West meets East
Doctors’ perspectives and experiences of patient-centered intercultural communication in Ukraine
DOI:
https://doi.org/10.1558/cam.19234Keywords:
doctors’ perspectives; Hofstede’s dimensions of national cultures; intercultural communication; patient-centered communication; socio-historical barriers; Slavic; UkraineAbstract
Research has identified the tasks associated with effective patient-centered communication (PCC), but less is known about the contexts that can enable or hinder its implementation. This study explores East Slavic doctors’ perspectives and experiences of intercultural PCC with Western patients. Semi-structured interviews informed by the principles of PCC were carried out with 15 doctors from two private clinics in Ukraine. The interviews were analyzed both for content and themes, informed by the dimensions of culture approach developed by Geert Hofstede and co-authors.
The findings suggest disparities between the Ukrainian doctors’ perspectives and experiences of PCC and those encountered in the West, with those of the former seeming to be influenced by socio-historical and educational barriers, and by dimensions of national culture in Ukraine. In conceptualizing PCC, the societal context needs to be taken into account, lest some important functions of medical communication be placed at risk.
References
Abdelrahim, Huda, Maha Elnashar, Amal Khidir, Amal Killawi, Maya Hammoud, Abdul Latif Al-Khal and Michael D. Fetters (2017) Patient perspectives on language discordance during healthcare visits: Findings from the extremely high-density multicultural State of Qatar. Journal of Health Communication 22 (4): 355–363. https://doi.org/10.1080/10810730.2017.1296507 DOI: https://doi.org/10.1080/10810730.2017.1296507
Bates, Joanne and Rodney Andrew (2001) Untangling the roots of some IMGs’ poor academic performance. Academic Medicine 76 (1): 43–46. https://doi.org/10.1097/00001888-200101000-00012 DOI: https://doi.org/10.1097/00001888-200101000-00012
Borg, Michael A. and Liberato Camilleri (2019) Broad-spectrum antibiotic use in Europe: More evidence of cultural influences on prescribing behaviour. Journal of Antimicrobial Chemotherapy 74 (11): 3379–3383. https://doi.org/10.1093/jac/dkz312 DOI: https://doi.org/10.1093/jac/dkz312
Braun, Virginia and Victoria Clarke (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3 (2): 77–101. https://doi.org/10.1191/1478088706qp063oa DOI: https://doi.org/10.1191/1478088706qp063oa
Bruyneel, Luk, Emmanuel Lesaffre, Bart Meuleman and Walter Sermeus (2019) Power distance and physician–nurse collegial relations across 14 European countries: National culture is not merely a nuisance factor in international comparative research. Journal of Nursing Scholarship 51 (6): 708–716. https://doi.org/10.1111/jnu.12514 DOI: https://doi.org/10.1111/jnu.12514
Chang, Chulhun Ludgerus, Byung Kyu Park and Sung Soo Kim (2013) Conversational analysis of medical discourse in rehabilitation: A study in Korea. Journal of Spinal Cord Medicine 36 (1): 24–30. https://doi.org/10.1179/2045772312Y.0000000051 DOI: https://doi.org/10.1179/2045772312Y.0000000051
Claramita, Mora, Mubarika D. F. Nugraheni, Jan van Dalen and Cees van der Vleuten (2013) Doctor-patient communication in Southeast Asia: A different culture? Advances in Health Sciences Education: Theory and Practice 18 (1): 15–31. https://doi.org/10.1007/s10459-012-9352-5 DOI: https://doi.org/10.1007/s10459-012-9352-5
Cousin, Gaetan, Marianne Schmid Mast, Debra L. Roter and Judith A. Hall (2012) Concordance between physician communication style and patient attitudes predicts patient satisfaction. Patient Education and Counseling 87 (2): 193–197. https://doi.org/10.1016/j.pec.2011.08.004 DOI: https://doi.org/10.1016/j.pec.2011.08.004
