Patients’ fear of physicians and perceptions of physicians’ cultural competence in healthcare

ABSTRACT

Background: Fear of physicians is associated with a variety of negative relationship and clinical outcomes. Culturally competent communication has been suggested as a way for physicians to reduce patient fear. Previous research has not, however, assessed whether patients’ perceptions of physicians’ cultural competence are associated with the level of felt fear. This study assessed associations between patients’ fear of physicians and their perceptions of physicians’ cultural competence in healthcare interactions.

Method: In this cross-sectional study, a purposive sample of 306 patients were recruited from the patient base of a local clinic system with three locations, one rural, one suburban, and one urban in Appalachian Ohio. Using validated paper-and-pencil questionnaires, we assessed patients’ perceptions of physicians’ cultural competence in four domains (macro cultural issues, proxemics/chronemics, language issues, and patient-centeredness) as well as fear of physicians.

Results: Fear of physicians was associated with perceptions that physicians’ accommodated cultural differences related to issues of personal space and time and with perceptions of physicians’ provision of patient-centered care. Other domains of intercultural competence indicated negative association, but were not significant.

Conclusions: The findings of this study provide evidence that some forms of physician accommodation of cultural difference are associated with reduced fear of physicians. These findings have implications for promoting physicians' cultural competence in healthcare interactions. These implications, with a focus on patient-physician communication are discussed.

KEYWORDS:

• Cultural competency
• Patient perceptions
• Communication skills
• Cultural differences
• Doctor–patient communication
• Fear of physicians
• Patient satisfaction
• Physician–patient relations

Acknowledgments

We recognize the administrative and logistic support and invaluable encouragement we received from the American Cancer Society Ohio Division throughout the course of the project, and the Holzer Health Systems in Southeastern Ohio for their support with the data collection. We are grateful to all the participants in this study who took the time to share their experiences and insights with us. We also thank the anonymous reviewers for performing a careful reading of our manuscript and for providing helpful comments and suggestions.

Disclaimer statements

Contributors None.

Funding The American Cancer Society (ACS)/Ohio University Scripps College of Communication Partnership and the School of Communication Studies, Ohio University, USA provided funding for a larger project which examined the role of cultural differences on health care receivers’ perceptions of health care providers’ cultural competence in health care interactions that this study is a part of Grant Number: Southeast Ohio American Cancer Society Communication Partnership, GA0012118.02.

Conflicts of interest None.

Ethics approval Institutional Review Board approval was obtained from Ohio University to conduct this study.

Additional information

Notes on contributors

Rukhsana Ahmed

Rukhsana Ahmed, PhD, is an Associate Professor, Department of Communication, University of Ottawa and Co-Director, Diversity and Equity Research Group (DERG), Faculty of Arts, University of Ottawa, Canada.

Benjamin R. Bates

Benjamin R. Bates, PhD, is the Barbara Geralds Schoonover Professor of Health Communication, School of Communication Studies, Ohio University, USA.