literature review of interpersonal communication

Interpersonal Communication: A Mindful Approach to Relationships

(12 reviews)

Jason S. Wrench, State University of New York

Narissra M. Punyanunt-Carter, Texas Tech University

Katherine S. Thweatt, State University of New York

Last Update: 2023

ISBN 13: 9781942341772

Publisher: Milne Open Textbooks

Language: English

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Reviewed by Jinnie Jeon, Assistant Professor, Adler University on 5/30/23

N/A read more

Comprehensiveness rating: 5 see less

Content Accuracy rating: 5

Relevance/Longevity rating: 5

Clarity rating: 5

Consistency rating: 5

Modularity rating: 5

Organization/Structure/Flow rating: 5

Interface rating: 5

Grammatical Errors rating: 5

Cultural Relevance rating: 5

“Interpersonal Communication: A Mindful Approach to Relationships” by Jason S. Wrench, Narissa M. Punyanunt-Carter, and Katherine S. Thweatt is a truly illuminating journey into the depths of human interaction. A cutting-edge book written in an engraining and accessible style, it expertly blends theoretical foundations with practical applications, encouraging readers not just to understand but also to implement the principles of effective communication. The author’s unique focus on mindfulness, a concept rarely emphasized in similar literature, provides a fresh perspective and an essential tool for nurturing and enhancing relationships in today’s fast-paced, technology-driven world. This approach enables readers to become more present and thoughtful communicators. Despite the intricacies of the subject matter, the text remains approachable and practical, enriched by real-life examples and exercises that promote self-reflection. The original cover art by Melinda Ahan adds a touch of beauty and uniqueness to this enlightening piece of work. Overall, the book stands as a seminal text for anyone seeking to improve their interpersonal communication skills, from students to professionals and beyond.

Reviewed by Dana Trunnell, Associate Professor of Communication, Prairie State College on 3/15/23

This text covers interpersonal communication concepts and theory in extraordinary detail with the added bonus of weaving mindfulness into each topic. If anything, I find the chapters to be almost too long for undergraduate reading expectations. That said, the mindfulness approach, along with the care taken to cover topics from multiple perspectives is appreciated. One especially great resource is the accompanying instructor resource manual, which is very detailed, updated, and helpful. It is not the afterthought that some OER textbooks provide. I would like to see more coverage of LGBTQIA+ issues.

The text is accurate, without grammatical and proofreading errors. I do think the text can be rather repetitive in spots, so word economy might be something to think about for future revisions and editions.

Interpersonal Communication is a timeless discipline and the text reflects this disciplinary longevity. I find the mindfulness approach to be an important update as the mindfulness trend establishes itself into a more long-term approach to thinking about relationships, communication, and life, in general. But, the text should be updated to be more aware and inclusive of emerging norms in race, LGBTQIA+, and sociopolitical issues.

Clarity rating: 4

Information is presented in an easy-to-read format and concepts are explained clearly. As I mentioned above, at times, the text can be pretty repetitive, which affects readability.

The content in this text is consistent with the approaches of for-profit volumes on Interpersonal Communication.

I like that this text displays the full chapter when one clicks on the link instead of only one subsection of that chapter. So, students can read the entire chapter from one link without having to scroll through other pages using navigational tools. I have found that the latter is very confusing to students, who might read only the first subsection and not the entire chapter. These links can easily be incorporated into an LMS module for easy access. In addition, each chapter is organized consistently, beginning with introductory information about each unit. The chapters are divided by major topics/concepts and each division includes Learning Objectives, Key Takeaways, and application Exercises. Time is devoted in each chapter to the application of the mindfulness approach as it relates to the topic of study. Chapters end with a list of important terms, a case study, and end-of-chapter assessments.

The content flowed well with transitions linking the chapters. I think the ordering of the chapters made sense. I also think it makes sense to organize them completely differently. The beauty of interpersonal communication is that it is so important and pervasive in our lives that we can jump in anywhere and get the discussion started. I do think, however, it is easy to adapt the flow of the text to any class – titular notions of “Chapter 1,” “Chapter 2,” etc. mean less with an electronic resource that is linked to LMS modules than a physical book.

Interface rating: 4

The textbook is easy to use and easy to navigate as it uses the consistent approach of other texts housed in the Open Textbook Library. Chapters are consistently organized and it is easy to move throughout the text. I love that hyperlinks are provided so students can access referenced surveys, measures, and other supplementary material. Unfortunately, some of these are dead links.

I did not encounter grammatical errors as I read.

Cultural Relevance rating: 3

The book acknowledges the importance of cultural factors as they influence various parts of the interpersonal communication process. However, the text would benefit from an update that helps students navigate the current communication climate, especially as they relate to current issues associated with race, sociopolitical events, and LGBTQIA+ people.

This text is particularly good for introductory-level interpersonal communication students. Instructors who value mindfulness as a daily practice will find this text especially suitable for their teaching style. New instructors will be impressed and feel supported by the extensive ancillary material.

Reviewed by Beth Austin, Assistant Teaching Professor, University of Wisconsin - Superior on 9/23/22

This book covers all the relevant material covered in a typical textbook on interpersonal communication. read more

This book covers all the relevant material covered in a typical textbook on interpersonal communication.

After briefly looking through the book and with publisher and the authors' credentials, I am confident in the accuracy of the content.

This text was published in 2020 and the images, research, and mindfulness angle are still relevant. Only time will tell the reception that mindfulness receives over the years.

This book is easy to read and contains foundational jargon for the discipline.

The text is internally consistent in terms of terminology and framework.

The page layout of this book provides the reader with captivating images which provide reading breaks. The infographics are colorful and visually dynamic.

The flow and structure of this book follow the table of contents for many other interpersonal communication texts.

This book is user-friendly and easy on the eyes.

I did not find any grammatical errors in this book.

I did not see any evidence of insensitive or offensive material in the book.

Chapter 14: The Darkside of Interpersonal Communication provides information about which many undergraduate students may relate.

Reviewed by Riley Richards, Assistant Professor, Oregon Institute of Technology on 8/22/22

This book offers a unique perspective on IPC, particularly through its mindfulness lens. Through this lens, it covers the standard and expected major ideas needed to cover in an IPC class and is covered in other IPC textbooks. The information covered and how it is presented (i.e., readability) are fit for undergraduate students in an introductory or standalone IPC course. Areas of content that stand out in this text, compared to other IPC texts, are the chapters on mediated communication and especially the dark side of IPC. Additionally, emotions through the lens of mindfulness are discussed throughout the text while other IPC texts lump the connection between emotion and communication into a section or chapter. From an instructor standpoint, I especially appreciated the authors explaining how research findings were found (i.e., methodology) instead of simply providing the student with the information and a citation through the research spotlight sections. My only minor critique is the family and marriage relationship chapter. The marriage portion albeit limited is related to family but also seemed out of place in the text. A standalone chapter on romantic/sexual relationships seems like a natural next step in the next edition. Also, instructors can easily substitute this section for other material. Finally, the additional materials (e.g., Ted Talk, YouTube videos) provide accessible material for a student who may wish to learn more in-depth information or prefer information through different mediums.

The authors did well in balancing the breadth and depth of the subject within each chapter and across the book. I did not find parts or the sum of the parts to be biased or inaccurate.

As of this review, the content is up to date across the board from current research findings to the inclusion of seminal research and examples of concepts (e.g., COVID-19) that students can relate to. Additionally, the text is written (also through its license) in such a way that other instructors can freely expand on the authors’ examples or go in and make their own. Finally, I believe the lens of mindfulness to be around and relatable for quite some time based on national data about Generation Z coming through university doors for at least the next few decades.

The text was clear. The authors do a good job clearly defining and calling the reader’s attention to major ideas before going in-depth into the concept. The real-world case study included at the end of every chapter and its prompted thinking questions (which could easily be in-class discussion questions) is helpful for readers to consider key ideas in contexts immediately after reading the chapter.

The text keeps consistent and uses terminology as it was originally defined/discussed and is consistent with the larger IPC literature.

The text is clearly divided into chapters and sections within chapters. Instructors can easily use standalone chapters and/or add/remove sections within chapters to meet their pedagogy needs. The text is not overly self-referential, and a new reader would not need to read chapters in order. However, the reader would be best to have some background to IPC (i.e., chapters 1-3) before reading how the material applies in specific contexts.

The chapters are logically ordered and run in order similar to most IPC texts (i.e., I did not have to change my course vary much when transitioning to a new text). Each chapter opens with clear learning outcomes and ends with a reminder of the key terms and supplies the reader with a means to immediately apply the content through case studies, quizzes, and personality tests.

Overall, there were no major issues. Few exceptions such as a table going over onto the next page, textbox, or section header breaking apart sentences in the same paragraph (e.g., “end of chapter” in chapter 12). These few exceptions do not take away from the content being covered.

In my read through I found no major issues. I also offered my students extra credit to find errors (aids their writing) and they did not find any issues either.

The text was neither culturally insensitive nor offensive. The examples provided vary across genders, sexes, sexualities, races, and ethnicities. This is especially true in the culture chapter.

Overall, I strongly recommend this text to others. This is my first time using and reviewing an OER. I have used it for one summer term so far but plan to continue to use it in the future. No textbook is perfect for our individual needs, we all teach differently. However, the beauty of the author’s choice of license allows each of us to use the text differently. Thus, as the years go on, I will continue to pick and choose and supplement where I need to based on my curriculum and learning outcomes.

Reviewed by Abby Zegers, Correctional Education Coordinator, Des Moines Area Community College on 11/17/21

This text is incredibly comprehensive to the point that I feel that it could possibly be two texts or classes, depending on how much time you had. Each chapter dives relatively deep into its topic and not only is it visually appealing with up to date charts, graphs and pictures, the downloadable version has hyperlinks to directly take the student to a certain inventory that the chapter is utilizing as a supplement. I found this to be really engaging. The text has a separate instructor manual which is incredibly useful with all of the materials, power points, quizzes and other necessary information needed to instruct this class. There is a glossary at the end of the text. No index was available which in my opinion would be helpful simply due to the fact that many topics/subjects or inferences are utilized throughout the chapters and not necessarily in the one devoted to that topic.

I found the content to be accurate and free from bias. I noticed only a few grammatical errors but content was incredibly accurate and up to date with references cited appropriately throughout.

Interpersonal communication is a topic that holds relevance and longevity as many things stay the same however the authors did an excellent job with current communication topics such as Chapter 12 devoted to Interpersonal Communication in Mediated Contexts. This is a topic I spend a great deal of time on with my classes as it is so current and relative to their lives right now. I think that this information will change in the future however the content available now on the topic will remain relevant as “history”. I found value in the links to different personality tests or activities that were relevant to the topic at hand and appreciated that they were available so easily as students are more likely to click a link rather than jot down something they might look up later.

I found this text to be very elaborate into many topics relating to interpersonal communication and the extensive glossary was very helpful. The supplemental activities and videos presented are a wonderful way to apply what is approached in each lesson. The text uses a “mindfulness” approach which might be a new concept to some however I think it’s a great way to see the value and importance of the topic.

I found no issues with consistency. Each chapter is laid out the same with Learning Outcomes identified in each section, exercises that could be great journal activities or discussions, key takeaways, a chapter wrap up including key terms used, a real world case study and a quiz followed by references. It is consistent throughout the text and a great way to appeal to different types of learners.

The way this text is set up allows for one to jump around if need be however; the beginning focuses more on history and theory which in itself is important along with communication models. This in itself could almost be its own text with the depth the authors go to in the material along with the abundance of activities and self-assessments allowing the reading to analyze their own styles creates a nice foundation to continue into the material. For my own classes, I would never have enough time to get through this text and give it the attention that it deserves so the ability to pick and choose topics and chapters relative to today is really an attractive part of it for me.

I think this text flows very well and much of the material from the beginning builds upon itself. The chapters are in appropriate order with building content however; it is beneficial that an instructor could pick and choose different areas they wanted to focus on without losing too much. The text ends with Chapter 13 being Interpersonal Relationships at Work and Chapter 14 being The Dark Side of Interpersonal Communication and I feel that these were appropriate choices to wrap up the text with.

