Barbara C. Schouten

When does self-sacrificial leadership motivate prosocial behavior? It depends on followers’ prevention focus

In the present set of studies, the authors examine the idea that self-sacrificial leadership motivates follower prosocial behavior, particularly among followers with a prevention focus. Drawing on the self-sacrificial leadership literature and regulatory focus theory, the authors provide results from 4 studies (1 laboratory and 3 field studies) that support the research hypothesis. Specifically, the relationship between self-sacrificial leadership and prosocial behavior (i.e., cooperation, organizational citizenship behavior) is stronger among followers who are high in prevention focus. Implications for the importance of taking a follower-centered approach to leadership are discussed.

Words that make pills easier to swallow: a communication typology to address practical and perceptual barriers to medication intake behavior

Purpose The barriers to patients’ successful medication intake behavior could be reduced through tailored communication about these barriers. The aim of this study is therefore (1) to develop a new communication typology to address these barriers to successful medication intake behavior, and (2) to examine the relationship between the use of the typology and the reduction of the barriers to successful medication intake behavior. Patients and methods Based on a literature review, the practical and perceptual barriers to successful medication intake behavior typology (PPB-typology) was developed. The PPB-typology addresses four potential types of barriers that can be either practical (memory and daily routine barriers) or perceptual (concern and necessity barriers). The typology describes tailored communication strategies that are organized according to barriers and communication strategies that are organized according to provider and patient roles. Eighty consultations concerning first-time medication use between nurses and inflammatory bowel disease patients were videotaped. The verbal content of the consultations was analyzed using a coding system based on the PPB-typology. The Medication Understanding and Use Self-efficacy Scale and the Beliefs about Medicine Questionnaire Scale were used as indicators of patients’ barriers and correlated with PPB-related scores. Results The results showed that nurses generally did not communicate with patients according to the typology. However, when they did, fewer barriers to successful medication intake behavior were identified. A significant association was found between nurses who encouraged question-asking behavior and memory barriers (r = −0.228, P = 0.042) and between nurses who summarized information (r = −0.254, P = 0.023) or used cartoons or pictures (r = −0.249, P = 0.026) and concern barriers. Moreover, a significant relationship between patients’ emotional cues about side effects and perceived concern barriers (r = 0.244, P = 0.029) was found as well. Conclusion The PPB-typology provides communication recommendations that are designed to meet patients’ needs and assist providers in the promotion of successful medication intake behavior, and it can be a useful tool for developing effective communication skills training programs.

GPs' interactional styles in consultations with dutch and ethnic minority patients

The aim of this study was to examine interactional styles of general practitioners (GPs) in consultations with Dutch patients as compared to ethnic minority patients, from the perspective of level of mutual understanding between patient and GP. Data of 103 transcripts of video-registered medical interviews were analyzed to assess GPs’ communication styles in terms of involvement, detachment, shared decision-making and patient-centeredness. Surveys were used to collect data on patients’ characteristics and mutual understanding. Results show that overall, GPs communicate less adequately with ethnic minority patients than with Dutch patients; they involve them less in decision-making and check their understanding of what has been discussed less often. Intercultural consultations are thus markedly distinguishable from intracultural consultations by a lack of adequate communicative behavior by GPs. As every patient has a moral and legal right to make informed decisions, it is concluded that GPs should check more often whether their ethnic minority patients have understood what has been said during the medical consultation.

