Silent partners in medical care: A cross-cultural study of patient participation

Although patient participation is acclaimed to be a much healthier model of the doctor-patient encounter than the traditional paternalistic paradigm, there has been a dearth of research that has empirically assessed the effects of patient involvement or addressed barriers that must be overcome before patients can actively participate in the medical encounter. The purpose of this investigation was twofold: to assess the effects of patient participation on patient commitment to medical decisions and patient satisfaction and to examine cultural barriers related to patient participation. The investigation supported the claim that patient participation increases patient commitment to medical decisions and patient satisfaction. The investigation also supported the claim that patient participation is higher for Mainland American patients than Asian American patients. The justification for cultural differences, however, was not supported. Specifically, it was predicted that cultural norms influence patients' assertiveness and their self- and response-efficacy regarding patient participation that, in turn, influences patient participation. The study supported the claim that Asians are less assertive and participate less than Mainlanders. Assertiveness, however, was not related to patient participation. Cultural differences for response- and self-efficacy were not found. Yet both response- and self-efficacy were significant predictors of patient participation. The findings of this study highlight the importance of working toward collaborative relationships and have important implications for developing future patient participation tools. Limitations and directions for future research are discussed.