SILENT PARTNERS IN MEDICAL-CARE - A CROSS-CULTURAL-STUDY OF PATIENT PARTICIPATION

Although patient participation is acclaimed to be a much healthier mod el of the doctor-patient encounter than the traditional paternalistic paradigm, there has been a dearth of research that has empirically ass essed the effects of patient involvement or addressed barriers that mu st be overcome before patients can actively participate in the medical encounter. The purpose of this investigation was twofold: to assess t he effects of patient participation on patient commitment to medical d ecisions and patient satisfaction and to examine cultural barriers rel ated to patient participation. The investigation supported the claim t hat patient participation increases patient commitment to medical deci sions and patient satisfaction. The investigation also supported the c laim that patient participation is higher for Mainland American patien ts than Asian American patients. The justification for cultural differ ences, 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, influ ences patient participation. The study supported the claim that Asians are less assertive and participate less than Mainlanders. Assertivene ss, however, was not related to patient participation. Cultural differ ences for response- and self-efficacy were not found. Yet both respons e- and self-efficacy were significant predictors of patient participat ion. The findings of this study highlight the importance of working to ward collaborative relationships and have important implications for d eveloping future patient participation tools. Limitations and directio ns for future research are discussed.