards*; D055361:Multilevel Analysis; D009426:Netherlands; D009633:Nonverbal Communication / Q000523:psychology; D009721:Nurse Midwives / Q000523:psychology*; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods / Q000523:psychology; D011296:Prenatal Diagnosis / Q000523:psychology*; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D014743:Videotape Recording
keywords: Affective communication; Client-directed gaze; Nonverbal behavior; Prenatal genetic counseling; Psychosocial-communication; Video recording