I loved the ability to read through this text in electronic format and the hyperlinks were incredibly helpful and I had no issues with connectivity to sources. Images were clear and loaded as they should. I printed off a copy of the text and there were no formatting issues in doing so. I feel that utilizing the hard copy method or downloading the pdf version are both great options to have that appease different types of learners.

There were a few minor grammatical errors here and there but nothing that distracted me or was relative enough that I documented it. I felt like it was very well written and edited.

There is a specific chapter dedicated to Cultural and Environmental Factors in Interpersonal Communication however; references to cultural and gender issues are spread throughout and I feel like the information is inclusive.

Overall, I found this text to be a really great OER and am using pieces of it for my classes. I appreciate a text that appeals to many different styles of learners with text, videos, interactive quizzes and assessment and slides. So much material is available and covered and I find many sections of this to be useful in a few different classes that I teach. I am thankful to have found this text and look forward to continuing to use it.

Reviewed by Jennifer Adams, Professor, DePauw University on 11/13/21

Comprehensiveness rating: 4 see less

This book is lengthy, and each chapter contains more good content than I expected. There are chapters on each topic you would expect (although organized somewhat differently than most of the popular print textbooks in this discipline). For example, the information on perception is mostly in chapter 3, but some info about the topic was found across two other chapters (and attribution theory is not really included at all). There is no specific chapter on emotion, but there is content about it throughout. Furthermore, something that was somewhat new to me was incorporating the idea of "mindfulness" along with competence to understand communication processes. There is a chapter on technology that I think is growing in importance. This book doesn't really push the envelope on considering issues of identity like race or gender, but there is a good chapter on culture (and I would say that is also true of many for-profit books). The sections on relational communication are really thorough and give a good range or ideas and theories for each different relational experience. While the organization was slightly different than the book I was used to using (the Floyd text), I was able to find all of my content normally covered somewhere in this textbook.

I found no errors in this textbook that I have found aside from minor typos or a few strange sentences. The content is accurate and attributed to the correct sources. There is a lengthy and useful reference list.

This book includes all of the theories and concepts that I have been teaching for two decades. Their examples are really useful. One thing I did notice is that a lot of space is taken up by quizzes or activities - things like personality tests. I don't really use those in any way, but I do wonder if those types of things might be trendy - I don't know that or sure, but I didn't use them. I do think that the focus on "mindfulness" is something that is popular now that has not been in the past, but I certainly hope that the value in mindfulness doesn't trend away any time soon. I really thought that the book was up to date and see no reason it can't be updated relatively easily.

This book is comparable to the popular for-profit interpersonal communication textbooks that are available. It is addressed to the reader, and it is easy to read. It does introduce new terminology and concepts , but these are always defined clearly. At the end of every chapter, there is a 'take-away" section that includes key-terms, so there is the ability to look those up outside of the basic text as well. There are activities at the end of each chapter as well, to help develop.

Yes, the entire book is about interpersonal communication and it does not diverge from topics covered in the popular for-profit books. I didn't find any inconsistencies in the way that the material is presented. In fact, the opposite is true: their focus on "mindfulness" as a skill that can be developed holds each chapter together, so that there is not just information about the important ideas and theories, there is also a constant reflection on the values of mindfulness as it relates to all of the topics (and relationship types) that are covered.

This is really well organized. The book is divided into chapters, and each chapter is divided into subsections that have numbered placement within the chapter and headings throughout. (For example, chapter seven materials are divided into 7.1, 7.2, 7.3, etc). If you didn't want to assign the entire book, you could easily pick sections here and there to use (and you can save only those sections as PDFs to insert on your syllabus or organizing platforms).

Organization/Structure/Flow rating: 4

The book is not organized like my class was, but it wasn't a major deal and I simply hoped around a bit. So, for example, I thought that the chapter on culture should come sooner than chapter 6, perhaps before verbal and nonverbal communication. I also wasn't sure that some of the content in chapter 7 called "Talking and Listening" was placed well there - it seemed redundant in some ways, but some info (like social penetration theory or the johari window) seem like they should be in an earlier chapter about perception. That being said, these concerns are ultimately very minor - the content I expected was there, and I could assign page #s for specific sections that I needed to address at different times in the semester. I did not use this book chronologically from chapter 1 to the end, but that has been true for for-profit books I have used in the past, too. I found the chronology to be good.

I used this book in the fall of 2021, and recommended that all students download the PDF version, which is what I primarily use. The book's TOC is hyperlinked, and so you can easily find the content you are looking for and click to go to the relevant sections. When I do keyword searches for specific theories or concepts, they come up easily without error. It's easy to use and the layout is professional and attractive (pictures and images come through formatted correctly, charts and graphs look clear).

This book is well written. Aside from a few typos here and there, I didn't find lots of problems with readability. It's not perfect; for example, sometimes where there are bullet points, they are not written in a parallel style, or something like that which might be noticeable, but that was pretty infrequent. The writing is clear and correct.

Cultural Relevance rating: 4

There is nothing offensive that I found in this book. The book includes examples and ideas that are inclusive or race, ethnicity and gender. There is an entire chapter on cultural communication, so it does present information about cross-cultural differences and communication. I would like to see more about gender and more explicitly about race, but some of that content IS here (I just find myself spending more time on this every semester, but I must use supplemental material on topics such as white fragility or privilege and how that impacts interpersonal communication).

Although I hate the price of textbooks, I have been hesitant to use open source materials in the past due to a perceived lesser quality. This book has changed my mind. It isn't perfect, but it saves students 50-100 dollars, and the information that they purchase isn't perfect either. This book presents as professional, and it reads that way as well. Of course, I supplement this book with popular readings and examples, but almost all of the academic content I needed was in this book. I do recommend it.

Reviewed by Joseph Nicola, Professor, Century College on 10/6/21

The text provides a very detailed and granular index and glossary. Very helpful when planning lessons and homework readings. The text is hyperlinked from the index/glossary making it helpful for students. Presents a good explanation of the many... read more

Content is accurate, error-free and unbiased. Does a fair job at covering the large content scope of Interpersonal Comm subject manner. Does not address some popular content covered in an undergrad course on the subject. However the text does provide a nice foundation for class lecture and discussion. Sources are referenced at the end of every chapter.

Relevance/Longevity rating: 4

Content is up-to-date, but not in a way that will quickly make the text obsolete within a short period of time. The text is written and/or arranged in such a way that necessary updates will be relatively easy and straightforward to implement.

The text clearly covers the basic principles of the large content subject matter. Does a fare job a covering basic principles that are foundational for the discipline.

The subject of gender identity is not greatly covered. Terms within the LGBTQIA are briefly mentioned but not explained further. A future edition would benefit from this addition.

Good concordance and glossary of terms with page numbers. Easy to read and follow. Has “Key Takeaways” and End of Chapter “Exercises at the end of each chapter. For the most part, the text adequately covers the material needed.

Yes. It appears consistent throughout.

This is a well organized text. That does a fair job at covering that large foundational scope of interpersonal communication. Has “Key Takeaways” and "End of Chapter Exercises" at the end of each chapter.are very nice for class activities and discussion.

Text is organized very well.

Good text and well interfaced. Easy to navigate.

Text is well written with clear paragraphs, bullet points and formatted topic headings. No errors found.

The text does devote a large amount of content to explaining the importance of cultural awareness for being a competent communicator. Provides a good starting foundation to start with class lectures and class discussion. Graphics do depict a diverse student population which is nice to see that intention. Some content that could be added on: *It should be noted that the important subject topic of gender identity is not greatly covered with this text. Terms within the LGBTQIA are briefly mentioned but not explained further. *Only briefly mentioned the importance of Emotional Intelligence but lacks in content and key terms within the subject and practical examples.

The subject of gender identity is not greatly covered. Terms within the LGBTQ+ are briefly mentioned but not explained further. Well designed and layout with some minimal graphics and color-coated topic headings. There could be more for a future printing. Offers some personality and perspective assessment activities that would serve as a good chapter activity.

Reviewed by Aditi Paul, Assistant Professor, Pace University on 8/13/21

The authors do a really good job at covering a variety of introductory, foundational, and contemporary topics pertaining to interpersonal communication. read more

The authors do a really good job at covering a variety of introductory, foundational, and contemporary topics pertaining to interpersonal communication.

Content Accuracy rating: 3

The authors do a good job of laying the foundation of the importance of mindfulness in interpersonal communication. However, the discussion surrounding mindfulness and how it should be integrated into different aspects of interpersonal communication was less than thorough. Mindfulness almost came as an afterthought rather than being weaved into the main material in most chapters.

The importance of mindfulness in interpersonal communication is a highly relevant topic, especially in today's age where most of our communication over digital media has become primarily mindless. The authors also do a good job at including new and relevant topics such as body positivity in non-verbal communication, computer-mediated communication apprehension, internet infidelity, and postmodern friendships.

The text was very clear and easy to follow.

Consistency rating: 3

As mentioned earlier, the lack of consistency was evident in the discussion of mindfulness. The authors introduce mindfulness in terms of "attention, intention, and attitude" in the first chapter. But in the rest of the chapters, especially chapter 5 onward, the conversation around mindfulness dwindles.

The modularity of the book was good.

The organization of the book was good. The only critique I would have is the placement of the chapter on culture and interpersonal communication. I would have preferred that topic to be introduced earlier than chapter 6 since a lot of our verbal and non-verbal communication is colored by culture.

The interface of the book was good.

The grammar of the book was good.

The book was culturally sensitive. It included sexually and culturally marginalized groups into the conversation.

Reviewed by Rebecca Oldham, Assistant Professor, Middle Tennessee State University on 5/20/21

This textbook provides a thorough introduction to communication studies. It covers multiple important theories, seminal research, major concepts, and practical suggestions for improving communication. The instructor guide includes many helpful tools, including chapter outlines, presentation slides, in-class activities, practice quiz questions, and links to TEDTalks and YouTube example videos from recent popular films and TV shows. It also comes with a student workbook. This textbook has as many, if not more, supplemental materials as a traditional textbook.

However, some sections of the book could be expounded upon with future revisions. For example, I would have expected to see more variety of research about on marriage beyond Fitzpatricks typologies (e.g., John Gottman's research or references to other romantic relationship research). Other topics I would like to see in future revisions are (1) the rhetorical triangle and (2) the elaboration likelihood model.

However, the comphrehensiveness is still such that instructors additions to this textbook for curriculum would merely be supplemental.

This textbook uses a mixture of seminal and recent research to review major topics of interpersonal communication to supports accuracy. When relevant, the authors describe research studies and methods, not just the findings, which enhances students' science and information literacy.

The textbook is written with up-to-date research and references to recent culture and political issues from the past year (e.g., COVID-19, political polarization). References to mediated communication are very up-to-date, with the exception of TikTok not being mention. The instructor's manual provides excellent examples of concepts in recent popular TV and film that students are sure to enjoy because they are not out-dated and the media is familiar for this age group.

However, I would reframe the concept of relationships in the textbook beyond "marriage" to "committed romantic relationships" given the increase of polyamory/consensual non-monogamy, open relationships, and long-term cohabitation/commitment without marriage. Although marriage is still largely the norm in the United States, the changing landscape of romantic relationship development could be more strongly present in this textbook.

The tone of the authorship balances an academic and conversational tone well-suited for an undergraduate audience. Jargon is well-defined in-text and glossary is provided. The writing is professional and academic, without being esoteric.

No inconsistencies in terminology, theoretical frameworks, nor pedagogical approaches were detected. The authors have clearly reviewed this textbook for quality and consistency.

The textbook is well organized into manageably-sized blocks of text with many headings and subheadings, which helps the reader navigate the text. Instructors should find it easy to identify how parts of this textbook overlap with their existing communcation or relationships course for ready adaptation and integration into existing curriculum.

This textbook is largely organized like other communication textbooks: Introduction/Overview, Identity, Verbal/Nonverbal Communication, Culture, Mediated Communication, and various types of relationships (e.g., family, professional, etc.). It's logical and familiar organization makes it easy to navigate and integrate with standard introducation to communication courses.

Very few issues with distortion of images or overlap in page elements or formatting inconsistencies.

No obvious grammatical errors were detected. The writing style is accessible and easy to read.

