Áine Lorié1, Diego A Reinero2, Margot Phillips1, Linda Zhang1, Helen Riess3. 1. Massachusetts General Hospital/Harvard Medical School, Empathy and Relational Science Program, Department of Psychiatry, Boston, MA, USA. 2. Massachusetts General Hospital/Harvard Medical School, Empathy and Relational Science Program, Department of Psychiatry, Boston, MA, USA; New York University, Department of Psychology, New York, NY, USA. 3. Massachusetts General Hospital/Harvard Medical School, Empathy and Relational Science Program, Department of Psychiatry, Boston, MA, USA. Electronic address: hriess@mgh.harvard.edu.
Abstract
OBJECTIVE: To conduct a systematic review of studies examining how culture mediates nonverbal expressions of empathy with the aim to improve clinician cross-cultural competency. METHODS: We searched three databases for studies of nonverbal expressions of empathy and communication in cross-cultural clinical settings, yielding 16,143 articles. We examined peer-reviewed, experimental or observational articles. Sixteen studies met inclusion criteria. RESULTS: Nonverbal expressions of empathy varied across cultural groups and impacted the quality of communication and care. Some nonverbal behaviors appeared universally desired and others, culturally specific. Findings revealed the impact of nonverbal communication on patient satisfaction, affective tone, information exchange, visit length, and expression decoding during cross-cultural clinical encounters. Racial discordance, patients' perception of physician racism, and physician implicit bias are among factors that appear to influence information exchange in clinical encounters. CONCLUSION: Culture-based norms impact expectations for specific nonverbal expressions within patient-clinician dyads. Nonverbal communication plays a significant role in fostering trusting provider-patient relationships, and is critical to high quality care. PRACTICE IMPLICATIONS: Medical education should include training in interpretation of nonverbal behavior to optimize empathic cross-cultural communication and training efforts should accommodate norms of local patient populations. These efforts should reduce implicit biases in providers and perceived prejudice in patients.
OBJECTIVE: To conduct a systematic review of studies examining how culture mediates nonverbal expressions of empathy with the aim to improve clinician cross-cultural competency. METHODS: We searched three databases for studies of nonverbal expressions of empathy and communication in cross-cultural clinical settings, yielding 16,143 articles. We examined peer-reviewed, experimental or observational articles. Sixteen studies met inclusion criteria. RESULTS: Nonverbal expressions of empathy varied across cultural groups and impacted the quality of communication and care. Some nonverbal behaviors appeared universally desired and others, culturally specific. Findings revealed the impact of nonverbal communication on patient satisfaction, affective tone, information exchange, visit length, and expression decoding during cross-cultural clinical encounters. Racial discordance, patients' perception of physician racism, and physician implicit bias are among factors that appear to influence information exchange in clinical encounters. CONCLUSION: Culture-based norms impact expectations for specific nonverbal expressions within patient-clinician dyads. Nonverbal communication plays a significant role in fostering trusting provider-patient relationships, and is critical to high quality care. PRACTICE IMPLICATIONS: Medical education should include training in interpretation of nonverbal behavior to optimize empathic cross-cultural communication and training efforts should accommodate norms of local patient populations. These efforts should reduce implicit biases in providers and perceived prejudice in patients.
Authors: Paul E Nevin; Magaly Blas; Angela Bayer; Marina Angelica Chiappe Gutierrez; Deepa Rao; Yamilé Molina Journal: Health Care Women Int Date: 2019-05-15
Authors: Tovah Cowan; Michael D Masucci; Tina Gupta; Claudia M Haase; Gregory P Strauss; Alex S Cohen Journal: Schizophr Res Date: 2022-01-22 Impact factor: 4.939
Authors: Sorin Ursoniu; Costela Lacrimioara Serban; Catalina Giurgi-Oncu; Ioana Alexandra Rivis; Adina Bucur; Ana-Cristina Bredicean; Ion Papava Journal: Int J Environ Res Public Health Date: 2021-12-07 Impact factor: 3.390
Authors: Gordon T Kraft-Todd; Diego A Reinero; John M Kelley; Andrea S Heberlein; Lee Baer; Helen Riess Journal: PLoS One Date: 2017-05-15 Impact factor: 3.240
Authors: Monica Oliveira Bernardo; Dario Cecílio-Fernandes; Patrício Costa; Thelma A Quince; Manuel João Costa; Marco Antonio Carvalho-Filho Journal: PLoS One Date: 2018-05-31 Impact factor: 3.240