Culture and Medical Decision Making: Healthcare Consumer Perspectives in Japan and the U.S, Health Psychology
Objective: Two studies identified core value influences on medical decision making processes across and within cultures. Methods: In Study 1, Japanese and U.S. adults reported desired levels of medical decision making influence across conditions that varied in seriousness. Cultural antecedents (interdependence, independence and power distance) were also measured. In Study 2, U.S. adults reviewed a colorectal cancer screening decision aid. Decision preparedness was measured along with interdependence, independence and desire for medical information. Results: In Study 1, higher interdependence predicted stronger desire for decision making information in both countries, but was significantly stronger in Japan. The path from information desire to decision making influence desire was significant only in Japan. The independence path to desire for decision making influence was significant only in the U.S. Power distance effects negatively predicted desire for decision making influence only in the U.S. For Study 2, high (low) interdependents and females (males) in the U.S. felt that a colorectal cancer screening decision aid helped prepare them more (less) for a medical consultation. Low interdependent males were at significantly higher risk for low decision preparedness. Conclusions: Study 1 suggests that Japanese participants may tend to view medical decision making influence as an interdependent, information sharing exchange, while U.S. respondents may be more interested in power sharing that emphasizes greater independence. Study 2 demonstrates the need to assess value influences on medical decision making processes within as well as across cultures and suggests that individually tailored versions of decision aids may optimize decision preparedness.
Lee, Y. Angela. 2015. Culture and Medical Decision Making: Healthcare Consumer Perspectives in Japan and the U.S. Health Psychology. 34(12): 1133-1144.