Essay: Gender, affiliation and control

This assignment constitutes a critical review of Arguete and Roberts (2000) research paper about Gender, affiliation and control in physician-patient encounters. Sex Roles. In medical care, communication is vital between a physician and a patient. Previous studies done on gender, affiliation concluded that female and male physicians incline to separate and remain steady with communication styles, with females being more affiliative and males being more controlling (Zimmerman & Anderson. 1993). Zimmerman & Anderson (1993) also stated that patient satisfaction is positively influenced or associated with the physician affiliative behaviours and negatively associated with physician controlling behaviours.

The study was done with two male and two female actor physicians. The aim of the study was set out to examine the effectiveness of physician gender (male, female) and communication styles (affiliative, controlling) on participant’s responses to physicians. The rationale for this research paper done by Aruguete and Roberts (2000) on the subject matter is that aspects of communication style and gender can address the effectiveness to modify important components of the health care process.

The study had 3 hypotheses. Hypothesis 1 stated that the affiliative style would result in greater ratings of satisfaction, trust, self-disclosure, and likelihood of recommending the physician relative to the controlling style. Hypothesis 2 stated that the gender of the physician alone would have no effect on participant satisfaction, trust, self-disclosure, or likelihood of recommending the physician. Hypothesis 3 stated that participants would show greater compliance with a female physician when she uses the affiliative style and greater compliance with a male physician when he uses the controlling style.

The study was done with between subjects. They were 146 undergraduates students, of which 55 were male and 91 female. The mean age for the participants was 21 years and they range from 17-50 years. Ethical approval and informed consent was given. The students were from General Psychology classes at a small Midwestern University. The participants were offered incentive to receive an extra credit for the course. They were all from lower income and the majority income was under $10,000 a year. On all of the videotapes, (1) videotape showed the female physician displaying the affiliative style and (2) the male physician displaying the affiliative style and (3) female physician displaying controlling style and (4) the male physician displaying controlling style. The participants each viewed one of the four videotapes with physicians varying in communication style and gender.

The affliative communication style was composed of verbal and non-verbal behaviours that promote the establishment of a positive relationship between the doctor and the patient. These behaviours communicate friendliness, interest, empathy, a desire to help, a non-judgemental attitude and social orientation (Buller and Buller, 1987) cited in Arguete, Roberts (2000). These included backchannel responses, e.g. ‘uh-huh, yeah’. The controlling style manages patient behaviour by dominating the conversation, interrupting frequently and asking many questions. Controlling style include the giving of direction e.g. ‘open your mouth and closed ended questions that requires a yes or no answer.

The participants were asked to complete 10 questionnaires after watching one of the four videotapes. The questionnaires include: An 11-item background questionnaire (measuring gender, age, race, income level, education level, and medical history); A 26-item patient satisfaction scale (a=. 96; Wolf, Putman, James and Stiles, 1978). The three hypotheses were accepted. They used the ANOVA and the ANCOVA to analyse the data. The results showed that affiliative communication style evoked the greatest levels of participation satisfaction, trust, self-disclosure and compliance and the physician gender did not affect any variables. In determining patient response, a physician communication styles is more important than gender.

The main limitation with the current study by Arguete and Roberts (2000) is that most patients relate to male and female doctors differently and that depends on how they were treated with them. Furthermore Arguete and Roberts (2000) research paper does not include race|/ethnicity. Hooper, Comstock, Godwin, Godwin (1982) stated that race have been seen as a vital barrier in cultural communication between a patient-physician. Hopper et al also observed that most cultures were not explored in the doctor-patient communication. Hooper et al (1982) also find out that problems in communication due to cultural differences and language between patients and physicians can often be a factor to a difference in the understanding that patients and physicians have regarding the cause of disease and the effectiveness of available treatments.

Patients who belong to the same race or group showed that there could be some progress of communication when the patient and physicians belonged to the same race/ethnic group (Duggan, A., P & Parrott, R. 2001). However, Johnson, Saha, Arbelaez Beach and Cooper (2004) found out that the match between the physician and patient with respect to the explanatory model of illness and expectations for the visit were equally important in determining outcome. White patients and African American patients have different communication styles during medical visits. The disease was controlled and it was unknown whether the actor-physicians were told behave the way they did.

For this type of research to be validated, patients are supposed to be willing to participate and physicians as well. Patients who are participating are suppose to be interested in communication issues or to be more likely to have had positive or negative experiences with the health care system in the past. Physicians participated in this study were actors, and these actor-physicians may be different from actual physicians in important ways they were trained. This study was done with pseudo patients and they were observing videos, and the study was not done in a randomized fashion. The student were not assigned to any fake doctors, so that was going to make the rating hard as they would rate these doctors thinking back to their own doctors. Students who favour female physicians with affiliative style will highly likely to rate them higher. The participants were given one video to watch with nothing to compare it to.

The strength of the research is that it had a good sample size. For future research, another study can be done comparing and organizing patients according to a patient’s age, gender, ethnicity, education, health status, and length of the patient-physician relationship.

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