Role of power distance and perceived response efficacy on patients' motivation for verbal communication in patient-provider interactions

Background. Studies have shown that increasing patient involvement in healthcare improves patients' health outcomes. However, little is known about how participatory communication between patients and healthcare providers can be facilitated. Objective. The purpose of the study is to understand how and why patients are motivated to communicate with healthcare providers. This study will examine how patients' cultural orientations and beliefs influence willingness to participate during interactions with providers. According to the proposed model, power distance is the causal antecedent to patients' beliefs about participatory interactions, which, in turn, influence patients' motivation to approach or avoid verbal communication during medical interviews. Methods. From June to December 2011, 486 students (M = 21.6, SD = 5.3) were recruited from medium and large-sized colleges via an online survey. Power distance (acceptance of unequal distribution of power between patients and healthcare providers), perceived response efficacy (beliefs about one's involvement), assertiveness (willingness to voice one's opinion), and communication apprehension (avoidance of involvement) were assessed using validated questionnaires. Structural equation modeling was conducted to investigate interconnections among the four variables. Results. Lower power distance was associated with higher perceived response efficacy, which, in turn, was associated with higher assertiveness, and lower communication apprehension (p < 0.001). Conclusions. Efforts to create more participatory environments between patients and healthcare providers should be tailored to patients' cultural orientations and beliefs. Future research should focus on the impact of cultural context on patient-provider communication, which can explain patients' ability and willingness to actively participate in health communication.