Dahm, Maria R. (2011) Exploring perception and use of everyday language and medical terminology among international medical graduates in a medical ESP course in Australia. English for Specific Purposes 30 (3): 186–197. https://doi.org/10.1016/j.esp.2011.02.004 DOI: https://doi.org/10.1016/j.esp.2011.02.004
Dahm, Maria R., Lynda Yates, Kathryn Ogden, Kim Rooney and Brooke Sheldon (2015) Enhancing international medical graduates’ communication: The contribution of applied linguistics. Medical Education 49 (8): 828–837. https://doi.org/10.1111/medu.12776 DOI: https://doi.org/10.1111/medu.12776
de Haes, Hanneke and Jozien Bensing (2009) Endpoints in medical communication research, proposing a framework of functions and outcomes. Patient Education and Counseling 74 (3): 287–294. https://doi.org/10.1016/j.pec.2008.12.006 DOI: https://doi.org/10.1016/j.pec.2008.12.006
Epstein, Ronald M., Peter Franks, Kevin Fiscella, Cleveland G. Shields, Sean C. Meldrum, Richard L. Kravitz and Paul R. Duberstein (2005) Measuring patient-centered communication in patient-physician consultations: Theoretical and practical issues. Social Science & Medicine 61 (7): 1516–1528. https://doi.org/10.1016/j.socscimed.2005.02.001 DOI: https://doi.org/10.1016/j.socscimed.2005.02.001
Fochsen, Grethe, Kirti Deshpande and Anna Thorson (2006) Power imbalance and consumerism in the doctor–patient relationship: Health care providers’ experiences of patient encounters in a rural district in India. Qualitative Health Research 16 (9): 1236–1251. https://doi.org/10.1177/1049732306293776 DOI: https://doi.org/10.1177/1049732306293776
Ge Gao, Nancy Burke, Carol P. Somkin and Rena Pasick (2009) Considering culture in physician–patient communication during colorectal cancer screening. Qualitative Health Research 19 (6): 778–789. https://doi.org/10.1177/1049732309335269 DOI: https://doi.org/10.1177/1049732309335269
Haggerty, Jeannie L., Raynald Pineault, Marie-Dominique Beaulieu, Yvon Brunelle, Josee Gauthier, Francois Goulet and Jean Rodrigue (2008) Practice features associated with patient-reported accessibility, continuity, and coordination of primary health care. Annals of Family Medicine 6 (2): 116–123. https://doi.org/10.1370/afm.802 DOI: https://doi.org/10.1370/afm.802
Hall, Pippa, Erin Keely, Suzan Dojeiji, Anna Byszewski and Meridith Marks (2004) Communication skills, cultural challenges and individual support: Challenges of international medical graduates in a Canadian healthcare environment. Medical Teacher 26 (2): 120–125. https://doi.org/10.1080/01421590310001653982 DOI: https://doi.org/10.1080/01421590310001653982
Harmsen, J. A. M. (Hans), Roos M. D. Bernsen, Marc A. Bruijnzeels and Ludwien Meeuwesen (2008) Patients’ evaluation of quality of care in general practice: What are the cultural and linguistic barriers? Patient Education and Counseling 72 (1): 155–162. https://doi.org/10.1016/j.pec.2008.03.018 DOI: https://doi.org/10.1016/j.pec.2008.03.018
Henderson, Amanda and Wai-Tong Chien (2007) Health beliefs and expectations implicit in decision-making in a Hong Kong Chinese surgical population. Journal of Clinical Nursing 16 (3): 603–609. https://doi.org/10.1111/j.1365-2702.2006.01572.x DOI: https://doi.org/10.1111/j.1365-2702.2006.01572.x
Hofstede, Geert (2001) Culture’s Consequences: Comparing Values, Behaviors, Institutions and Organizations Across Nations (2nd edition). London: Sage Publications.
Hofstede, Geert, Gert Jan Hofstede and Michael Minkov (2010) Cultures and Organizations: Software of the Mind. Intercultural Cooperation and its Importance for Survival (3rd edition). New York: McGraw-Hill.
