Physician and Patient Perceptions of Physical Touch in Primary Care Consultations in Lebanon: A Qualitative Study

Abstract

Background: Verbal and non-verbal communications are an inherent component of physician-patient interactions. The psychological and physiological benefits of non-verbal communication such as gestures, expressions, eye contact, and particularly physical touch in healthcare have been previously explored by the scientific community, albeit insufficiently in the primary care context. Objective: This study aims to address this gap by investigating physician and patient perceptions of expressive touch and its effect on patient satisfaction in primary care consultations in Lebanon. Methods: We recruited 12 physicians and 13 patients and subjected them to audiotaped semi-structured interviews. We selected the patients from three hospitals, while physician responders were from the Faculty of Medical Sciences of the Lebanese University. We translated the survey instrument into Arabic and validated it using back translation sustained by a pilot study. We performed constant comparative qualitative analysis for obtained relevant data. Results: Patient satisfaction and trust were associated with good verbal and non-verbal communication. Patient and physician responders recognized the benefit of empathy in building long-term relationships. Social and non-intimate expressive touches were positively perceived by patients, although within ethical and religious boundaries. Male physicians expressed clear apprehension for the use of touch, especially towards female patients, due to religious considerations. On the other hand, touch from female physicians was reportedly accepted by patients of both genders, while touch from their male counterparts was associated with more uneasiness. Discussion and Conclusions: Religious concerns are prevalent among Lebanese physicians and patients alike. However, the use of reassuring physical touch is still a cornerstone of the patient-physician relationship in Lebanon, albeit with some limitations. The potential therapeutic effect of verbal and non-verbal communication is evident and warrants further investigation. Communication training efforts should emphasize the importance of religiously and ethically appropriate expressive touch in healthcare. This would serve to promote positive physician and patient perceptions of this practice and improve clinical communication and expressiveness.