Authors clearly took steps to be inclusive and draw attention to issues of equity with regard to gender identity, sexual orientation, race/ethnicity, religion, political identity, and other groups (for examples, see sections on dating scripts, post-modern friendships, racist language, cross-group friendships). I would recommend future revisions include information about African American Vernacular English (AAVE) possible under a section about culture, dialects, or accents, given its direct relevance to communication.

I plan on replacing the textbook for my Interpersonal Communication course with this textbook. In most respects, it is equivalent to the textbook that is currently required. However, it also is an improvement on the current textbook in terms of the density of research citations and in the supplemental material. Instructors of introductory communication courses can feel confident in adopting this textbook to reduce costs, lower educational barriers, without sacrificing educational rigor and quality.

Reviewed by Jennifer Burns, Adjunct Faculty, Middlesex Community College on 3/13/21

Interpersonal Communication: A Mindful Approach to Relationships, provides an in-depth understanding to the variables that comprise interpersonal communication, I especially appreciate the mindful (know thyself) lens!! read more

After examining the context and student workbook, I was impressed with the content accuracy. I did not pick up on saturation of bias and or stigmatizing language.

Yes, content is up-to-date, and it is encouraged to contact the author with needed updates, and or changes. It is also encouraged to personalize the book to fit the needs of the students!

This textbook is clear, concise and to the point!

The framework and theory are woven throughout the text.

The text is divided into digestible sections, that allow for independent assignment of course material. The formatting is easy on the eyes!

Love the text organization, the content is clear, logical and sequential!

You do need an access code from author to obtain access to the teacher resources.

Did not notice grammatical errors.

I did not perceive this text to be culturally insensitive.

Reviewed by Jessica Martin, Adjunct Instructor, Communication Studies, Portland Community College on 1/5/21

This book presents a comprehensive breakdown of the major types of interpersonal communication. The chapters included in this course text align with the traditional content in an interpersonal communication course. I like how it also includes a... read more

Consistent sources are cited throughout the course text at the end of each chapter, proving its accuracy . The sources appear to be non-bias and overall boost the credibility of the text.

Being that the text includes a chapter primarily focused on mediated communication, I would say that the text is up to date and contains adequate information to support relevancy.

The text is written in a straightforward, simplistic type of manner. This would make it easy for any college student to follow along with the content and keep up with the terminology. Any time a new term is introduced, plenty of examples are given to explain that term. This same format is followed consistently throughout the course text.

Each chapter begins with clear learning outcomes, follows with consistent sub-headers and clear introductions to new terminology. I also noted how each chapters includes exercises to help students further understand course content.

Each chapter is clearly divided up into specific sections to help with lesson planning and overall lecturing materials. This would make it easy to create lecture material for the course.

The text is organized effectively in that there are clear transitions from one topic to another. As mentioned previously, each chapter begins with clear learning objectives, and concludes with exercises, key-takeaways, and a list of key terms.

I would say that overall this course text is easy to navigate. Plenty of charts, tables, and photographs are consistently used to help introduce new ideas and key theories.

I did not note any grammatical errors.

The text includes a chapter titled "Culture and Environmental Factors in Interpersonal Communication," which includes all of the necessary key terms that you would hope to see in an interpersonal communication course.

Reviewed by Prachi Kene, Professor, Rhode Island College on 10/22/20

This book presents a comprehensive overview of the different aspects, types, and models of communication. Further topics of discussion include verbal and non-verbal elements of communication, impact of communication on a variety of relationships (friendships, family, marriage, dating, siblings, coworkers, etc.), mediated communication, and conflict. The book concludes with an exploration of "the dark side of communication." Key concepts discussed throughout the book are listed in the glossary.

The content of the book is informed by advances in the fields of communication and psychology. These sources are acknowledged throughout the content and cited in the references section at the end of each chapter. Information is discussed in an unbiased manner.

The content is up-to-date and includes information about communication and technology. Given the clear organization of the text, it will be amenable to modifications as the impact of technology on communication continues to evolve.

This text is easy to read and follow due to the clear organization and clarity of expression. Exercises and key take aways following each section make the content easy to understand and remember.

The content of this text is consistent and free of contradictions. Multiple perspectives to view and understand concepts are presented in a cogent manner.

Each chapter is divided into smaller and coherent sections that will easily align to lesson planning, creation of lecture materials, and graded tasks/assignments.

This text is well-organized and smoothly transitions from one topic to another. Specifically, each section begins with learning objectives and concludes with exercises and "key takeaways." Chapters are followed by a list of key terms, "real world case study," and quiz that makes the concepts meaningful to the reader.

This book is easy to navigate. Tables, figures, and pictures are used effectively to emphasize the key concepts and ideas. However, occasionally a table spans across multiple pages.

This text does not contain grammatical errors.

The text acknowledges the role of culture in communication and contains a chapter titled, "Cultural and Environmental Factors in Interpersonal Communication." Impact of culture on communication is also infused into other chapters.

Chapter 1: Introduction to Human Communication
Chapter 2: Overview of Interpersonal Communication
Chapter 3: Intrapersonal Communication
Chapter 4: Verbal Elements of Communication
Chapter 5: Nonverbal Communication
Chapter 6: Cultural and Environmental Factors in Interpersonal Communication
Chapter 7: Talking and Listening
Chapter 8: Building and Maintaining Relationships
Chapter 9: Conflict in Relationship
Chapter 10: Friendship Relationships
Chapter 11: Family & Marriage Relationships
Chapter 12: Interpersonal Communication in Mediated Contexts
Chapter 13: Interpersonal Relationships at Work
Chapter 14: The Dark Side of Interpersonal Communication

Ancillary Material

Instructor Manual
Lecture Slide Deck

About the Book

Interpersonal Communication: A Mindful Approach to Relationships helps readers examine their own one-on-one communicative interactions using a mindfulness lens. The writing team of Jason S. Wrench, Narissra M. Punyanunt-Carter, and Katherine Thweatt incorporates the latest communication theory and research to help students navigate everyday interpersonal interactions. The 14 chapters in this book cover topics typically taught in an undergraduate interpersonal communication course: family interactions, interpersonal dynamics, language, listening, nonverbal communication, and romantic relationships, as well as exploring emerging areas such as self-compassion, body positivity, friendships, and “the dark side”. The writing takes on a purposefully informal tone to engage readers. Each chapter is broken into different sections that have unique instructional outcomes, key takeaways, and exercises, and concludes with real-world case studies and sample quiz questions. Also included is an extensive glossary with over 350 definitions.

About the Contributors

Jason S. Wrench (Ed.D., West Virginia University) is a professor in the Department of Communication at the State University of New York at New Paltz. Dr. Wrench specializes in workplace learning and performance, or the intersection of instructional communication and organizational communication. His varied research interests include workplace learning and human performance improvement, computer-mediated communication, interpersonal communication, empirical research methods, family communication, humor, risk/crisis communication, and supervisor-subordinate interactions. Dr. Wrench regularly consults with individuals and organizations on workplace communication and as a professional speech coach for senior executives.

Narissra M. Punyanunt-Carter (Ph.D., Kent State University) is a professor in the Department of Communication and assistant dean of international affairs for the College of Media and Communication. She is also an associate professor of Communication Studies at Texas Tech University in Lubbock, Texas. She teaches the basic interpersonal communication course. Her research areas include mass media effects, father-daughter communication, mentoring, advisor-advisee relationships, family studies, religious communication, humor, and interpersonal communication. She has published over 70 articles that have appeared in several peer-reviewed journals, such as Communication Research Reports, Southern Journal of Communication , and Journal of Intercultural Communication Research . She has also published numerous instructional ancillaries and materials. She is also a coauthor of Organizational communication: Theory, Research, and Practice (2014, Flat World Knowledge). Dr. Punyanunt coedited The Impact of Social Media in Modern Romantic Relationship (2017, Lexington).

Katherine S. Thweatt (Ed.D, West Virginia University) is an associate professor at the State University of New York at Oswego. Dr. Thweatt’s areas of interest are interpersonal communication, instructional communication, and health communication. She has published in the areas of teasing, teacher immediacy and misbehaviors, cognitive flexibility, and healthcare research. Healthcare publications involved shared medical appointments, heart failure, and infectious disease.

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Open Access

Peer-reviewed

Research Article

Strategies to improve interpersonal communication along the continuum of maternal and newborn care: A scoping review and narrative synthesis

Roles Conceptualization, Formal analysis, Methodology, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliation Julius Global Health, Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands

Roles Conceptualization, Formal analysis, Methodology, Writing – review & editing

Affiliation Department of Anthropology, University of Amsterdam, Amsterdam, The Netherlands

Roles Formal analysis, Methodology, Writing – review & editing

Affiliation Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis, TN, United States of America

Roles Conceptualization, Methodology, Writing – review & editing

Affiliation Department of Sexual and Reproductive Health and Research Including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland

Affiliation Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland

Roles Methodology, Writing – review & editing

Affiliation Department of Obstetrics and Gynecology, Greater Regional Hospital, Accra, Ghana

Affiliation Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana

Affiliations Julius Global Health, Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands, Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Accra, Accra, Ghana

Klaartje M. Olde Loohuis,
Bregje C. de Kok,
Winter Bruner,
Annemoon Jonker,
Emmanuella Salia,
Özge Tunçalp,
Anayda Portela,
Hedieh Mehrtash,
Diederick E. Grobbee,

Published: October 11, 2023
https://doi.org/10.1371/journal.pgph.0002449
Reader Comments

Effective interpersonal communication is essential to provide respectful and quality maternal and newborn care (MNC). This scoping review mapped, categorized, and analysed strategies implemented to improve interpersonal communication within MNC up to 42 days after birth. Twelve bibliographic databases were searched for quantitative and qualitative studies that evaluated interventions to improve interpersonal communication between health workers and women, their partners or newborns’ families. Eligible studies were published in English between January 1 st 2000 and July 1 st 2020. In addition, communication studies in reproduction related domains in sexual and reproductive health and rights were included. Data extracted included study design, study population, and details of the communication intervention. Communication strategies were analysed and categorized based on existing conceptualizations of communication goals and interpersonal communication processes. A total of 138 articles were included. These reported on 128 strategies to improve interpersonal communication and were conducted in Europe and North America (n = 85), Sub-Saharan Africa (n = 12), Australia and New Zealand (n = 10), Central and Southern Asia (n = 9), Latin America and the Caribbean (n = 6), Northern Africa and Western Asia (n = 4) and Eastern and South-Eastern Asia (n = 2). Strategies addressed three communication goals: facilitating exchange of information (n = 97), creating a good interpersonal relationship (n = 57), and/or enabling the inclusion of women and partners in the decision making (n = 41). Two main approaches to strengthen interpersonal communication were identified: training health workers (n = 74) and using tools (n = 63). Narrative analysis of these interventions led to an update of an existing communication framework. The categorization of different forms of interpersonal communication strategy can inform the design, implementation and evaluation of communication improvement strategies. While most interventions focused on information provision, incorporating other communication goals (building a relationship, inclusion of women and partners in decision making) could further improve the experience of care for women, their partners and the families of newborns.

Citation: Olde Loohuis KM, de Kok BC, Bruner W, Jonker A, Salia E, Tunçalp Ö, et al. (2023) Strategies to improve interpersonal communication along the continuum of maternal and newborn care: A scoping review and narrative synthesis. PLOS Glob Public Health 3(10): e0002449. https://doi.org/10.1371/journal.pgph.0002449

Editor: Patience A. Afulani, University of California San Francisco (UCSF), UNITED STATES

Received: July 6, 2022; Accepted: September 12, 2023; Published: October 11, 2023

Copyright: © 2023 Olde Loohuis et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The authors confirm that the data supporting the findings of this study are available within the article ( Table 1 ).

Funding: KMOL, BCdK, JLB, MAC, KAB, HBA and DEG were supported by the Dutch Research Council (NWO, NWA.1160.18.159, https://www.nwo.nl/en/projects/nwa116018159 ). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Introduction

Improving the quality of maternal and neonatal health services would accelerate reductions in maternal and neonatal deaths in low- and middle-income countries (LMICs) [ 1 ]. Quality of care, as the 2015 World Health Organization (WHO) quality of care framework identifies, has two major domains: provision of care and experience of care [ 2 ]. The experience of care dimension includes effective interpersonal communication, which is also closely linked to mistreatment of women during childbirth [ 3 ]. In a multi-country study, almost one in five women felt that health workers or staff did not listen and respond to their concerns, and more than half reported no consent for episiotomies performed during childbirth [ 4 ].

