Trust and Perceptions of Physicians\u2019 Nonverbal Behavior Among Women with Immigrant Backgrounds

Marij A Hillen,Mathilde G E Verdam,Ellen M A Smets,Hanneke C J M De Haes

doi:10.1007/s10903-017-0580-x

Marij A Hillen, Mathilde G E Verdam + Show 2 more

Open Access

https://doi.org/10.1007/s10903-017-0580-x

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Abstract

Previous findings suggest immigrant patients have lower trust in their physicians, and perceive nonverbal communication differently compared to non-immigrant patients. We tested discrepancies in trust and the impact of non-verbal behavior between immigrants and non-immigrants in The Netherlands. Nonverbal communication of an oncologist was systematically varied in an experimental video vignettes design. Breast cancer patients (n = 34) and healthy women (n = 34) viewed one of eight video versions and evaluated trust and perceived friendliness of the oncologist. In a matched control design, women with immigrant and non-immigrant backgrounds were paired. Immigrant women reported stronger trust. Nonverbal communication by the oncologist did not influence trust differently for immigrants compared to for non-immigrants. However, smiling strongly enhanced perceived friendliness for non-immigrants, but not for immigrants. Immigrant patients’ strong trust levels may be formed a priori, instead of based on physicians’ communication. Physicians may need to make extra efforts to optimize their communication.

Highlights

Patients need to trust their physicians when confronted with illness and associated treatments
Immigrants were more likely to be religious than non-immigrants (t(65) = 4.96, p < .001)
We found stronger trust in an oncologist among immigrant women compared to non-immigrants

Summary

Introduction

Patients need to trust their physicians when confronted with illness and associated treatments. Patients with ethnic minority backgrounds may be vulnerable to diminished trust in their physician [10]. In the United States (US), lower trust levels were found among African American and/or Latino patients compared to Caucasians [11,12,13,14,15,16,17]. For African American patients in particular, this has been explained from a historical perspective: a legacy of being discriminated against in medical research still substantially affects African American patients’ trust in medical research and clinicians [18]. There exists only limited research that substantiates lower trust for other minority patient groups in and outside the US.

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