Ibrahim, Yassin M. A. (2001) Doctor and patient questions as a measure of doctor-centredness in UAE hospitals. English for Specific Purposes 20 (4): 331–344. https://doi.org/10.1016/S0889-4906(00)00020-X DOI: https://doi.org/10.1016/S0889-4906(00)00020-X
Jensen, Jakob D., Andy J. King, Lisa M. Guntzville and LaShara A. Davis (2010) Patient–provider communication and low-income adults: Age, race, literacy, and optimism predict communication satisfaction. Patient Education and Counseling 79 (1): 30–35. https://doi.org/10.1016/j.pec.2009.09.041 DOI: https://doi.org/10.1016/j.pec.2009.09.041
Kale, Emine, Arnstein Finset, Hanne-Lise Eikeland and Pal Gulbrandsen (2011) Emotional cues and concerns in hospital encounters with non-Western immigrants as compared with Norwegians: An exploratory study. Patient Education and Counseling 84 (3): 325–331. https://doi.org/10.1016/j.pec.2011.05.009 DOI: https://doi.org/10.1016/j.pec.2011.05.009
Langberg, Emil Morup, Lise Dyhr and Annette Sofie Davidsen (2019) Development of the concept of patient-centredness – A systematic review. Patient Education and Counseling 102 (7): 1228–1236. https://doi.org/10.1016/j.pec.2019.02.023 DOI: https://doi.org/10.1016/j.pec.2019.02.023
Lau, Sofie Rosenlund, Soren Troels Christensen and Jesper T. Andreasen (2013) Patients’ preferences for patient-centered communication: A survey from an outpatient department in rural Sierra Leone. Patient Education and Counseling 93 (2): 312–318. https://doi.org/10.1016/j.pec.2013.06.025 DOI: https://doi.org/10.1016/j.pec.2013.06.025
Mazzi, Maria Angela, Michela Rimondini, Egbert van der Zee, Wienke Boerma, Christa Zimmermann and Jozien Bensing (2018) Which patient and doctor behaviours make a medical consultation more effective from a patient point of view. Results from a European multicentre study in 31 countries. Patient Education and Counseling 101 (10): 1795–1803. https://doi.org/10.1016/j.pec.2018.05.019 DOI: https://doi.org/10.1016/j.pec.2018.05.019
McGrath, Pam, David Henderson, John Tamargo and Hamish A. Holewa (2012) Doctor–patient communication issues for international medical graduates: Research findings from Australia. Education for Health 25 (1): 48–54. https://doi.org/10.4103/1357-6283.99206 DOI: https://doi.org/10.4103/1357-6283.99206
Meeuwesen, Ludwien, Atie van den Brink-Muinen and Geert Hofstede (2009) Can dimensions of national culture predict cross-national differences in medical communication? Patient Education and Counseling 75 (1): 58–66. https://doi.org/10.1016/j.pec.2008.09.015 DOI: https://doi.org/10.1016/j.pec.2008.09.015
Moore, Malcolm (2009) What do Nepalese medical students and doctors think about patient-centred communication? Patient Education and Counseling 76 (1): 38–43. https://doi.org/10.1016/j.pec.2008.11.018 DOI: https://doi.org/10.1016/j.pec.2008.11.018
Paternotte, Emma, Sandra van Dulmen, Nadine van der Lee, Albert J. J. A. Scherpbier and Fedde Scheele (2015) Factors influencing intercultural doctor-patient communication: A realist review. Patient Education and Counseling 98 (4): 420–445. https://doi.org/10.1016/j.pec.2014.11.018 DOI: https://doi.org/10.1016/j.pec.2014.11.018
Pilotto, Louis S., Geraldine F. Duncan and Jane Anderson-Wurf (2007) Issues for clinicians training international medical graduates: A systematic review. Medical Journal of Australia 187 (4): 225–228. https://doi.org/10.5694/j.1326-5377.2007.tb01204.x DOI: https://doi.org/10.5694/j.1326-5377.2007.tb01204.x
Sandhu, Harbinder, Ann Adams, Laura Singleton, David Clark-Carter and Jane Kidd (2009) The impact of gender dyads on doctor-patient communication: A systematic review. Patient Education and Counseling 76 (3): 348–355. https://doi.org/10.1016/j.pec.2009.07.010 DOI: https://doi.org/10.1016/j.pec.2009.07.010
Schouten, Barbara C. and Ludwien Meeuwesen (2006) Cultural differences in medical communication: A review of the literature. Patient Education and Counseling 64 (1–3): 21–34. https://doi.org/10.1016/j.pec.2005.11.014 DOI: https://doi.org/10.1016/j.pec.2005.11.014
Silverman, Jonathan, Suzanne Kurtz and Juliet Draper (2013) Skills for Communicating with Patients (3rd edition). London: CRC Press.