Effective interpersonal communication is a cornerstone of medical practice [ 5 , 6 ]. Effective communication can serve three different goals: facilitating the exchange of information, creating a good interpersonal relationship including building of trust, and enabling the inclusion of patients in decision making [ 7 – 12 ]. Communication is furthermore an important theme in respectful maternity care, and a way to protect the human rights of women, for example, through ensuring confidentiality, fulfilling the right to be fully informed and allowing for informed consent [ 9 ].

Interpersonal communication between health workers and patients can affect health care outcomes, including patients’ satisfaction, knowledge and understanding, adherence to treatment, quality of life and psychological and physical health [ 8 , 10 , 11 ]. Within maternal and newborn care (MNC), good interpersonal communication contributes to better experiences, improved respectful care and reduced mistreatment [ 7 , 8 , 13 ]. This is particularly relevant in low-resource settings where poor communication and mistreatment are common [ 4 ], contributing to negative or traumatic birth experiences [ 12 ]. To illustrate, in Kenya, person-centred care, which included many interpersonal communication related aspects, was associated with improved MNC outcomes [ 13 ].

Various aspects of interpersonal communication processes between health workers and patients have been described. The communication framework of Feldman-Stewart and Brundage is particularly useful to illustrate ‘how’ interpersonal communication works [ 14 , 15 ], and can thus be helpful in understanding how interpersonal communication could be improved. First, this framework suggests that both health workers and patients have goals in terms of what they want to achieve during the interaction. Second, each participant has certain needs, beliefs, values, skills and emotions that shape ways to interact. Third, each participant receives and sends messages. And finally, the framework underscores that the environment in which the interaction takes place matters for communication, and thus for strategies designed to improve interpersonal communication [ 14 , 15 ]. Further guidance on effective communication within MNC is emphasized within WHO’s recommendations across the continuum of MNC [ 16 – 18 ]. While these recommendations do not provide a definition of effective communication within the context of MNC, they provide guidance to ensure effective communication is prioritized between health workers, women, their partners and families [ 16 ].

Despite the increased recognition of the importance of interpersonal communication for MNC there is no clear overview of the different strategies that can be adopted to reduce mistreatment and improve respectful care [ 19 ]. Therefore, the objective of this review was to map and categorize implemented strategies to improve interpersonal communication between health workers, women and their partners within MNC up to 42 days after birth.

Protocol and registration

This review was drafted and conducted in accordance with the PRISMA guidelines [ 20 ] and the Cochrane Handbook for Systematic Reviews [ 21 ]. The study protocol was registered in PROSPERO in July 2020 (CRD42020191622). The protocol was initially developed for a systematic review including a possible meta-analysis on effectiveness. We converted to a scoping review with narrative analysis due to the number and heterogeneous nature of the primary research articles, and because this provided a sufficient basis for answering the research questions.

Domain and population

The domain of our review consisted of studies that implemented a strategy to improve interpersonal communication between health workers, women, and their partners in care across the continuum of MNC. We also anticipated that experiences to improve interpersonal communication from related domains in sexual and reproductive health and rights (SRHR) would facilitate cross-learning from MNC, and therefore extended the domain to include the reproduction-related SRHR subdomains of safe abortion, family planning and (in)fertility.

The study population included women and their partners as well as newborns and their parents/caregivers/families throughout the continuum of MNC and reproduction-related SRHR subdomains. This included antenatal, intrapartum and postnatal care up to 42 days. In this paper, we used ‘women and partners’ to describe the population. Health workers included different cadres as specified in the WHO recommendations to optimize health workers’ roles within MNC [ 22 ]: lay health workers, (auxiliary) nurses and midwives, and (associate) physicians (including obstetricians, paediatricians, general practitioners and residents).

Eligibility criteria

Studies were eligible for inclusion if they were primary, peer-reviewed articles reporting on interpersonal communication quality improvement strategies between health workers and women and partners in MNC and reproductive-related SRHR subdomains. All studies that included health workers who were engaged with in-service training (i.e., not training by students as part of a qualifying degree) were eligible. Studies conducted in any setting within MNC and reproductive-related SRHR subdomains were eligible. Studies that included a paediatric population were only eligible if >50% of participants were newborns (up to 42 days old) or newborns’ parents. Studies published from January 2000 to July 2020 were included to reflect contemporary practices.

We excluded studies that focused on mass communication, group communication, one-way communication, interprofessional communication and communication between mothers and babies. Furthermore, we excluded studies that reported on packages of strategies where communication was not a primary aim, because in these complex intervention studies communication was usually a small part of the intervention, and so difficult to disentangle from other activities. Furthermore, studies that implemented a new communication-based treatment programme (e.g., cognitive behaviour therapy) to treat a specific disease or problem were excluded because these constituted a new form of health service delivery, except when the intervention specifically focused on improving the interpersonal communication within the delivery of the health service. We excluded reviews, but primary studies from relevant systematic reviews were checked for eligibility. We included only English articles, because of language limitations within the team. In total, six studies were excluded in full text screening because of language restrictions.

Information sources

We searched the following information sources: PubMed/Medline, EMBASE, CINAHL, SCOPUS, PsychINFO, Anthropology PLUS, SocioINdex, Cochrane Central Register of Controlled Trials (CENTRAL), Latin American and Caribbean Health Sciences Literature (LILACS), African Journals Online (AJOL), and Global Health Library.

Search terms consisted of MeSH and combined text related to ‘communication’, ‘health workers’, ‘MNC or related SRHR domains’, ‘women and families’ and ‘intervention’. The search was developed with support from a librarian. For the complete search strategy see S1 Appendix . References of included articles were snowballed and checked for eligibility. De-duplication was performed using Endnote (V.X9).

Selection of sources of evidence

First, titles and/or abstracts of studies identified through the search strategy were independently screened to assess whether studies met the inclusion criteria by two of the four reviewers (AJ, ES, WB, KMOL). Next, full texts were screened in the same way. In case a full text article was missing or inaccessible, authors were contacted once through email or ResearchGate and were given the option to respond within a month to provide us with the full text. Rayyan QCRI ( https://rayyan.qcri.org/welcome ) was used to screen articles. Any disagreement that arose was discussed by the persons who screened the articles until consensus was reached, or a fifth review team member was consulted (JLB or BCdK) to resolve the issue through further discussion.

Data charting process including data items

Data were extracted using a standardized pre-piloted form (by AJ, ES, WB, KMOL, BCdK). The data extracted included study characteristics and information for evidence synthesis: first author, year of publication, country, study setting, aims and objectives, study design, study population characteristics, description of intervention and communication goals of the intervention, and the types of outcomes measured. Extracted data were double checked by one of the team members (KMOL).

Synthesis of results

We initially planned to perform a systematic review including a meta-analysis on interpersonal communication strategies’ effectiveness. However, the number and heterogeneity of designs and interventions among the retrieved articles led us to convert the study to a scoping review with narrative synthesis that focussed on providing an overview and categorization of the various strategies taken to improve interpersonal communication [ 23 ]. In this scoping review process, we summarized key findings of articles. We categorized strategies into the three communication goals proposed by Ong et al. [ 8 ]: 1) to facilitate the exchange of information, 2) create a good interpersonal relationship, and 3) enable the inclusion of women and partners in the decision making. These categories were pragmatically used as heuristic tools, i.e. functional methods (not necessarily perfect), and studies were assigned to one or more of these categories based on the information available. In addition, we analysed the results to understand ‘how’ interpersonal communication and the communication improvement strategies worked, using the model proposed by Feldman-Stewart and Brundage [ 14 ]. This model was updated (and re-visualized) with insights from this review and further deliberations within the review team.

We identified a total of 19956 articles through our search (see flow diagram in Fig 1 ). After removing duplicates, we screened 16826 articles on title and abstract and 369 articles in full text. Twenty-nine articles were additionally included through snowballing and reference screening of review articles. A total of 138 articles were included, reporting on 128 strategies to improve interpersonal communication.

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https://doi.org/10.1371/journal.pgph.0002449.g001

Study characteristics

Table 1 presents an overview of the included studies. Interventions were implemented in Europe and North America (n = 85), Sub-Saharan Africa (n = 12), Australia and New Zealand (n = 10), Central and Southern Asia (n = 9), Latin America and the Caribbean (n = 6), Northern Africa and Western Asia (n = 4) and Eastern and South-Eastern Asia (n = 2). The majority were in high-income countries (n = 95), compared to 33 interventions in LMICs [ 24 ]. The majority of studies were performed within the domain of maternal health (n = 80 studies), with others performed in newborn health (n = 47), family planning (n = 20) and (in)fertility (n = 2). Thirty-seven were randomized controlled trials (RCTs), 73 were non-RCT intervention studies.

https://doi.org/10.1371/journal.pgph.0002449.t001

Communication goals

Nearly all strategies (n = 126/128) addressed at least one of the communication goals (facilitating the exchange of information, creating a good interpersonal relationship, and enabling the inclusion of women and partners in the decision making [ 7 ]). Fifty-eight addressed two goals, and six studies [ 25 – 30 ] addressed all three goals. Box 1 provides an elaboration with examples of improvement strategies for each goal. S2 Appendix provides an overview of the communication goals of all studies.

Box 1: Examples of improvement strategies for the three communication goals

Communication goal: facilitating the exchange of information.

Example 1. Bakker et al. 2003. Manual, intervention card and training on a counselling protocol on smoking cessation in pregnancy, consisting of 7 steps.
Example 2. Maurer et al. 2019. Regular communication through messages/emails with information and tools to support discussions with health workers.

Communication goal: Creating a good interpersonal relationship

Example 1. Shao et al. 2018. Simulation based training for NICU nurses to improve their empathic communication skills.
Example 2. Bashour et al. 2013. Training for effective communication skills with a focus on the interaction between health workers and patients.

Communication goal: Enabling the inclusion of women and partners/families in MNC decision making

Example 1. Muthusamy et al 2012. Written information to receive before counselling including tips about questions to ask.
Example 2. Chinkam et al. 2016. Scripted counselling package about birth choices and trial of labour after caesarean using shared decision-making principles.

The goal ‘facilitating the exchange of information’ was present in most strategies (n = 98/128) [ 25 – 137 ]. Examples included visual aids [visuals], decision tools, and health worker training focused on the information aspect of communication.

In total, 58 studies aimed to improve the goal ‘creating a good interpersonal relationship’ (n = 58/128) [ 25 – 30 , 38 , 39 , 73 , 75 , 77 – 79 , 82 – 84 , 90 – 94 , 104 , 106 , 109 , 110 , 112 – 115 , 120 – 122 , 131 , 132 , 138 – 164 ]. These often sought to improve relationships by enhancing verbal and non-verbal communication, including touching the patient, showing empathy and compassion.

The goal ‘inclusion of women and partners in the decision making’ was addressed by 41 strategies (n = 41/128) [ 25 – 30 , 32 – 35 , 43 – 45 , 69 – 71 , 80 , 81 , 85 , 88 , 89 , 95 – 98 , 100 , 102 , 107 , 108 , 117 , 134 – 137 , 140 , 141 , 160 – 169 ], for example by asking women about their values and beliefs. Often a decision aid tool was used, such as the WHO Family Planning Care Guidance (FPCG) flipchart decision aid where both women and health workers have information presented on their ‘side’ of a flipchart to support provision of information and shared decision making [ 35 , 70 , 96 , 170 ]. Training sessions were regularly used to improve this goal too, for example in Toivonen et al. (2020) [ 141 ], where health workers in a neonatal intensive care unit were trained to collaborate with parents using shared decision making and person-centred care principles.

Strategies to improve communication

Two main types of strategy were used to improve interpersonal communication: training of health workers (n = 81) and tools to facilitate interpersonal communication (n = 67), with a few employing other distinct approaches (n = 7). Box 2 provides examples of these two main strategies.

Box 2: Examples of the two main strategies used to improve communication

Training of health workers.

Training of health workers to improve their communication.

