DIMENSIONS OF THE PROVIDER-PATIENT ENCOUNTER: CULTURAL PERCEPTIONS OF HOME AND U.S. HEALTH CARE DELIVERY SYSTEMS (UNITED STATES)

Many members of cultural minorities have chronic and debilitating illnesses which need effective medical care. The discovery of patient expectations and the application of proxemics within the intercultural health encounter may lead to improvement of provider-client relations and adherence to recommended health regimens. A total of 398 international students completed a 97-item questionnaire dealing with four communication factors: (1) communicator style, (2) affective behavior, (3) information processing, and (4) time with the provider. A partially nested repeated measures design was used. Six geocultural groups were created and subsumed under two levels of cultural contact preference. Treatments consisted of items directed toward the: (1) home provider, (2) US doctor, (3) US nurse, and (4) US technician. Although major hypotheses received only partial support, several interesting patterns emerged. The home provider and US doctor were found to be the friendliest, most attentive, and relaxed of the four providers. The US nurse was the main information giver and receiver. The US doctor, interestingly enough, was viewed most positively in caring and sympathetic behavior toward patients. The US nurse was the only provider with significant results for virtually all hypotheses; this indicates she played an integral role in the health encounter. Geocultural differences were marked between Arabs and Indians and between Asians and Mediterraneans, with Indians consistently more negative in their responses to all providers on all dimensions. The exploratory hypotheses found significant relationships among affective behavior, communicator style, and time for both the home provider and US doctor. Regression analyses found patient satisfaction constructs to be partially explained by the communication factors. The communicative patterns of the home provider and US doctor were distinctly different in the first two SSA clusters