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Doctor-Patient Communication Models, Patient Decision-Making Participation, and Patient Emotional Expression: A Cross-Cultural Comparison of Samples from the UK and China

  • Chao Liu
  • , Ye Hui Tu
  • , Li Jen Lin
  • , Hao Chen
  • , Thu Hua Liu
  • , Huang Li Lin
  • , Renbo Liu
  • , Wen Ko Chiou*
  • *Corresponding author for this work
  • Chang Gung University
  • Ming Chi University of Technology
  • Xiamen University of Technology
  • Chang Gung Memorial Hospital
  • King's College London

Research output: Contribution to journalJournal Article peer-review

16 Scopus citations

Abstract

Background: Effective doctor-patient communication is critical to healthcare outcomes, but cultural differences can significantly influence communication dynamics. Understanding how cultural factors shape communication styles is essential, particularly in cross-cultural healthcare settings. Power distance and individualism/collectivism are key cultural dimensions that may impact doctor-patient interactions. Objective: This study aims to examine the impact of cultural differences between China and the UK on doctor-patient communication, focusing on communication quality, patient participation in decision-making, and emotional expression. Methods: A total of 1000 participants (500 from China and 500 from the UK) were surveyed using four measurement tools: the Doctor-Patient Communication Scale (DPCS), the Hofstede Cultural Dimensions Questionnaire (HCDQ), the Patient Participation in Decision-Making Scale (PPDMS), and the Emotional Expression in Healthcare Scale (EEHS). The data were analyzed using independent samples t-tests, Pearson correlation, and regression analysis. Results: The findings reveal significant cultural differences between China and the UK in terms of communication quality, patient participation, and emotional expression. British patients reported significantly higher scores on all scales, reflecting the more egalitarian and individualistic communication style in the UK compared to the more hierarchical and collectivist style in China. Power distance and individualism/collectivism were significant predictors of communication outcomes, with higher power distance and stronger collectivism associated with lower communication quality, reduced patient participation, and more restrained emotional expression. Conclusion: Cultural dimensions significantly affect doctor-patient communication, highlighting the importance of considering cultural differences in healthcare settings. This study underscores the need for tailored communication strategies that accommodate cultural norms to improve patient engagement and healthcare outcomes across different cultural contexts. Future research should address the limitations of this study, including its reliance on self-reported data, and explore additional cultural contexts to better understand the complexities of cross-cultural healthcare communication.

Original languageEnglish
Pages (from-to)2505-2524
Number of pages20
JournalPatient Preference and Adherence
Volume19
DOIs
StatePublished - 2025

Bibliographical note

Publisher Copyright:
© 2025 Liu et al.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 16 - Peace, Justice and Strong Institutions
    SDG 16 Peace, Justice and Strong Institutions

Keywords

  • cultural differences
  • decision-making participation
  • doctor-patient communication
  • emotional expression
  • individualism/collectivism
  • power distance

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