Example 1: Toivonen et al. 2020. An education intervention to increase the quality of family-centred care in different NICU’s.
Example 2: Posner et al. 2011. Workshop for residents in obstetrics and gynaecology on disclosing an adverse event.

Tools to facilitate communication

An (electronic) aid that can be used by health workers or women and partners to improve communication

Example 1: Langston et al. 2010. WHO decision support tool to structure the family planning counselling session.
Example 2: Kakkilaya et al. 2011. Visual aid with visual/graphical information for parents when delivery at the threshold of viability is imminent.

Training of health workers.

The majority of studies (n = 81/128) trained health workers to improve interpersonal communication skills as a single strategy, or as one of their strategies [ 25 , 26 , 28 – 30 , 36 – 42 , 46 , 47 , 49 – 51 , 53 , 55 , 56 , 58 , 59 , 61 , 63 , 66 , 68 , 73 , 77 , 79 – 81 , 83 – 85 , 88 , 90 – 94 , 99 , 104 – 106 , 108 , 110 , 112 – 117 , 120 – 122 , 127 , 128 , 130 , 132 , 135 , 137 – 143 , 145 – 149 , 151 – 153 , 155 – 159 , 161 – 163 , 165 , 168 , 171 , 172 ]. Training programmes had different durations, ranging from 30 minutes [ 46 , 163 ] to several months [ 26 ]. Nineteen studies (n = 19/82) used simulation-based training to teach communication skills [ 29 , 38 – 41 , 47 , 68 , 77 , 84 , 90 , 91 , 105 , 110 , 112 , 114 , 115 , 151 , 153 , 155 , 157 , 161 ]. Some studies employed specific underlying communication theories as a basis of their training, for example the 5-A method for counselling [ 46 , 61 , 79 , 104 ] or motivational interviewing techniques [ 26 , 81 , 104 , 121 ]. Often, training was combined with communication tools such as scripts or guidelines to provide guidance, structure or reminders [ 26 , 51 , 72 , 79 , 80 , 83 , 85 , 88 , 92 , 93 , 99 , 104 , 108 , 116 , 173 ].

Tools to facilitate interpersonal communication.

Sixty-seven studies (n = 67/128) used tools to improve interpersonal communication between health workers and women and partners: decision aids, visual aids, prompts and scripts, and guidelines based on specific theory-based approaches to communication [ 25 , 26 , 31 – 33 , 35 – 37 , 43 – 45 , 48 , 50 – 52 , 54 , 57 , 60 , 62 , 64 , 65 , 67 , 69 – 71 , 75 , 78 – 80 , 82 , 83 , 85 , 87 – 89 , 92 , 93 , 95 – 100 , 102 – 104 , 108 , 109 , 116 , 117 , 123 – 126 , 128 – 132 , 134 – 136 , 144 , 154 , 160 , 164 , 166 – 168 , 172 , 174 ].

Decision aids (n = 23/67) [ 32 , 33 , 35 , 43 – 45 , 60 , 64 , 69 – 71 , 80 , 87 , 88 , 95 – 97 , 108 , 123 , 124 , 126 , 134 , 136 , 167 , 168 , 174 ] were often used as tools to support health workers, and/or women and partners in decision making about a health-related issue. Visual aids were used in 17 strategies (n = 17/67) [ 36 , 37 , 48 , 50 – 52 , 62 , 65 , 75 , 80 , 83 , 92 , 103 , 108 , 117 , 128 , 135 , 136 ], and supported health workers in their interpersonal communication and explanations. An example of a culturally sensitive visual aid was a cloth embroidery depicting safe maternal practices in pregnancy [ 62 ]. Prompts (n = 11/67) were also regularly used [ 26 , 31 , 54 , 67 , 85 , 87 , 88 , 92 , 123 , 129 , 175 ]. In these studies, health workers (or women [ 88 ]) received a (computer-assisted) cue or prompt to deliver or ask for counselling. A fourth type of tool used in studies was a script, or guideline regarding a specific approach to interpersonal communication often based on underlying communication theory (n = 30/67) [ 25 , 26 , 31 , 54 , 57 , 67 , 78 , 79 , 82 , 85 , 89 , 92 , 98 – 100 , 102 – 104 , 109 , 116 , 125 , 129 – 132 , 144 , 154 , 160 , 164 , 166 ]. This was primarily developed for the health worker, for example a small card with sample questions [ 166 ], a more extended script package [ 102 ], a checklist [ 85 ], or the use of Gamble’s approach to guide counselling [ 82 ].

Other strategies to improve interpersonal communication.

Seven studies used other strategies to facilitate interpersonal communication, including facilitation, women and partner or family empowerment, and multidisciplinary consultations [ 27 , 34 , 57 , 64 , 67 , 107 , 150 ]. The strategy of La Rosa et al. [ 150 ] consisted of health workers wearing a white coat to increase patients’ confidence or to act as a non-verbal communication facilitator. Peremans et al. 2010 [ 64 ] aimed to improve the quality of communication for contraceptive counselling by general practitioners (GPs), who used a decision aid during contraceptive counselling or were confronted with a ‘standardized patient’ who was empowered to ask a few additional questions regarding their contraceptive options. Three of the seven studies used a multidisciplinary approach to improve interpersonal communication, with joint consultations involving various medical specialists, psychologists and/or nurses [ 27 , 67 , 107 ].

Interpersonal communication effectiveness and outcomes

Table 1 includes a narrative overview of key findings of the included studies. Outcomes assessed were diverse, and ranged from health workers’ confidence levels in their communication skills, the participants’ experiences of care, behaviour change (e.g., contraceptive uptake), to impact on health outcomes. Most studies reported a positive effect on at least one of the outcomes measured. One article reported negative consequences after the use of a decision making tool at the NICU [ 134 ].

Update of Feldman-Stewart and Brundage communication framework

Based on our findings, the reflections embedded in related articles, and the reflections of the review team, we adapted the communication framework developed by Feldman-Stewart and Brundage [ 14 ] to illustrate how interpersonal communication works. We identified four ways in which this framework could be further adapted for the context of respectful MNC ( Fig 2 ). First, we changed the name of ‘patient’ into ‘women and partners’. This is important in MNC communication because it may help remind health workers that they relate to and communicate with not just the women, but also their partners. Second, we reformulated the communication process as the interaction between health workers, women and partners to emphasize its bidirectional nature. This bidirectional nature was already acknowledged in the original papers for the framework by using a double arrow. By explicitly mentioning it in our updated framework we aimed to create awareness that focussing on women and their partners (as well as on the health workers) might be an important alternative strategy to improve interpersonal communication. Third, we included the three communication goals (to facilitate information exchange, create a good interpersonal relationship, and enable the inclusion of women and partners in decision making) to further explain the nature of communication processes or interaction. Including the different goals of communication may remind health workers that these three goals will need different and specific attention in case they need to be improved. Inclusion of these goals in a communication framework will facilitate making deliberate choices when designing interventions to improve interpersonal communication. Fourth, we divided the ‘environment’ into different health system levels (micro, meso, and macro) to emphasize that multiple types of context influence interpersonal communication [ 176 ]. Again, for the design of interventions these can result in a more precise conceptualization of the communication process. As such, this can facilitate a better exploration of how environmental aspects at different ‘levels’ of health systems, and the environment beyond, might influence communication.

https://doi.org/10.1371/journal.pgph.0002449.g002

This review identified 128 different interventions to improve interpersonal communication between health workers and women and partners in MNC. We found studies across different thematic areas to facilitate cross-learning for MNC. The majority were in high-income countries. They addressed three main goals of communication: facilitating the exchange of information, creating a good interpersonal relationship, and enabling the inclusion of women and partners in the decision making. The majority of studies focused on facilitation of exchange of information, and only a few incorporated all three goals. Strategies to improve interpersonal communication primarily consisted of health worker training and providing communication tools to facilitate interpersonal communication. We observed substantial heterogeneity in intervention design, implementation and outcome evaluation and measurements. This reduced the opportunities for an evaluation of effectiveness across different interventions within this scoping review.

Interpersonal communication within health care settings is a broad and diversely defined concept. Our comprehensive approach, in which we incorporated studies about interpersonal communication within pregnancy-related reproductive health domains, facilitated learning from related domains. This helped us to build on insights from other more specific reviews of interpersonal communication improvement strategies for care during antenatal care [ 177 ], and labour and childbirth [ 19 ]. Furthermore, we added value for future communication improvement activities by exploring how different communication goals were addressed. Finally, we further improved understanding of how interpersonal communication works within the MNC context by updating the previously developed framework. As such, in the absence of a clear definition of what ‘effective communication’ is, our classification and adapted model can contribute to developing such a clearer definition.

Although arguably the principles of patient-centred care date back to the ancient Greeks [ 178 ], the concept has recently received more attention in a push to transform health care into a more individually-tailored and rights-based approach instead of the traditional paternalistic (bio)medical model. These principles are embedded in midwifery and are related to optimal outcomes for maternal and newborn care [ 179 ]. This shift to focus on the experience of care [ 2 ] and patient-centred care [ 7 ] is reflected by the growing attention to the communication goals of ‘creating a good interpersonal relationship’ and ‘enabling the inclusion of women and families in the decision making’. However, our review found that information provision was still the dominant goal used in interventions (75%), suggesting there is scope for improvement to address the other domains relevant for patient-centred care and shared decision making. The importance of this shift to patient-centred care is illustrated by a review of women’s satisfaction with maternity care in LMICs [ 180 ]. This review demonstrated that aspects of relational communication such as listening and kindness could improve maternal satisfaction [ 180 ]. Similarly, a review on the effect of patient-provider communication on health outcomes in diverse medical settings and specialisms showed that involvement of patients in decision making could lead to improved psychological and somatic health outcomes [ 10 ].

Communication is a cornerstone of healthcare [ 5 ]. Most strategies in our review focused on health workers and their interpersonal communication skills through training or tool provision, and emphasized information provision. However, interactive communication by default includes and affects women and partners as participants, and yet only a few studies in our review specifically targeted women (and their partners) in their strategies [ 57 , 181 , 182 ]. Therefore, a deliberate effort to address this gap and include women, partners or newborns’ families in the design of strategies could be beneficial, especially for strategies that aim to include women and partners in decision making. Such a deliberate effort could address potential factors that affect interpersonal communication and shared decision making, such as health literacy challenges or language preferences. In addition to benefits for the individual women and partners, this can also mitigate the risk of increased health inequities that arise as a consequence of interventions that are (more) easily taken up by more wealthy, educated or literate patients [ 183 , 184 ]. A number of equity and inclusion-promoting communication approaches have been previously identified. These include the use of culturally appropriate and less complex language without medical jargon, messages of short duration, and clear layouts or formats. A deliberate effort to include equity promoting approaches in communication improvement interventions presents an opportunity for health workers to engage, include and empower women and partners otherwise at (high) risk of being disengaged or marginalised, and to tackle a widening health equity gap [ 184 – 186 ].

Effective interpersonal communication is a core principle of respectful MNC, and all three goals of communication support this [ 187 ]. The recently documented unacceptably high number of women experiencing mistreatment and (verbal) abuse in maternity care worldwide [ 4 , 188 – 191 ] stresses the need to implement and test strategies to improve respectful communication [ 189 ]. A recent multi-country study showed for example that many obstetric procedures were performed without the adequate informed consent of women, including caesarean section (among 10.8% of women), episiotomy (56.1%), induction of labour (26.9%) and vaginal examinations (58.9%) [ 4 , 192 ]. This lack of consent could be greatly reduced by improved interpersonal communication. More generally, better interpersonal communication could lower the occurrence of mistreatment, and has been emphasized in global guidelines as a way to improve quality of care [ 2 , 18 , 193 , 194 ] and respectful maternity care [ 16 , 195 – 198 ].

The importance of an enabling environment, however, needs to be recognized. The health care setting at all levels (micro, meso and macro) impacts the ability of individual health workers to effectively communicate [ 199 ]. Enabling factors can include a non-excessive workload (and thus time to communicate), availability of adequate space and resources, [ 183 , 200 ] and a work atmosphere where team work and good communication are the norm [ 199 ]. The enabling environment should also include the consideration of culture, which can impact understandings and expectations of what ‘good communication’ is between the health worker and women and partners [ 201 ].