The Communication Styles Inventory (CSI) A Six-Dimensional Behavioral Model of Communication Styles and Its Relation With Personality

In this study, a six-dimensional model of communication styles is proposed and operationalized using the Communication Styles Inventory (CSI). The CSI distinguishes between six domain-level communicative behavior scales, Expressiveness, Preciseness, Verbal Aggressiveness, Questioningness, Emotionality, and Impression Manipulativeness, each consisting of four facet-level scales. Based on factor and item analyses, the CSI is shown to be an adequate instrument, with all reliabilities of the domain-level scales surpassing the .80 level. Consistent with the behavioral view espoused in this study, the CSI scales showed medium to high levels of convergent validity with lexical communication marker scales and behavior-oriented communication scales and discriminant validity with nonbehavioral intrapersonal cognitions and feelings vis-à-vis communication. In addition, personality, as operationalized using the HEXACO Personality Inventory—Revised (HEXACO-PI-R) and Revised NEO Personality Inventory (NEO-PI-R), was found to have medium to strong associations with communication styles, supporting the integration of the trait and communication styles perspectives.

Informal interpreting in general practice: the migrant patient’s voice

ABSTRACT Objective: To explore the perspective of Turkish-Dutch general practitioner (GP) patients on informal interpreting from an integrated theory base, focusing on interpreters’ roles, trust and power. Design: Semi-structured in depth interviews were conducted with 21 first-generation Turkish-Dutch migrant patients who made use of informal interpreters to communicate with their GPs. An interview guide was designed based on the theoretical framework of interpreter’s roles, trust and power, covering questions about interpreters’ role, trust in informal/professional interpreters and power division in the medical consultation. The interviews were transcribed verbatim and analyzed according to the constant comparative method. Results: Besides providing linguistic translation, informal interpreters were expected to perform the roles of advocates and caregivers of the patients. Informal interpreters were trusted more than professional interpreters, mainly for fidelity reasons, that is, because the patients assumed that informal interpreters would act in their best interests. Although informal interpreters were often perceived as the primary interlocutor, the patients did not feel dominated by them, but rather empowered by their presence. Conclusion: Our findings indicate a connection between the role of the advocate, the fidelity dimension of trust and the perceived empowerment of the patients. By linking interpreters’ role to trust and power, this study contributes to theory building in the field of informal interpreting, which is needed to design evidence-based interventions to improve health care delivery to patients with insufficient language ability and thus to advance health care delivery to migrant patients, which is currently lagging behind.

Informal Interpreters in Medical Settings

Abstract Between 2008 and 2010, academics in five European countries collaborated on an EU-funded project, Training Inter-cultural and Bilingual Competences in Health and Social Care (TRICC). Among TRICC’s aims was to deepen understanding of informal interpreting through eliciting the perspectives of interpreters themselves. To identify commonalities and differences in the experiences, attitudes and practices of informal interpreters in distinct settings, the Dutch and Turkish partners interviewed 15 young migrant adults in the Netherlands and 15 Kurdish speakers in Istanbul respectively, asking them about emotional and technical aspects of interpreting, and about their expectations and roles, communicative challenges and actions. Thematic analysis of the 30 interviews corroborated the findings of previous research – namely, that informal interpreters are highly visible, use diverse communicative strategies, adopt various roles, and occasionally speak as primary interlocutors. Noticeable differences between the two sets of interpreters included their attitudes towards interpreting and their preferences for informal versus professional interpreting, both of which can be better understood in the light of the cultural backgrounds of the interpreters and the institutional and political frameworks within which they interpret. This comparative study appears to support Angelelli ’s (2004a) claim that interpreted events are heavily influenced by socio-political and cultural contexts.

To Be Involved or Not to Be Involved? Using Entertainment-Education in an HIV-Prevention Program for Youngsters

The purpose of this study is to gain insight into factors that are associated with youngsters’ involvement with dance4life, a global HIV-prevention program. The Youth Engagement Framework, which includes factors impacting youngsters’ involvement on three levels (individual, social, and system), was used as a theoretical base. In total, 67 youngsters participated, with 21 of them still involved in dance4life’s program, and 46 not. They either were individually interviewed or took part in subsequent online or face-to-face focus groups. Results show that both individual, social, and system-level factors are associated with youngsters’ involvement. Involved youngsters have higher intrinsic motivation to prevent HIV, receive more social support from parents and friends, and are stimulated more by dance4life to remain part of their program than youngsters who are no longer involved. Hence, HIV-prevention programs should focus on all three levels simultaneously to successfully stimulate youngsters’ involvement.

