Han Z. Li

Backchannel Responses as Misleading Feedback in Intercultural Discourse

This study examined the relationship between the frequency of backchannel responses and listener recall scores in inter- and intra-cultural conversations. The nature of the study was a simulated physician–patient interaction. Participants were 40 Canadians and 40 Chinese who formed 40 dyads in four experimental conditions: Canadian physician/Canadian patient, Chinese physician/Chinese patient, Chinese physician/Canadian patient, and Canadian physician/Chinese patient. All conversations were video-taped and micro-analyzed. The data generated three intriguing findings. (1) There were significant positive correlations between backchannel responses and listener recall scores in the two intra-cultural groups, indicating that backchannel responses facilitated content communication. (2) There were significant negative correlations between backchannel responses and listener recall scores in the two inter-cultural groups, indicating that backchannel responses might have served as misleading feedback and caused mis-communication. (3) The Chinese/Chinese condition had the highest backchannel responses; the Canadian/Canadian condition had the lowest with the two inter-cultural groups in between. This finding provides support for the Communication Accommodation theory. Implications for verbal and nonverbal communication training in intercultural interactions were discussed.

Reconceptualizing interruptions in physician-patient interviews: cooperative and intrusive.

Abstract Results of past research on physician-patient interruption present an inconclusive picture. This study reconceptualizes interruption into cooperative and intrusive categories. Thirty physician-patient interviews, 13 male/male and 17 male/female, were audiotaped and microanalyzed. It was found that physicians did not interrupt patients more or vice versa. Rather, physicians and patients interrupted differently, the former more intrusively and the latter, more cooperatively. Furthermore, physicians did not dominate speaking turns nor speak more words than patients, as previously believed. We argue that their difference may not be measured by the number of words or speaking turns because it is embedded in their respective communication style. It was also found that female patients exhibited eleven times as much cooperative interruptions as did male patients. When physicians interrupted patients, they were unsuccessful only 6% of the time. When patients interrupted physicians, they were unsuccessful 32% of the time. The results of this study point out the necessity to reconceptualize interruptions in physician-patient interviews.

Associations among Attachment Style, Maintenance Strategies, and Relational Quality across Cultures

Previous research has suggested that attachment style is an indicator of relationship behavior and perception universally across cultures; however, research comparing the effect of attachment style on relational maintenance in culturally distinct societies is still non-existent. The present study investigated the effect of the secure or insecure attachment style on commonly used relational maintenance strategies and desired relational features in three geographically distant cultures: the US mainland, Hawaii, and South Korea. Results indicated that as predicted, regardless of culture, secure attachment style was associated with higher ratings of relationship quality (trust, commitment, liking, control mutuality, and satisfaction) and the self- and partner-perceived uses of Stafford and Canarys (1991) relationship maintenance strategies. Culture did not change the effect of attachment style on the dependent factors; however, culture, as an independent factor, contributed to the variance in the self-/partner-perceived maintenance strategies and relationship quality.

The Relationship Between Culture, Health Conceptions, and Health Practices: A Qualitative–Quantitative Approach

This study investigated cultural variations in health conceptions and practices using a quasi-experimental design. A total of 60 participants, recruited from three cultural groups in Canada, were individually interviewed between the fall of 2009 and the fall of 2010. Transcribed interviews were quantified according to the importance participants ascribed to emergent themes. The data generated three intriguing findings: (a) Consistent with an interdependent self-construal or ecological self, First Nations participants were more likely to report health conceptions and practices that expand beyond the individual self to include their family, the community, and the environment when compared with Anglophones and Francophones of European ancestry; (b) First Nations participants placed more importance on maintaining their traditions and culture as a health-promoting strategy, compared with Anglophones and Francophones; and (c) some of the health conceptions identified by all three groups significantly predicted the practices they engage in to promote health. These findings suggest that culture has a noticeable impact on health conceptions, which in turn influence health practices. There are at least two important implications: (a) Health policy makers need to take into account the role culture plays in the way people conceptualize health to ensure that health policies and programs reflect the particular beliefs and needs of their target populations and (b) health-care professionals need to be aware of the diverse views of their patients to provide culturally appropriate care.

Inter‐ and intra‐cultural variations in self–other boundary: A qualitative‐quantitative approach

Past research on the theories of self‐construal and individualism‐collectivism in cross‐cultural contexts presents inconsistent and inconclusive results. Some researchers have seriously questioned the validity of major instruments measuring self‐construal across cultural groups. To address the validity issue, this study developed quantitative measures from ethnographic data. In five scenarios mapping self to close‐other boundaries, 171 Anglo‐Canadians and 224 Mainland Chinese were asked to make a decision and offer a reason for the decision. Two intriguing findings emerged from the data. (1) In comparison with Anglo‐Canadians, Mainland Chinese were more likely to share material belongings with close‐others and less likely to share their thoughts/opinions. The first part of this finding provides unequivocal support for the theories of self‐construal and individualism‐collectivism, whereas the latter part challenges an important assumption of these theories, which contends that collectivists should be more ...

Training patients to ask information verifying questions in medical interviews

Purpose – The main purpose of the paper was to examine whether a short patient training session on various ways of requesting physicians to clarify a piece of previously elicited information during medical consultation would improve information communication, thus increasing patient satisfaction.Design/methodology/approach – A total of 114 adult patients voluntarily participated in the study which was carried out at a clinic in Canada. Half of the participants were randomly assigned to the experimental group and half to the control group. Males and females were evenly distributed in both experimental and control groups. Prior to their medical visits, participants in the experimental group received 10‐15‐minute face‐to‐face training, whereas the control group did not receive any training. The purpose of the training was to facilitate information transmission, with the intention to increase communication effectiveness and patient satisfaction. Immediately after their medical visits, all participants filled ...

Counseling Chinese patients about cigarette smoking: the role of nurses

Purpose – The main purpose of this study is to determine the cigarette smoking rate and smoking cessation counseling frequency in a sample of Chinese nurses.Design/methodology/approach – At the time of data collection, the hospital had 260 nurses, 255 females and five males. The 200 nurses working on the two daytime shifts were given the questionnaires; none refused to participate, reaching a response rate of 100 percent. All the participants were females as the five male nurses were working in the operation rooms at the time of data collection, are were thus not accessible.Findings – Some key findings include: only two nurses, out of 200, identified themselves as current cigarette smokers; all provided anti‐smoking counseling to patients, the majority of them did not think their efforts were successful; cigarette smoking is a problem in China: the nurses estimated that 80 percent of male and 10 percent of female patients were current smokers; in the opinions of the nurses, Chinese smokers used smoking as...

Cigarette smoking and anti-smoking counselling among Chinese physicians

We surveyed 493 Chinese physicians about their cigarette smoking patterns and frequency and methods of anti-smoking counselling in Wuhan, the capital city of Hubei Province, in early 1996. We found that 61% of the male and 12% of the female physicians were current cigarette smokers—an increase of 20% for men and 150% for women in comparison with findings among physicians in the same city nine years previously. About one-third of the smokers reported a daily consumption of 20 cigarettes or more, and 45% consumed fewer than five cigarettes daily. Two-thirds of the physicians had counselled their patients about smoking in the past year, and 57% of them had done so ‘often’ or ‘always’.