This review highlights the importance of interpersonal communication between health workers and women and partners. There are other aspects of communication within MNC that can be possible anchors of quality improvement as well. These include interprofessional communication between health workers, which can be improved by simulation training [ 202 ] or ‘time outs’, deliberate interprofessional communication moments during labour [ 203 ]. Similarly, other quality improvement strategies have aimed to increase the frequency of contact moments between health workers and women, often through mobile-health [ 204 – 214 ]. Improved information provision by health workers can also occur without an interpersonal component, for example through an information video [ 215 ] or leaflets [ 216 ]. Finally, in addition to the targeted communication improvement strategies within the scope of this review, several successful multi-component or complex interventions have been reported, that take a comprehensive approach and target various interpersonal communication aspects simultaneously. An example is the multi-component strategy of Abuya et al. [ 217 ] which covered many respectful maternity care elements including interpersonal communication between health workers and women [ 217 ]. If, how, and in what way these intervention packages work (better), is relevant to include in future studies. Because of the complex interactions between strategies and local contexts, this requires implementation research with a learning agenda on how to design to make these interventions more context specific, and what the underlying mechanisms of action are.

Strengths, limitations and future considerations

Our broad domain and systematic search enabled us to capture a large number of intervention studies and thereby to incorporate a broader perspective of effective interpersonal communication in different domains of SRH and MNH. Due to the large number of included studies, we may not have done full justice to complexities and nuances because we were only able to summarize limited information from each intervention. Language limitations may have resulted in the exclusion of relevant studies or reduced the diversity of study settings (six non-English articles were excluded). Exclusion of grey literature prevented review of potentially relevant reports from (non-governmental) organizations and other projects.

Although our search deliberately included databases that indexed journals from LMICs, the vast majority of studies were conducted in high-income settings. More research and better documentation of strategies to improve interpersonal communication in LMICs is therefore necessary, given both the need to develop culturally-tailored strategies in general and the greater health system constraints in these settings [ 218 , 219 ]. Contextualized strategies appear especially relevant when targeting communication goals such as ‘building a relationship’, and ‘inclusion of patients in decision making or shared decision making’. Importantly, we believe communication strategies should always be adapted to local settings irrespective of their high- or low-income status. Because of the broad domain and inclusion of many studies from diverse settings, we believe our classification could serve well as a basis for designing strategies, measurement tools and implementation studies that can be further shaped and tailored to local settings.

Finally, our review also points towards the need to develop guidance for the reporting of communication interventions’ implementation and evaluation. We observed often a lack of detail on the exact design of a communication intervention and heterogeneity in reported outcomes, which reduces the opportunities for others to learn and adapt these strategies elsewhere. Such reporting guidance would ideally reflect the value of mixed methods designs to ensure evaluation studies report both what has been done, its effectiveness and an understanding of how the strategies worked, and whether they are sustainable over time. Existing tools [ 220 , 221 ] can be used to start documenting these processes.

This scoping review provides a classification of strategies to improve interpersonal communication between health workers and women and partners. This classification can be used as the foundation to inform the design and further tailoring of strategies to improve interpersonal communication, measurement tools and evaluation studies at local settings. While most communication strategies focus on the facilitation of information exchange, incorporation of the other goals of communication (creating a good interpersonal relationship, and including women and families in decision making) are essential to ensure optimal improvement of patient-centred communication in MNC. A learning agenda on how to do this especially in low-resource settings could provide concrete and actionable guidance for settings where the burden of maternal and newborn mortality is highest, and quality of care improvements are urgent.

Supporting information

S1 checklist. prisma 2009 checklist..

https://doi.org/10.1371/journal.pgph.0002449.s001

S1 Appendix. Complete search strategy for different databases.

https://doi.org/10.1371/journal.pgph.0002449.s002

S2 Appendix. Communication goals.

https://doi.org/10.1371/journal.pgph.0002449.s003

Acknowledgments

We would like to acknowledge the contributions of Sasha Kruger to the development of the protocol, the support of Pauline Wiersma and Janneke Staaks in developing the search strategy, and Giulia Ensing and Gina Melis in references management. We thank Rio Withall for the framework visualization design. Furthermore, we would like to extend our appreciation to Action on Preeclampsia Ghana (APECGH), and especially APECGH’s CEO Mrs Koiwah-Koi Larbi Ofosuapea, for feedback on the protocol and reflections on the role of communication in care for women with hypertensive disorders of pregnancy in Ghana. Finally, we thank Linda McPhee and Steve Russell for providing input in editing this manuscript.

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Social Media Use and Impact on Interpersonal Communication

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literature review of interpersonal communication

Yerika Jimenez 2 &
Patricia Morreale 3

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This research paper presents the findings of a research project that investigated how young adult interpersonal communications have changed since using social media. Specifically, the research focused on determining if using social media had a beneficial or an adverse effect on the development of interaction and communication skills of young adults. Results from interviews reveal a negative impact in young adult communications and social skills. In this paper young adult preferences in social media are also explored, to answer the question: Does social media usage affect the development of interaction and communication skills for young adults and set a basis for future adult communication behaviors?

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Social media
Social interaction
Interpersonal communications
Young adults

1 Introduction

Human interaction has changed drastically in the last 20 years, not only due to the introduction of the Internet, but also from social media and online communities. These social media options and communities have grown from being simply used to communicate on a private network into a strong culture that almost all individuals are using to communicate with others all over the world. We will concentrate on the impact that social media has on human communication and interaction among young adults, primarily college students. In today’s society, powerful social media platforms such as Myspace, Facebook, Twitter, Instagram (IG), and Pinterest have been the result of an evolution that is changing how humans communicate with each other. The big question we asked ourselves was how much has social media really impacted the way that humans communicate and interact with each other, and if so, how significant is the change of interpersonal interaction among young adults in the United States today?

The motivation behind this research has been personal experience with interaction and communication with friends and family; it had become difficult, sometimes even rare, to have a one-on-one conversation with them, without having them glancing at or interacting with their phone. Has social interaction changed since the introduction of advanced technology and primarily social media? In correlation with the research data collected in this study, it was concluded that many participants’ personal communication has decreased due social media influence encouraging them to have online conversations, as opposed to face-to-face, in-person conversations.

2 Related Work

The question of how social media affects social and human interaction in our society is being actively researched and studied. A literature review highlights the positive and negative aspects of social media interaction, as researchers battle to understand the current and future effects of social media interaction. A study done by Keith Oatley, an emeritus professor of cognitive psychology at the University of Toronto, suggests that the brain may interpret digital interaction in the same manner as in-person interaction, while others maintain that differences are growing between how we perceive one another online as opposed to in reality [ 1 ]. This means that young adults can interpret online communication as being real one-on-one communication because the brain will process that information as a reality. Another study revealed that online interaction helps with the ability to relate to others, tolerate differing viewpoints, and express thoughts and feeling in a healthy way [ 2 , 3 ]. Moreover a study executed by the National Institutes of Health found that youths with strong, positive face-to-face relationships may be those most frequently using social media as an additional venue to interact with their peers [ 4 ].

In contrast, research reveals that individuals with many friends may appear to be focusing too much on Facebook, making friends out of desperation rather than popularity, spending a great deal of time on their computer ostensibly trying to make connections in a computer-mediated environment where they feel more comfortable rather than in face-to-face social interaction [ 5 ]. Moreover, a study among college freshman revealed that social media prevents people from being social and networking in person [ 6 ].

3 Experimental Design

This research study was divided into two parts during the academic year 2013–2014. Part one, conducted during fall semester 2013, had the purpose of understanding how and why young adults use their mobile devices, as well as how the students describe and identify with their mobile devices. This was done by distributing an online survey to several Kean University student communities: various majors, fraternity and sorority groups, sports groups, etc. The data revealed that users primarily used their mobile devices for social media and entertainment purposes. The surveyed individuals indicated that they mainly accessed mobile apps like Facebook, Pinterest, Twitter, and Instagram, to communicate, interact, and share many parts of their daily life with their friends and peers.

Based on the data collected during part one, a different approach and purpose was used for part two, with the goal being to understand how social media activities shape the communication skills of individuals and reflects their attitudes, attention, interests, and activities. Additionally, research included how young adult communication needs change through the use of different social media platforms, and if a pattern can be predicted from the users’ behavior on the social media platforms. Part two of this research was conducted by having 30 one-on-one interviews with young adults who are college students. During this interview key questions were asked in order to understand if there is a significant amount of interpersonal interaction between users and their peers. Interpersonal interaction is a communication process that involves the exchange of information, feelings and meaning by means of verbal or non-verbal messages. For the purposes of this paper, only the data collected during spring 2014 is presented.

4 Data Collection

Through interviews, accurate results of the interaction of young adults with social media were collected. These interviews involved 30 one-on-one conversations with Kean University students. Having one-on-one interviews with participants allowed for individual results, first responses from the participant, without permitting responses being skewed or influenced by other participants, such as might occur in group interviews. It also allows users to give truthful answers, in contrast to an online or paper survey, as they might have second thoughts about an answer and change it. The one-on-one interviews consisted of ten open-ended questions, which were aimed to answer, and ultimately determine, how social media interaction involuntarily influences, positively or negatively, an individual’s attitude, attention, interests, and social/personal activities. The largest motive behind the questions was to determine how individual communication skills, formally and informally, have changed from interacting with various social media platforms. The interviews, along with being recorded on paper, were also video and audio-recorded. The average time for each interview was between two to ten minutes. These interviews were held in quiet labs and during off-times, so that the responses could be given and recorded clearly and without distraction (Fig. 1 ). A total of 19 females and 11 males participated, with ages ranging from 19 to 28 years old.

Female participant during one-on-one interview

After conducting the interviews and analyzing the data collected, it was determined that the age when participants, both male and female, first began to use social media ranged between 9 to 17 years. It was found that, generally, males began to use social media around the age of 13, whereas females started around the age of 12. The average age for males starting to use social media is about 12.909 with a standard deviation of 2.343. For females, the average age is 12.263 with a standard deviation of 1.627. From this, we can determine that males generally begin to use social media around the age of 13, whereas females begin around the age of 12.

After determining the average age of when participants started using social media, it was necessary to find which social media platforms they had as a basis; meaning which social media platform they first used. MySpace was the first social media used by twenty-three participants, followed by Facebook with three users, and Mi Gente by only one user, with two participants not using social media at all. It was interesting to find that all of the participants who started using Myspace migrated to Facebook. The reasoning provided was that “everyone [they knew] started to use Facebook.” According to the participants, Facebook was “more interactive” and was “extremely easy to use.” The participants also stated that Myspace was becoming suitable for a younger user base, and it got boring because they needed to keep changing their profile backgrounds and modifying their top friends, which caused rifts or “popularity issues” between friends. After finding out which platform they started from, it was also essential to find out which platform they currently use. However, one platform that seemed to be used by all participants to keep up-to-date with their friends and acquaintances was Instagram, a picture and video-based social media platform. Another surprising finding was that many users did not use Pinterest at all, or had not even heard of the platform. After determining which social media platforms the users migrated to, it was essential to identify what caused the users to move from one platform to another. What are the merits of a certain platform that caused the users to migrate to it, and what are the drawbacks of another platform that caused users to migrate from it or simply not use it all?

4.1 Social Interaction Changes

For some participants social interaction had a chance for a positive outcome, while others viewed it in a more negative aspect. The participants were asked if their social interactions have changed since they were first exposed to social media (Table 1 ). One participant stated that “it is easier to just look at a social media page to see how friends and family are doing rather than have a one-on-one interaction.” As for people’s attitudes, they would rather comment or “like” a picture than stop and have a quick conversation. On the other hand, another participant felt that social media helped them when talking and expressing opinions on topics that they generally would not have discussed in person. Moreover, the participants are aware of the actions and thing that they are doing but continue to do it because they feel comfortable and did not desire to have one-on-one interactions with people.

The participants were also asked to explain how social media changed their communication and interactions during the years of using social media (Table 2 ). The data shows that participants interact less in person because they are relating more via online pictures and status. For other participants, it made them more cautious and even afraid of putting any personal information online because it might cause problems or rifts in their life. On the contrary, some participants stated that their communication and interaction is the same; however, they were able to see how it had changed for the people that are around them. A participant stated that “internet/social media is a power tool that allows people to be whatever they want and in a way it creates popularity, but once again they walk around acting like they do not know you and ‘like’ your pictures the next day.”