Siu, Judy Yuen-man (2015) Communicating under medical patriarchy: Gendered doctor-patient communication between female patients with overactive bladder and male urologists in Hong Kong. BMC Women’s Health 15: Article 44. https://doi.org/10.1186/s12905-015-0203-4 DOI: https://doi.org/10.1186/s12905-015-0203-4
Sommer, Jessica, William Macdonald, Caroline Bulsara and David Lim (2012) Grunt language versus accent: The perceived communication barriers between international medical graduates and patients in Central Wheatbelt catchments. Australian Journal of Primary Health 18 (3): 197–203. https://doi.org/10.1071/PY11030 DOI: https://doi.org/10.1071/PY11030
Stewart, Moira, Judith Belle Brown, Wayne Weston, Ian R. McWhinney, Carol L. McWilliam and Thomas Freeman (2013) Patient-Centered Medicine: Transforming the Clinical Method (3rd edition). London: CRC Press. https://doi.org/10.1201/b20740-1 DOI: https://doi.org/10.1201/b20740-1
Suurmond, Jeanine and Conny Seeleman (2006) Shared decision-making in an intercultural context. Barriers in the interaction between physicians and immigrant patients. Patient Education and Counseling 60 (2): 253–259. https://doi.org/10.1016/j.pec.2005.01.012 DOI: https://doi.org/10.1016/j.pec.2005.01.012
Ting, Xu, Bao Yong, Liang Yin and Tian Mi (2016) Patient perception and the barriers to practicing patient-centered communication: A survey and in-depth interview of Chinese patients and physicians. Patient Education and Counseling 99 (3): 364–369. https://doi.org/10.1016/j.pec.2015.07.019 DOI: https://doi.org/10.1016/j.pec.2015.07.019
van den Brink-Muinen, Atie, Peter F. Verhaak, Jozien M. Bensing, Ottmar Bahrs, Myriam Deveugele, Linda Gask, Francisca Leiva, Nicola Mead et al. (2000) Doctor-patient communication in different European health care systems: Relevance and performance from the patients’ perspective. Patient Education and Counseling 39 (1): 115–127. https://doi.org/10.1016/S0738-3991(99)00098-1 DOI: https://doi.org/10.1016/S0738-3991(99)00098-1
Wallace, Chelsea, Stefanie Vandevijvere, Arier Lee, Lindsay M. Jaacks, Michael Schachner and Boyd Swinburn (2019) Dimensions of national culture associated with different trajectories of male and female mean body mass index in countries over 25 years. Obesity Reviews 20 (S2): 20–29. https://doi.org/10.1111/obr.12884 DOI: https://doi.org/10.1111/obr.12884
Wang Qian (2010) Doctor-Patient Communication and Patient Satisfaction: A Cross-Cultural Comparative Study Between China and the US. Unpublished doctoral dissertation, Purdue University, Lafayette, IN.
Wette, Rosemary and Susan J. Hawken (2016) Measuring gains in an EMP course and the perspectives of language and medical educators as assessors. English for Specific Purposes 42: 38–49. https://doi.org/10.1016/j.esp.2015.11.002 DOI: https://doi.org/10.1016/j.esp.2015.11.002
Zhang Yuhai, Haixia Su, Lei Shang, Duan Li, Rui Wang, Ruiqiao Zhang and Yongyong Xu (2011) Preferences and perceived involvement in treatment decision making among Chinese patients with chronic hepatitis. Medical Decision Making 31 (2): 245–253. https://doi.org/10.1177/0272989X10375990 DOI: https://doi.org/10.1177/0272989X10375990
Zhong Zhi-Jin, Jinghong Nie, Xinyi Xie and Kexin Liu (2019) How medic–patient communication and relationship influence Chinese patients’ treatment adherence. Journal of Health Communication 24 (1): 29–37. https://doi.org/10.1080/10810730.2018.1561768 DOI: https://doi.org/10.1080/10810730.2018.1561768
Published
How to Cite
Issue
Section
License
copyright Equinox Publishing Ltd.