Informal interpreters in medical settings: A comparative socio-cultural study of the Netherlands and Turkey

Abstract Between 2008 and 2010, academics in five European countries collaborated on an EU-funded project, Training Inter-cultural and Bilingual Competences in Health and Social Care (TRICC). Among TRICC’s aims was to deepen understanding of informal interpreting through eliciting the perspectives of interpreters themselves. To identify commonalities and differences in the experiences, attitudes and practices of informal interpreters in distinct settings, the Dutch and Turkish partners interviewed 15 young migrant adults in the Netherlands and 15 Kurdish speakers in Istanbul respectively, asking them about emotional and technical aspects of interpreting, and about their expectations and roles, communicative challenges and actions. Thematic analysis of the 30 interviews corroborated the findings of previous research – namely, that informal interpreters are highly visible, use diverse communicative strategies, adopt various roles, and occasionally speak as primary interlocutors. Noticeable differences between the two sets of interpreters included their attitudes towards interpreting and their preferences for informal versus professional interpreting, both of which can be better understood in the light of the cultural backgrounds of the interpreters and the institutional and political frameworks within which they interpret. This comparative study appears to support Angelelli ’s (2004a) claim that interpreted events are heavily influenced by socio-political and cultural contexts.

Enhancing Health Communication Outcomes Among Ethnic Minority Patients: The Effects of the Match Between Participation Preferences and Perceptions and Doctor–Patient Concordance

Ethnic minority patients are less participative in medical consultations compared to ethnic majority patients. It is thus important to find effective strategies to enhance ethnic minority patients’ participation and improve subsequent health outcomes. This study therefore aimed to investigate the relation between the match between patients’ preferred and perceived participation and doctor–patient concordance in preferred doctor–patient relationship on patient satisfaction, fulfillment of information needs, and understanding of information among Turkish-Dutch and Dutch patients. Pre- and postconsultation questionnaires were filled out by 136 Dutch and 100 Turkish-Dutch patients in the waiting rooms of 32 general practitioners (GPs). GPs completed a questionnaire too. Results showed that a match between patients’ preferred and perceived participation was related to higher patient satisfaction, more fulfillment of information needs, and more understanding of information than a mismatch for both patient groups. For doctor–patient concordance a conditional main effect on all outcome measures emerged only among Turkish-Dutch patients. That is, for patients who were discordant with their GP, higher perceived participation was related to lower satisfaction, worse fulfillment of information needs, and worse understanding of the information. In order to improve medical communication GPs should thus primarily be trained to tailor their communication styles to match patients’ preferences for participation.

Does Media Use Result in More Active Communicators? Differences Between Native Dutch and Turkish-Dutch Patients in Information-Seeking Behavior and Participation During Consultations With General Practitioners

This study investigates differences between native Dutch and Turkish-Dutch patients with respect to media usage before and patient participation during medical consultations with general practitioners. In addition, the authors assessed the relation between patient participation and communication outcomes. The patients were recruited in the waiting rooms of general practitioners, and 191 patients (117 native Dutch, 74 Turkish-Dutch) completed pre- and postconsultation questionnaires. Of this sample, 120 patients (62.8%; 82 native Dutch, 38 Turkish-Dutch) agreed to have their consultations recorded to measure patient participation. Compared with Turkish-Dutch patients of similar educational levels, results showed that native Dutch patients used different media to search for information, participated to a greater extent during their consultations and were more responsive to their general practitioner. With respect to the Turkish-Dutch patients, media usage was related to increased patient participation, which was correlated with having fewer unfulfilled information needs; however, these relations were not found in the native Dutch patient sample. In conclusion, interventions that enhance participation among ethnic minority patients will better fulfill informational needs when such interventions stimulate information-seeking behavior in that group before a medical consultation.