Cultural differences in reactions to patient behaviour: A comparison of Swedish and Australian health professionals

Mary T. Westbrook, Lena A. Nordholm and Jeanette E. McGee

Social Science & Medicine, 1984, vol. 19, issue 9, 939-947

Abstract: Scott hypothesised that there are national differences in the theories held by health professionals regarding rehabilitation. Thus they have different perceptions of and reactions to patient behaviours. This was tested by comparing the reactions of female physiotherapists, occupational therapists and nurses in Sweden (N = 51) and Australia (N = 83) to behaviours of patients belonging to six diagnostic groups. It was predicted that national differences would be influenced by Australians' endorsement of a more psycho-social model of health care and Swedes' stronger beliefs in personal responsibility for health. Questionnaires containing case histories of the six patients and transcripts of interviews in which they expressed either depression, optimism, dependence, independence, self-blame or denial of blame for their illnesses were distributed to subjects. Case histories and interview transcripts were combined differently in six forms of the questionnaire. Subjects rated their impressions and evaluations of each patient on 14 Likert type scales and answered the question, "If the patient had said this to you how would you have reacted?" Subjects completed the Health Locus of Control Scale on which Swedes proved to have significantly stronger beliefs regarding personal responsibility for health. Highly significant differences were found in discriminant analyses of reactions to the six behaviours. Australians were more likely to perceive patients as dependent, depressed and poorly adjusted. They responded verbally to patients' feelings, recommended counselling and liked patients more. Swedes were more likely to react with specific treatments and technical aids. Swedes regarded patients who were dependent or who did not blame themselves as having poorer prognoses. Few differences occurred in ratings of the typicality of patients' behaviours or the degree of patients' acceptance or coping. The findings have particular relevance to multi-cultural nations. Bias may have occurred in the results because subjects represented only 40% of those sent the questionnaires.

Date: 1984
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