Doctor-patient communication and patient satisfaction: A cross-cultural comparative study between China and the U.S.

Qian Wang, Purdue University

Abstract

The studies were conducted to (a) explain the doctor-patient relationship and communication in Chinese cultural context, and (b) investigate the differences and similarities in doctors' communication styles, patient autonomy, patient satisfaction and their relations across two cultures. Study One is a qualitative exploration on doctor-patient communication in China using cultural centered approach. Twenty six participants from different cities and provinces of China were recruited for in-depth interviews. The researcher also spent several weeks visiting and observing in hospital and doctors' offices in China. Study One discovered several themes coming out from the interviews. These themes examined how trust was established between doctors and patients in China, and how doctor-patients communication/relationship was established in different hospitals and different medical philosophies. Results showed that: (a) Trust in doctors mostly relied on word-of-mouth communication, and trust was usually generated from patients' close friends, relatives, and existing social networks; (b) Complaints generally were not useful. Compensation and first-time relationships were established through the social and cultural meaning of “Hong Bao (Red envelope)”; (c) The patients generally wanted doctors to make decisions for them, and elders usually wanted to make decision together with their family, however, when making big decisions or release results, doctors usually reported to and consult with the patients' family members first; (d) Traditional Chinese medicine doctors had better communication skills and establish a long term relationship with patients; Lack of information transmission and lack of respect in communication lead to patients‘ dissatisfaction; (e) Patient dissatisfaction comes from expensive fees, disparity of healthcare resources, lack of communication skills, especially lack of privacy, respect, cold attitude and lack of protection of patients‘ right; patients satisfaction were also different between private hospitals and state-owned hospitals. Study Two is a cross-cultural comparative study examines the doctors‘ communication styles and how the styles and other social variables influence patient satisfaction. 1097 Chinese (562men and 534 women) and 1280 Americans (515 men and 765 women) were recruited for finishing a survey questionnaire on patient satisfaction and doctors‘ communication styles. The study demonstrated that the Chinese patients perceived more control communication styles and less affiliation communication styles from doctors than American patients. One of the most important findings is Chinese patients perceive more dominance communication style from their doctors as satisfying while the Americans perceive less dominance communication styles as satisfying. The study also found significant effect of waiting time and conversation time has significant effect on patient communication satisfaction and Healthcare satisfaction. A revised model was proposed based on the finding of the research. Overall, the results of Study Two showed some similarities in doctor-patient communication styles and the relation between the time and most communication styles, with patient satisfaction in both china and the United States. Meanwhile, Study One provides lots of context and details in doctor-patient communication and patient satisfaction in China, which the comparative study lacks. Implications and limitations of the two studies‘ findings, as well as directions for future research were discussed.

Degree

Ph.D.

Advisors

Sypher, Purdue University.

Subject Area

Communication|Medicine|Public health

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