5 Discussion

The data illustrated in this paper shows how much the introduction and usage of social media has impacted the interaction and communication of young adults. The future of interaction and communication was also presented as a possibility, if the current trend continues with young adults and social media or online communities. This raises the notion of possibly not having any social, in-person interaction and having all communication or interaction online and virtually with all family and friends.

6 Conclusion

Referring back to the question asked during the introduction: how much has social media impacted the way we communicate and interact with each other? After reviewing all the findings, seeing the relationship individuals have with their mobile phones, and comparing social media platforms, it is clear that many young adults have an emotional attachment with their mobile device and want interaction that is quick and to the point, with minimal “in-person” contact. Many young adults prefer to use their mobile device to send a text message or interact via social media. This is due to their comfort level being higher while posting via social media applications, as opposed to in-person interaction. To successfully and accurately answer the question: yes, social media has had a very positive and negative effect on the way we communicate and interact with each other. However, how effective is this method of “virtual” communication and interaction in the real world?

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Jimenez, Y., Morreale, P. (2015). Social Media Use and Impact on Interpersonal Communication. In: Stephanidis, C. (eds) HCI International 2015 - Posters’ Extended Abstracts. HCI 2015. Communications in Computer and Information Science, vol 529. Springer, Cham. https://doi.org/10.1007/978-3-319-21383-5_15

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Interpersonal Communication Style and Personal and Professional Growth among Saudi Arabian Employees

Lowai g. abed.

1 University of Jeddah, College of Communication and Media, Department of Communication and Public Relations, Jeddah 23218, Saudi Arabia

Mohaned G. Abed

2 Department of Special Education, Faculty of Educational Graduate Studies, King Abdulaziz University, Jeddah 21589, Saudi Arabia

Todd K. Shackelford

3 Department of Psychology, Oakland University, Rochester, MI 48306, USA

Associated Data

Due to the nature of this research, the participants did not agree for their identified data to be shared publicly.

This study explored the association of interpersonal communication style (ICS) with personal and professional growth among Saudi Arabians in the context of the work environment. It was hypothesized that different ICSs are differently associated with personal and professional growth. The participants were 143 Saudi Arabian adults, including members of both genders, who were employed, with varying incomes, and who had different education levels. The participants completed a self-report survey, assessing their ICS and their personal and professional growth in an employment context. Consistent with the hypothesis, the results indicated that different ICSs are differently associated with personal and professional growth. The controlling ICS had the strongest relationship to professional and personal growth, whereas the dynamic ICS had the weakest relationship to professional and personal growth. In the Discussion, we address the limitations of the study and identify several directions for future research, with specific reference to the Saudi Arabian cultural context.

1. Introduction

Interpersonal communication refers to the transmission of information between at least two individuals. Interpersonal communication style (ICS) is important for forming and maintaining relationships, whether in a work setting or a private space [ 1 ]. A person’s interpretation of messages is based on the verbal and non-verbal codes expressed in the sender’s and the receiver’s communications [ 2 ]. These interpretations are based, in part, on the cultural context [ 3 ]: for instance, certain facial expressions are interpreted as automatic responses to specific stimuli, whereas other non-verbal cues, such as direct eye contact, may mean something different in different cultures [ 3 ]. For these reasons, ICS is important for relationship functioning—which means knowing when and how to communicate, as well as when to express certain non-verbal cues, to send specific messages. The ICSs considered in the current study—controlling, egalitarian, structuring, dynamic, relinquishing, and withdrawal—can evoke certain interpretations by receivers of messages [ 4 ].

In work or personal contexts, a particular ICS may help individuals grow or may cause them to regress, in the context of a relationship [ 5 ]. ICSs can be categorized as either one-way or two-way communication styles, each associated with benefits and detriments [ 5 ]. For instance, one-way communication may hinder personal and professional growth, because it lacks an interactional component [ 6 ], whereas two-way or interactive communication allows for both the sender and the receiver to ask questions and clarify issues [ 6 ].

1.1. Objectives of the Current Study

A key objective of the current study was to identify associations between ICSs and personal and professional growth. The study explored the views that people have regarding various ICSs and how these styles may affect their relationships. Few studies have considered the associations of ICSs with reported psychological and emotional wellbeing in a non-Western sample, generally, and specifically in a Saudi Arabian sample. Thus, this study aimed to contribute to the empirical literature, by investigating the associations between ICSs and personal and professional growth in a sample of Saudi Arabian adults.

1.2. Interpersonal Communication Style

Interpersonal communication style (ICS) refers to a “typical set of behaviors an individual displays in their interaction with others” [ 7 ] (p. 539). “Interpersonal” refers to relationships and communication, and to the processes therein that shape social interactions. Because interpersonal communication relates to people, individual difference traits are one set of components that may affect interactions with others. Bateman and Zeithaml (1990, cited in [ 7 ]) identified six ICSs in a work environment: controlling; egalitarian; structuring; dynamic; relinquishing; and withdrawal. Table 1 presents brief descriptions of these styles.

Description of interpersonal communication styles (adapted from [ 7 ]).

Interpersonal Style	Type	Description
Controlling	One-way communication
Egalitarian	Two-way communication
Structuring	Task-focused
Dynamic	High-energy
Relinquishing	Deferential
Withdrawal	Lack of communication

According to Dwyer and Hopwood [ 7 ], managers in work contexts employ a particular ICS based on their personality traits, leadership style, and employment experience. Successful managers may adjust their ICS to meet the needs of the situation or to suit the context. Adaptability, in this case, suggests being open to new opinions or changes in an organization, as well as managing unexpected demands [ 7 ].

Interpersonal communication also entails sending and receiving both verbal and non-verbal signals. Ansari [ 4 ] argues that interpersonal communication skills (verbal and non-verbal) are important for maintaining interpersonal relationships, and for effective functioning in a work setting. On the other hand, Taylor [ 8 ] notes that much of modern communication, particularly organizational communication, is neither face-to-face nor limited to two people, when one considers digitized communication such as emails and video conferencing. The absence of or limitations associated with traditional signals of interpersonal communication can lead to conflict in work settings [ 9 ]. These conflicts may be due to misunderstandings or disagreements between managers and employees, or between employees [ 9 ]. Workplace conflict and misunderstanding, especially between management and employees, can lead to increased employee turnover [ 10 ]. Some of these workplace problems can be traced to poor or limited interpersonal communication by managers [ 4 ].

Bucata and Rizescu [ 11 ] argue that communication management is a domain of leadership that should be attended to by managers, because effective communication management facilitates employee training, harmonization, control, and assessment. The same scholars note that managerial communication plays a significant interpersonal role, because managers serve as leaders while engaging with peers, subordinates, and customers within and outside the organization. Bucata and Rizescu report research indicating that managers use 45% of their time to communicate with equals and employees, and only 10% to communicate with superiors. In addition, successful managerial communication facilitates employee job satisfaction, by enabling sharing of information between managers and employees, as well as enhanced employee performance, by effective communication of organizational objectives [ 11 ].

1.3. One-Way Communication

Communication theory highlights three approaches by which to conceptualize the communication process: one-way (linear); two-way (interactive); or transactional [ 12 ]. In each approach, the sender attempts to produce an attitudinal change in the receiver [ 12 ]. Feedback is important for many reasons, such as to signal reception of the message and to ensure that the communication has the intended effect [ 13 ]. Including feedback in a one-way or linear approach facilitates the effectiveness of the communication [ 12 ]. Moreover, it is important to identify whether the communication is formal or informal, even in an organizational context. Awad and Alhashemi [ 5 ] found that the formal context is likely to embody a one-way communication channel, especially if the communication is occurring through an official path, such as email, meeting, or text: this suggests a working arrangement that may limit the interactive approach, especially between managers and employees, because of a strict hierarchy within the organization [ 14 ]. In addition, there may be an emphasis on written communication that requires answers to specific queries, and does not welcome engaging with other issues [ 15 ]. This leads to an “ask-and-obey” approach to communication between managers and employers [ 15 ].

1.4. Two-Way Communication

In two-way communication, interaction is crucial; nonetheless, there are diverse interpretations of what “interaction” means [ 12 ]. Interaction typically refers to a reciprocal dialogue that includes opportunities for individuals to influence each other. This type of communication typically occurs between individuals who are cordial, but may be initiated and pursued by workplace managers who are democratic and transformational [ 16 ]. Awad and Alhashemi [ 5 ] provided evidence that informal communication in the workplace tends to be two-way, and is not usually sanctioned or regimented in the manner of one-way (especially manager–employee) communication. The authors further noted that informal communication may facilitate positive relationships that serve as a source of influence [ 5 ]. However, such informal interactions also can be a source of communication problems, such as when people engage in rumor-spreading [ 17 ].

Communication is essential to the development and maintenance of interpersonal relationships. A two-way communication approach provides the sender and receiver with opportunities to interact and communicate effectively, by sharing ideas, solving problems, and expressing thoughts and feelings. This communication can be verbal or non-verbal, either of which may include signals of intent [ 5 ]. Two-way communication may facilitate better working relationships and reduce misunderstandings that interfere with the personal and professional growth of employees. Ruler [ 12 ] argues that two-way communication is essential for effective interaction, as communication is a process of constructing meaning.

1.5. Personal and Professional Growth

Personal and professional growth can be affected by communication, whether in a work setting or in a private space [ 18 ]. The style of interpersonal communication that individuals use can affect whether they grow personally and professionally [ 1 ]. For instance, a controlling ICS can obstruct personal and professional growth, whereas an egalitarian ICS can support personal and professional growth [ 19 ]. Dwyer and Hopwood [ 7 ] argue that positive communication is adaptable, in that it expresses that an individual has “an open mind, responds with a positive attitude to change, and is willing to learn new ways to achieve targets and objectives” (p. 540). Based on this argument, individuals may grow personally and professionally when the communication is interactive and thereby provides opportunities to ask questions and to learn. The authors add that skilled communicators can switch ICSs, based on the situation and the people with whom they are interacting [ 7 ].

Bucata and Rizescu [ 11 ] found that communication from management is typically intended to inform employees, and to guide them towards high-quality workplace performance. Therefore, to communicate well means not only arranging one’s thoughts, but also expressing them in a manner that captures the attention of the receiver [ 11 ]. Ansari [ 4 ] supports this argument with the contention that effective interpersonal communication skills maintain a healthy and appropriate balance in interpersonal relationships. Previous research (see [ 4 ]) notes that effective interpersonal communication skills in organizations result in employee dedication, improved performance, and meaningful work relationships, as well as greater trust among and between employees and management.

Beenen and colleagues’ [ 20 ] study of managerial interpersonal communication skills found that the most effective interpersonal communication is represented in a threefold approach: supporting, motivating, and managing conflict. In addition, managerial interpersonal communication skills predicted attitudes and performance among employees and managers over and above personality traits and leadership style [ 20 ]. Thus, managerial ICS can affect how employees spend their time in the workplace, and whether they experience joy or despair, perform well or poorly, or are healthy or ill [ 20 ].

1.6. Conceptual Framework

Interpersonal Need Gratification theory [ 21 ] addresses relationships at work, and how they influence personal and professional growth. The theory posits that psychological needs are arranged in a hierarchy, and can affect the associations between job factors and satisfaction [ 21 ]. Thus, individuals enter a relationship based on what they seek to gain. For instance, an employee can form a relationship with a manager to find favor, or to learn and grow in the work context. Awad and Alhashemi [ 5 ] studied the effects of interpersonal communication on employee dedication, and found that when employee needs are met through satisfying communication, they are likely to develop successful relationships, and to experience satisfaction in their work. The authors also noted that Interpersonal Need Gratification theory is goal-oriented insofar as people need inclusion, control, and affection [ 5 ]. This may explain why personal and professional growth can depend on the type of relationship individuals have with others—which influences ICS.

