Can dimensions of national culture predict cross-national differences in medical communication?

Meeuwesen, Ludwien; Brink-Muinen, A. van den; Hofstede, Geert

doi:10.1016/j.pec.2008.09.015

Cited by 143 publications

(104 citation statements)

References 21 publications

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“…Countries with low power distance show a preference for a more patient-centred approach whereby the patient is involved in their treatment and diagnosis, and is able to ask questions. However, Meeuwesen et al (2009) found that, contrary to their expectations, the more feminine a country was, the more instrumental communication there was between GPs and patients, with a lot of questionasking by both doctor and patient, and much biomedical information exchange; in masculine countries, there was more affective than instrumental communication. In individualist countries, there was high exchange of psychosocial information.…”

Section: Discussioncontrasting

confidence: 60%

“…Some studies have been carried out in the healthcare context using one or more of the dimensions as a framework. These include studies in relation to cross-national differences in antibiotic use (Deschepper et al 2008), blood transfusion practices (de Kort et al 2010), medical communication between general practitioners (GPs) and patients (Meeuwesen et al 2009), and attitudes of medical practitioners towards medical professionalism (Chandratilake et al 2012).…”

Section: Practice Pointsmentioning

confidence: 99%

“…In strong uncertainty-avoiding nations, people are more expressive, and in weak uncertainty-avoiding nations the expression of feelings is inhibited and people are more tolerant of different opinions (Hofstede et al 2010b). In strong uncertainty-avoidance societies less attention is given to rapport building (e.g., less eye contact) with patients (Meeuwesen et al 2009), doctors may avoid ambiguity in diagnosis (Deschepper et al 2008), and more money tends to be spent on doctors than nurses, thus more tasks are performed by doctors themselves (Hofstede et al 2010b).…”

Section: Practice Pointsmentioning

confidence: 99%

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Cultural dimensions in the transition of overseas medical graduates to the UK workplace

et al. 2013

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Background: Historically, overseas-qualified doctors have been essential for meeting service needs in the UK National Health Service (NHS). However, these doctors encounter many cultural differences, in relation to training, the healthcare system and the doctor-patient relationship and training. Aim: To examine whether Hofstede's cultural model may help us understand the changes doctors from other countries experience on coming to work in the UK, and to identify implications for supervisors and clinical teams. Method: Telephone interviews were conducted with overseas medical graduates before starting work as a Foundation Year One (F1) doctor, followed up after four months and 12 months; and with educational supervisors. Data were analysed using a confirmatory thematic approach. Results: Sixty-four initial interviews were conducted with overseas doctors, 56 after four months, and 32 after 12 months. Twelve interviews were conducted with educational supervisors. The changes doctors experienced related particularly to Hofstede's dimensions of power distance (e.g. in relation to workplace hierarchies and inter-professional relationships), uncertainty avoidance (e.g. regarding ways of interacting) and individualism-collectivism (e.g., regarding doctor-patient/family relationship; assertiveness of individuals). Conclusion: Hofstede's cultural dimensions may help us understand the adaptations some doctors have to make in adjusting to working in the UK NHS. This may promote awareness and understanding and greater 'cultural competence' amongst those working with them or supervising them in their training.

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Section: Discussioncontrasting

confidence: 60%

Section: Practice Pointsmentioning

confidence: 99%

Section: Practice Pointsmentioning

confidence: 99%

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Cultural dimensions in the transition of overseas medical graduates to the UK workplace

et al. 2013

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“…This country-specific effect might be rooted in a general difference in medical culture between the two countries, as physicians in The Netherlands tend more toward the formalization of practices. 40,41 Also, the political and societal debate concerning euthanasia and other end-of-life decisions has a longer history in The Netherlands than in Belgium, and the Dutch Medical Treatment Contracts Act, 10 in which the importance of the patient's written authority for medical treatments has to be made explicit to them, has been in place several years longer than the Belgian Law on Patient Rights. 9 As a result, advance directive forms in The Netherlands (widely promoted by the Dutch Association for Voluntary Euthanasia) are more widespread compared with Belgium, which also may be part of the explanation.…”

Section: Discussionmentioning

confidence: 99%

Advance Care Planning in Belgium and The Netherlands: A Nationwide Retrospective Study Via Sentinel Networks of General Practitioners

Meeussen

Block

Echteld

et al. 2011

Journal of Pain and Symptom Management

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Context. Advance care planning (ACP) is an important part of patient-centered palliative care. There have been few nationwide studies of ACP, especially in Europe.Objectives. To investigate the prevalence and characteristics of ACP in two European countries and identify the associated factors.Methods. A mortality follow-back study was undertaken in 2007 via representative nationwide Sentinel Networks of general practitioners (GPs) in Belgium and The Netherlands using similar standardized procedures. All GPs reported on each non-suddenly deceased patient in their practice. Our main outcome measure was whether or not ACP, that is, an agreement for medical treatment and/or medical decisions in the last phase of life in the case of the patient losing competence, was present.Results. Among 1072 non-sudden deaths, ACP was done with 34% of patients and most often related to the forgoing of potential life-prolonging treatments in general (24%). In 8% of cases, ACP was made in consultation with the patient and in writing. In 23% of cases, care was planned with the patient's family only. Multivariate analysis revealed that ACP was more often made with patients if they were capable of decision making during the last three days of life (odds ratio [OR] 3.86; 95% confidence interval [CI] 2.4e6.1), received treatment aimed at palliation in the last week (OR 2.57; 95% CI 1.6e4.2), had contact with a GP in the last week (OR 2.71; 95% CI 1.7e4.1), died of cancer (OR 1.46; 95% CI 1.1e2.0), or died at home (OR 2.16; 95% CI 1.5e3.0).

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“…[37] Indeed, differences in national health policy play a role in the priority and implementation of patient education. [38] However, within-cultural differences also exist as the organizational climate perceptions (i.e.…”

Section: Introductionmentioning

confidence: 99%

Barriers to patient education and their relationship to nurses’ perceptions of patient education climate

Livne

Peterfreund

Sheps

2017

CNS

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A core component of patient-centered care is effective patient education. Although it is a part of professional nursing and has been found to promote high-quality healthcare, its implementation is often deficient. This study responds to the need for theory-based research on health communication and aims to provide a theoretical framework for understanding nurses' barriers to patient education. Drawing on organizational climate theory, the study examines two possible predictors of barriers to effective patient education, namely nurses' perceptions of patient education climate, and of their role as patient educators. The hypotheses were tested using a cross-sectional correlational design with a sample of 328 nurses from 26 units in one general hospital. Data were obtained by means of questionnaires. The results supported our hypotheses, as each predicting variable was significantly related to the relevant barriers to patient education: i.e. patient education climate perceptions predicted the barriers of overload, lack of policies, and low priority, whereas role perception predicted the barriers of difficulty in communication with patients, insufficient professional knowledge and skills, and the belief that educating patients was not the nurse's responsibility. To conclude, this study attributes the concept of patient education to organizational climate theory and, thus, may offer a theoretical framework for understanding the reluctance of hospital nurses to provide their patients with effective education. Practical implications for reducing barriers to patient education are discussed.

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Can dimensions of national culture predict cross-national differences in medical communication?

Cited by 143 publications

References 21 publications

Cultural dimensions in the transition of overseas medical graduates to the UK workplace

Cultural dimensions in the transition of overseas medical graduates to the UK workplace

Advance Care Planning in Belgium and The Netherlands: A Nationwide Retrospective Study Via Sentinel Networks of General Practitioners

Barriers to patient education and their relationship to nurses’ perceptions of patient education climate

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