title: Ethics in the communicative encounter: seriously ill patients' experiences of health professionals' nonverbal communication.
abstract: BACKGROUND
  The communicative encounter has been described as a fundamental element in caring for the patients, and further, in this encounter, the nonverbal body language and the tone of speech are agued to play a crucial role.
  
  
  OBJECTIVE
  This study explores how seriously ill hospitalised patients experience and assign meaning to the health professionals' communication with special attention to the nonverbal body language and tone of speech. The study is part of a larger study exploring how seriously ill patients experience and assign meaning to the sensory impressions in the physical hospital environment as well as to the health professionals' communication.
  
  
  METHODS
  The study is based on qualitative interviews supplemented by observations and applies Paul Ricoeur's phenomenological-hermeneutic theory of interpretation in processing the collected data. We included twelve patients with potentially life-threatening illnesses such as cancer, severe lung, liver and heart disease.
  
  
  RESULTS
  Through analysis and interpretation of the interviews, we identified two themes in the text: (i) Being confirmed, (ii) Being ignored and an inconvenience. The patients experienced that the health professionals' nonverbal communication was imperative for their experience of being confirmed or in contrast, their experience of being ignored and an inconvenience.
  
  
  CONCLUSIONS
  The health professionals' nonverbal communication proved essential for the seriously ill patients' experience of well-being in the form of positive thoughts and emotions. Consequently, this sensory dimension of the communicative encounter represents a significant ethical element in caring for the patients.
authors.affiliation: Health Services Research Unit, Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark.
authors.forename: Connie
authors.initials: C
authors.lastname: Timmermann
authors.affiliation: The Research Unit, Horsens Regional Hospital, Aarhus University and Department of Health, Science and Technology, Aalborg University, Aalborg, Denmark.
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Uhrenfeldt
authors.affiliation: Health Services Research Unit, Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark.
authors.forename: Regner
authors.initials: R
authors.lastname: Birkelund
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000941:ethics*; D003718:Denmark; D005260:Female; D006282:Health Personnel / Q000941:ethics* / Q000523:psychology*; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009633:Nonverbal Communication / Q000523:psychology*; D036301:Qualitative Research
keywords: attentiveness; caring; ethics of care; interviews; nonverbal communication; phenomenological-hermeneutic; seriously ill patients; well-being