1.7. Hypothesis

Based on Interpersonal Need Gratification theory, individuals may sometimes attempt to endear themselves to workplace superiors, to gain favor. Thus, employees may be more likely to listen to and yield to their superiors. Furthermore, yielding to superiors provides an opportunity for employees to learn and grow, as their superiors are usually more experienced in the workplace. Therefore, some ICSs may have a stronger influence on employees than others, based on what employees hope to achieve—that is, whether to find favor or to learn and grow. We offer the following hypothesis, which we investigated in a sample of Saudi Arabian adults: different ICSs are differently associated with personal and professional growth.

2.1. Study Design

A correlation design was used to investigate relationships among the target variables: in addition, an ANOVA single-factor analysis approach was employed to investigate these relationships. The independent variables included the different ICSs and demographic variables, and the dependent variable included an assessment of personal and professional growth. We tested the following hypothesis: different ICSs are differently associated with personal and professional growth.

A Likert-scale self-report survey (described below) was used to collect the data. The items considered by the current study had 5 ordinal response options: “strongly agree”; “agree”; “uncertain”; “disagree”; and “strongly disagree”, coded 5 to 1, respectively. ANOVA single-factor analysis was applied, to measure the variances associated with the ordered levels.

2.2. Participation and Procedure

The survey was administered by convenience sampling of 192 adult members of the public in Saudi Arabia. The survey included several demographic questions. More women than men participated, with the greatest number of participants in the age group 31–50 years. Exploratory demographic questions assessed level of education and monthly income. Table 2 presents a summary of available demographic information for the convenience sample of Saudi Arabian adults.

Summary of the demographic attributes of the participants.

Variable	Attribute	Total
Gender [G]	Male	68
	Female	124
	N	192
Age [A]	Less than 20	9
	21–30	24
	31–40	71
	41–50	61
	51–60	17
	More than 60	10
	N	192
Level of Education [LE]	Elementary school	13
	Middle School	23
	High school	36
	Diploma	60
	Bachelor’s degree	37
	Master’s degree	14
	Doctoral degree	9
	N	192
Monthly Income [MI]	No income	13
	Less than 5000 SR	29
	5000–9999 SR	55
	10,000–14,999 SR	57
	15,000–20,000 SR	29
	More than 20,000 SR	9
	N	192
Work Status [WS]	Yes	192
	No	0
	N	192

The participants were issued a survey after the researcher described the purpose of the study, and following provision of informed consent. Participation was voluntary and was not rewarded. The participants were instructed to answer items by selecting the response option that best reflected their answer. Although the survey was distributed to 192 participants, 49 participants responded to the first question but then discontinued participation: the final sample that provided complete data was thus 143.

Convenience sampling guided the pseudo-random sampling of participants in public spaces, with some subjective bias unavoidable in our efforts to select adults 18 years of age or older, who appeared likely to be employed. Following Dwyer and Hopwood [ 7 ], the data were coded to differentiate six ICSs: controlling (CS); egalitarian (ES); structuring (SS); dynamic (DS); relinquishing (RS); and withdrawal (WS). Each ICS was indexed by the item identified in Table 3 .

Item indexing the effect of interpersonal communication style on personal and professional growth (adapted from [ 7 ]).

Style	Codes	Items
Controlling	CS	When respected individuals use a controlling style in times of crisis, I am able to grow personally and professionally.
Egalitarian	ES	I grow personally and professionally when I express my ideas and opinions to reach a mutual understanding.
Structuring	SS	I grow personally and professionally when there are company standards and rules to be followed.
Dynamic	DS	I grow personally and professionally when I am encouraged to take action.
Relinquishing	RS	I grow personally and professionally when a manager delegates the responsibility of communication to me.
Withdrawal	WS	I grow personally and professionally when a manager restricts his influence in a discussion.

2.3. Ethical Considerations

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Research Ethics Committee of King Abdulaziz University (protocol KEP-92-120-42; date of approval: 15 February 2021). Written informed consent was obtained from those participating, prior to their participation. Due to the nature of this research, the participants did not agree for their identified data to be shared publicly. The authors declare no conflict of interest. The funders had no role in the design of the study, in the collection, analyses, or interpretation of the data, in the writing of the manuscript, or in the decision to publish the results.

Table 4 presents the descriptive statistics for personal and professional growth by ICS. For analytic and reportorial efficiency, “level” differentiates the strength of the reported personal and professional growth, assigned according to average growth. These findings indicate that, for example, the respondents reported high growth professionally and personally when directed by experienced individuals (CS). As another example, respondents reported moderate growth professionally and personally when encouraged to take action by their superiors (DS).

Descriptive statistics for personal and professional growth by interpersonal communication style (ICS).

ICS	Average	ICS	Level
CS1	4.2343	CS2	High
ES1	4.0138	ES2	High
SS1	4.0486	SS2	High
DS1	3.8472	DS2	Moderate
RS1	4.0277	RS2	High
WS1	3.9791	WS2	Moderate

Note: See text for full labels for ICSs.

The ANOVA results (see Table 5 ) showed a p -value of 0.04624, which was evidence for rejecting the null hypothesis, as the value was less than 0.05. This suggests that reported personal and professional growth differs with ICS.

ANOVA of effects of ICS on personal and professional growth.

Sources Variation					-Value	Critical
Between	13.25557	5	2.651115	2.264777	0.04624	2.223983
Within	1060.55	906	1.170585
Total	1073.806	911

4. Discussion

The goal of this study was to test the hypothesis that different interpersonal communication styles (ICSs) are differently associated with personal and professional growth. The results provide evidence consistent with the hypothesis: different ICSs are differently associated with personal and professional growth.

According to the participants’ reports, most were able to grow professionally and personally when directed by others and when respected individuals used the controlling style in times of crisis. By contrast, fewer respondents strongly agreed that they grew both professionally and personally when encouraged to take action by their superiors or when placed in a challenging situation by a superior’s request. Sethi and Seth [ 22 ] note that the controlling style is used to “direct others and gain their compliance” and can be “effective when used on occasion by respected individuals, particularly in times of crisis” (p. 38). The controlling style is a one-way communication approach, used to direct people. Minimal or no feedback is required when using the controlling style, and individuals employing this approach use power and manipulation to underpin their message [ 7 ] (p. 539). Although the controlling style can be effective, it is also a style of communication that can intimidate the receiver, raise communication barriers, and alienate others in normal situations [ 7 ] (p. 539). However, this style can be effective in times of crisis or emergency.

The dynamic style of interpersonal communication is an “energetic approach that uses inspiring requests to spur employees into action” [ 23 ] (p. 366). A few participants reported that they grew professionally and personally when they were encouraged to take action, or when they were placed in a challenging situation by a superior’s request. A dynamic style is a two-way form of communication that permits several actions between the sender and receiver, such as the use of inspiration to motivate action [ 7 ]. The dynamic style can be effective in times of crisis, but can be ineffective when the receiver has inadequate knowledge and experience. This may explain why participants indicated that they were unlikely to grow professionally and personally when this style was employed [ 23 ].

The withdrawal style of interpersonal communication also displayed a relatively low mean for growth, compared to the other styles. Thus, fewer respondents agreed that they grew professionally when a manager restricted their influence in discussion, or when the manager was unwilling to participate in a discussion. Typically, when employing this style, the sender avoided using their influence and legitimate power while communicating, leaving the receiver to attempt to interpret the message. This indicated indifference and unwillingness to participate or forward the communication, highlighting why it is often an ineffective managerial communication style [ 24 ].

It is also important to consider the demographic characteristics of the sample when interpreting the results. More women than men participated in the study. Merchant [ 25 ] investigated gender differences in communication styles, and found that men and women perceive the role of communication differently. Whereas women employ communication “as a tool to enhance social connections and create relationships, men use language to exert dominance and achieve tangible outcomes” [ 25 ] (p. 17). Another study addressing gender differences in communication found that women used more “affiliative speech”, which included agreement and conciliation, whereas men used more “assertive speech”, which included providing information to act on [ 26 ] (p. 7). Socialization and social/contextualist theoretical frameworks may help explain gender differences in communication styles: one such framework is Gender Socialization and Identity theory, which posits that gender is learned through socialization [ 27 ]. Future research may profitably secure data from larger samples of men and women, to afford a statistically defensible investigation of gender differences in ICSs, and associations with personal and professional growth.

Consideration of other demographic characteristics of the sample also may account for some of the results, and suggest directions for future research. For instance, the largest age group participating in the study was 31–40 years old, and most of the respondents had attained a college diploma. Moreover, all the participants reported that they were currently employed, suggesting recent encounters within their organizations that would directly inform their answers. Thus, the current results may reflect most clearly the perceptions of college-educated and currently employed Saudi Arabian adults. Future research might profitably investigate whether responses vary by education level and current employment status. Furthermore, although this is the first study to investigate the associations of ICSs with personal and professional growth in a Saudi Arabian sample, we suggest that future research investigate whether these results replicate in other Middle Eastern cultures.

5. Conclusions

In summary, ICSs appear to be differently associated with personal and professional growth in Saudi Arabian employees. The current results suggest that the controlling managerial style better predicts employee growth than does the dynamic or withdrawal style, for example. The controlling style is used to direct others and gain compliance, and is more effective in times of crisis, thereby facilitating employee growth. The dynamic and withdrawal styles, in contrast, require employees to interpret ambiguous or minimal managerial communication, making it difficult for employees to grow professionally or personally in the absence of clear managerial guidance or direction. The dynamic and withdrawal styles may be especially ineffective when employees are not knowledgeable and experienced. Several results of the current research parallel the results of work with Western samples, suggesting cross-cultural similarities in the relationships between ICSs and personal and professional growth. Other results may be specific to non-Western or Saudi samples, and this suggests an avenue for future research investigating the possibility of cultural differences.

Funding Statement

The Deanship of Scientific Research (DSR) at King Abdulaziz University, Jeddah, Saudi Arabia has funded this project, under grant no. (KEP-92-120-42).

Author Contributions

M.G.A. conceived the project, L.G.A. collected data and conducted analyses, and M.G.A. and L.G.A. generated the first draft of the manuscript. T.K.S. consulted on data collection, analysis, and presentation, and revised the text of manuscript. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Research Ethics Committee at King Abdulaziz University (protocol KEP-92-120-42; date of approval: 15 February 2021).

Informed Consent Statement

Written informed consent was obtained from the participants, prior to their participation.

Data Availability Statement

Conflicts of interest.

The authors declare no conflict of interest. The funders had no role in the design of the study, in the collection, analyses, or interpretation of the data, in the writing of the manuscript, or in the decision to publish the results.

Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

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Interpersonal Communication: A Mindful Approach to Relationships

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Table of Contents

Ancillary Material

About the Book

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Strategies to improve interpersonal communication along the continuum of maternal and newborn care: A scoping review and narrative synthesis

Introduction

Protocol and registration

Domain and population

Eligibility criteria

Information sources

Selection of sources of evidence

Data charting process including data items

Synthesis of results

Study characteristics

Communication goals

Box 1: Examples of improvement strategies for the three communication goals

Communication goal: Creating a good interpersonal relationship

Communication goal: Enabling the inclusion of women and partners/families in MNC decision making

Strategies to improve communication

Box 2: Examples of the two main strategies used to improve communication

Tools to facilitate communication

Training of health workers.

Tools to facilitate interpersonal communication.

Other strategies to improve interpersonal communication.

Interpersonal communication effectiveness and outcomes

Update of Feldman-Stewart and Brundage communication framework

Strengths, limitations and future considerations

Supporting information

S1 Appendix. Complete search strategy for different databases.

S2 Appendix. Communication goals.

Acknowledgments

Social Media Use and Impact on Interpersonal Communication

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1 Introduction

2 Related Work

3 Experimental Design

4 Data Collection

4.1 Social Interaction Changes

5 Discussion

6 Conclusion

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Interpersonal Communication Style and Personal and Professional Growth among Saudi Arabian Employees

Mohaned G. Abed

Todd K. Shackelford

Associated Data

1. Introduction

1.1. Objectives of the Current Study

1.2. Interpersonal Communication Style

1.3. One-Way Communication

1.4. Two-Way Communication

1.5. Personal and Professional Growth

1.6. Conceptual Framework

1.7. Hypothesis

2.1. Study Design

2.2. Participation and Procedure

2.3. Ethical Considerations

4. Discussion

5. Conclusions

Funding Statement

Author Contributions

Institutional Review Board Statement

Informed Consent Statement

Data Availability Statement

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