Non-Verbal Communication Between Primary Care Physicians and Older Patients: How Does Race Matter?

Štěpáníková, Irena; Zhang, Qian; Wieland, Darryl; Eleazer, G. Paul; Stewart, Thomas

doi:10.1007/s11606-011-1934-z

Cited by 36 publications

(28 citation statements)

References 54 publications

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“…54 A patient-physician interaction study found that African American physicians display more positive non-verbal communication with African American patients than do European American physicians, though these researchers also found an ingroup bias among African American physicians such that they displayed fewer positive non-verbal behaviors when interacting with European American patients. 57 Prior research in non-physician samples has demonstrated that African Americans sometimes display general automatic biases against racial ingroup members, 52 particularly under certain circumstances (e.g. when perceived negativity toward one’s group is high), 41 but that the content, contributions, and outcomes of these biases may differ from those of European Americans.…”

Section: Discussionmentioning

confidence: 99%

Racial Bias in Pain Perception and Response: Experimental Examination of Automatic and Deliberate Processes

Mathur

Richeson

Paice

et al. 2014

The Journal of Pain

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Racial disparities in pain treatment pose a significant public health and scientific problem. Prior studies demonstrate clinicians and non-clinicians are less perceptive, and suggest less treatment for, the pain of African Americans, relative to European Americans. Here we investigate the effects of explicit/implicit patient race presentation, patient race, and perceiver race on pain perception and response. African American and European American participants rated pain perception, empathy, helping motivation, and treatment suggestion in response to vignettes about patients’ pain. Vignettes were accompanied by a rapid (implicit), or static (explicit) presentation of an African or European American patient’s face. Participants perceived and responded more to European American patients in the implicit prime condition, when the effect of patient race was below the level of conscious regulation. This effect was reversed when patient race was presented explicitly. Additionally, female participants perceived and responded more to the pain of all patients, relative to male participants, and in the implicit prime condition, African American participants were more perceptive and responsive than European Americans to the pain of all patients. Taken together, these results suggest that known disparities in pain treatment may be largely due to automatic (below the level of conscious regulation), rather than deliberate (subject to conscious regulation) biases. These biases were not associated with traditional implicit measures of racial attitudes, suggesting that biases in pain perception and response may be independent of general prejudice. Perspective Results suggest racial biases in pain perception and treatment are at least partially due to automatic processes. When the relevance of patient race is made explicit, however, biases are attenuated and even reversed. We also find preliminary evidence that African Americans may be more sensitive to the pain of others than European Americans.

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Section: Discussionmentioning

confidence: 99%

Racial Bias in Pain Perception and Response: Experimental Examination of Automatic and Deliberate Processes

Mathur

Richeson

Paice

et al. 2014

The Journal of Pain

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“…Although few studies have explored ethnic differences in the expression of nonverbal pain behaviors, researchers have examined ethnic differences in the expression of emotions, which may provide additional detail regarding potential differences in the outward expression of pain behaviors (Marsh, Elfenbein, & Ambady, 2003; Mesquita & Walker, 2003; Stepanikova, Zhang, Wieland, Eleazer, & Stewart, 2012). Marsh et al (2003) found subtle cultural variations in basic nonverbal facial expressions, suggesting that some differences do exist in the nonverbal expression of emotions (i.e.…”

Section: Ethnic Differences In Pain Expressionmentioning

confidence: 99%

Ethnic Differences in Nonverbal Pain Behaviors Observed in Older Adults with Dementia

Ford

Snow

Herr

et al. 2015

Pain Management Nursing

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“…Those providers who successfully managed that pressure by portraying a relaxed, open consultation environment provided the counterpoint to the rest of the system. One way for individual health care providers to potentially improve patient–provider interactions is to optimize the limited time that providers have with their patients by building trust, using verbal and nonverbal communication approaches (Stepanikova, Zhang, Wieland, Eleazer, & Stewart, 2012). As trust increases, both patients and providers may find that their time together is more productive with greater benefit derived.…”

Section: Discussionmentioning

confidence: 99%

“…While additional probes and queries emerged from the analysis of transcripts, the potential for follow-up with and clarification by participants was not possible. In addition, nonverbal communication with health care providers was not possible to evaluate although this form of communication is an important aspect of the diagnostic and therapeutic process and all patient–provider encounters (Stepanikova et al, 2012). Future research is warranted to capture verbal and nonverbal behavioral components of encounters and how they shape patient perceptions and health outcomes.…”

Section: Discussionmentioning

confidence: 99%

It’s a Matter of Trust

2016

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Purpose To examine perceptions of older African Americans’ encounters with health care providers and ways to enhance trust. Method Transcribed semi-structured interviews with African American senior center members were analyzed, using Pattern Coding method. Results Four themes emerged: “Added Insult of Ageism,” “Alternative Remedies,” “Good Providers in a ‘Broken’ System,” and “The Foundation of Trust Is Person Recognition.” Provider behaviors leading to mistrust included erroneously assuming stereotypical preferences and competence, spending inadequate time listening to patients, disregarding patient preferences, and insufficiently explaining treatments. Discussion Of importance to improving trust among older African American patients is valuing individual histories and preferences by reallocating scarce time to person-centered listening, individualizing treatments, more completely explaining interventions, and assuring that patients understand and agree with treatment plans.

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Non-Verbal Communication Between Primary Care Physicians and Older Patients: How Does Race Matter?

Cited by 36 publications

References 54 publications

Racial Bias in Pain Perception and Response: Experimental Examination of Automatic and Deliberate Processes

Racial Bias in Pain Perception and Response: Experimental Examination of Automatic and Deliberate Processes

Ethnic Differences in Nonverbal Pain Behaviors Observed in Older Adults with Dementia

It’s a Matter of Trust

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