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Gestural communication in pain focused interactions
[Thesis]. Manchester, UK: The University of Manchester; 2014.
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Abstract
Background: Despite the importance of effective pain communication in medical and everyday settings, pain is often difficult to verbalise. However, when we speak we also produce co-speech gestures (the movements of our hands, arms and other body parts that are closely integrated with speech). Research on communication about concrete topics (e.g., events in a cartoon) suggests these gestures are understood by recipients and frequently add information that is not contained in speech. However, only a small number of studies have considered the role of these gestures in the more abstract, perceptual domain of pain communication. Such studies have revealed that co-speech gestures are frequently produced during descriptions of pain and contain a range of information about the pain experience. Within this thesis, I build on previous work by considering the interplay between speech and gestures in the communication of pain sensation, the factors that are associated with gesture production during pain communication, and whether recipients are able to pick up the additional pain information contained in this modality.Methods: I employed two research paradigms: gesture production and gesture comprehension. The gesture production paradigm involved collecting video-recorded interviews about recent pain experiences (both naturally occurring and experimentally-induced pain), from which gestures and speech were coded according to their occurrence and the information they contained. This permitted an analysis of whether gestures contained additional information about pain sensation that was not contained in the accompanying speech or represented pain sensation in a more specific manner than speech, and whether the production of gestures differed as a function of pain intensity and degree of pain catastrophizing. The gesture comprehension paradigm involved participants viewing video clips of pain descriptions in which gestures were present or absent, with one group that did see gestures receiving training about co-speech gesture prior to watching the clips. Participants recounted the pain information contained in each clip and their responses were analysed to identify whether they contained information that could be traced directly back to the gestures in the original clips.Results: The production studies revealed that when both speech and gestures contain information about pain sensation, gestures still contribute unique information about this aspect of the experience, although they do not provide a more specific representation of the information contained in speech. Considering the factors associated with gesturing about pain, the production of gestures and speech increased when pain was more intense, while catastrophizing about pain was negatively associated with gesture production. Finally, the comprehension study revealed that people obtain more information about pain when they have access to the speakers’ gestures as well as their speech, with training providing additional benefits here.Conclusions: This thesis demonstrates that gestures are an integral part of pain communication, contributing a substantial amount of information about pain that recipients are able to understand. Although further research is needed to consider how doctors and patients use gestures within clinical settings and their impact on patient outcomes, this work represents an important first step in demonstrating the value of gestures in pain communication.