This study sought to establish some ofthe problems that occur during a consultation process between a healthcare worker and a patient, such as intangible and tangible verbal/nonverbal communication problems. Tangible nonverbal problems refer to eye contact, gestures, body posture and facial expression. Tangible verbal problems refer to voice tone/attitude and language and intangible to race, age, gender, education and culture. It was made clear that the problems involved in the consultation process were, in the main, common to other fonns of communication such as that between a reference librarian and a client, customer, visitor or user. The factors that hindered communication were investigated by means of semi-structured interviews and questionnaires. The sample population was made up of 100 black isiZulu speaking females and seven healthcare workers of a heterogeneous background. The perception ofthe respondents in relation to the above-named factors (language, age, gender, attitude, culture, education, gestures and postures) was sought. The analysis of the results obtained showed that some of the significant factors that are a problem in communication include voice tone/attitude, eye contact, sitting position, gestures, facial expression and language. Patients, for the sake ofeffective concentration and free flow ofinfonnation, preferred healthcare workers who were polite, had a cheerful demeanour and who sat still and straight up (not looking around or standing). This is noted because the majority of the patients acknowledged such healthcare workers and were not satisfied with those who behaved otherwise. For example, in relation to previous consultations (irrespective of the Clinics), out of the 70 respondents who encountered problems, 61 (87%) in despair cited cases of rudeness, of which the majority of such cases related to African healthcare workers. Culture also mattered, when seen in terms of people being able to speak the same language and understand one another, with respect to the contextual meaning of words. As far as eye contact was concerned, it was apparent that adjustments had been made. For example, it was discovered that although it is the Zulu culture to avoid eye contact, especially between the young and the old, Zulu people have come to accept eye contact in a crosscultural South Africa. Their acceptance was also seen as due to the advantages ofeye contact. This was made clear by the fact that ofthe 90 (91%) respondents who acknowledged the fact that the healthcare workers maintained eye contact during the consultation process, 87 (97%) said it was polite as it gave them the assurance that the healthcare workers were paying attention to what they were saying. Among the socio-demographic variables investigated, the gender of the healthcare worker emerged as one ofthe important predictors of effective communication. This is because the majority of the respondents indicated feeling freer with someone of the same gender groupmg. Certain recommendations were made which were considered vital in improving not only the consultation process but any other form of communication, including that between a reference librarian and a client. The main recommendations were that the healthcare workers be polite and endeavour to speak the main language as the patients. Due to the fact that some healthcare workers hurry during consultation, it was recommended that more staff be employed.

Thesis (M.I.S.)-University of Natal, Pietermaritzburg, 2000.