Abstract
Communication is central to nursing care. Yet, the nonverbal aspect of communication tends to be neglected or underestimated in nursing studies. Research has shown that older patients interpret nurses' communication messages during the clinical encounter. This article conceptualizes older adults' interpretation of and need for nonverbal communication (NVC) to enhance patient-centered communication advocated by the World Health Organization. The Corbin and Strauss (2015) inductive Grounded Theory approach was used to collect data from 3 hospital units in Cameroon using in-depth interviews with eight older adults, thirteen nurses, and four student nurses between July 2018 and January 2020. Open coding, axial coding, and selective coding were used for analysis, which reveals that interpretations of NVC can be positive or negative. It means that older adults view nurses either as angels or as difficult persons, depending on the nurses' positive or negative NVC and behaviors. These interpretations lead to consequences ranging from a preference for some nurses to noncompliance with care. The results further show that older adults need active listening, humor, and affection from nurses. Information regarding older adults' interpretation of and need for NVC can be used to improve curriculum content and to develop skills in and awareness of NVC with older adults. It is recommended that further research expand on effective nonverbal techniques during COVID-19 times where the meaning of facial expressions and voice inflection can be disrupted.