title: Hostile sexist male patients and female doctors: a challenging encounter.
abstract: BACKGROUND
  Patient characteristics and attitudes can affect how patients react to the physician's communication style, and this reaction can then influence consultation outcomes.
  
  
  OBJECTIVE
  The goal of the present study was to investigate whether the attitude of a sexist male patient affects how he perceives a female physician's nonverbal communication and whether this then results in expecting less positive consultation outcomes.
  
  
  METHODS
  Participants were analog patients who viewed four videotaped male and four videotaped female physicians in a consultation with one of their patients. Physician videos were preselected to represent a range of high and low patient-centered physician nonverbal behavior. Participants filled in questionnaires to assess how patient-centered they perceived the female and male physicians' nonverbal communication to be, and participants indicated how positive they expected the consultation outcomes to be. Moreover, we assessed the participants' sexist attitudes with a questionnaire measuring hostile and benevolent sexism.
  
  
  METHODS
  Students (N = 60) from a French-speaking university in Switzerland were recruited on campus.
  
  
  METHODS
  The main outcome measures were the extent to which analog patients expect the consultation outcomes to be positive (high satisfaction, increased trust in the physician, intention to adhere to treatment recommendations, and perceived physician competence) and the extent to which analog patients perceive physicians as patient-centered (judged from the physicians' nonverbal cues).
  
  
  RESULTS
  Male analog patients' hostile sexism was negatively related to perceiving the physicians as patient-centered, and male analog patients' hostile sexism was also negatively related to expected positive consultation outcomes. For male patients viewing female physicians, mediation analysis revealed that perceived physician patient-centeredness mediated the negative relationship between hostile sexism and expected positive consultation outcomes.
  
  
  CONCLUSIONS
  Male hostile sexist patients perceive a female physician's nonverbal communication as less patient-centered and this negatively affects their expectation of positive outcomes from the consultation.
authors.affiliation: Institute of Work and Organizational Psychology, University of Neuchatel, Rue Emile-Argand 11, 2009, Neuchâtel, Switzerland, christina.klockner@unine.ch.
authors.forename: Christina
authors.initials: C
authors.lastname: Klöckner Cronauer
authors.forename: Marianne
authors.initials: M
authors.lastname: Schmid Mast
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D009633:Nonverbal Communication; D018802:Patient-Centered Care; D010361:Patients / Q000523:psychology*; D010822:Physicians, Women; D063507:Sexism
references.citation: Patient Educ Couns. 2002 Sep;48(1):51-61
references.pmid: 12220750
references.citation: Patient Educ Couns. 2003 Jan;49(1):45-52
references.pmid: 12527152
references.citation: J Pers Soc Psychol. 1986 Dec;51(6):1173-82
references.pmid: 3806354
references.citation: Health Psychol. 1994 Sep;13(5):384-92
references.pmid: 7805632
references.citation: Patient Educ Couns. 2005 Sep;58(3):244-51
references.pmid: 16081235
references.citation: J Fam Pract. 2000 Sep;49(9):796-804
references.pmid: 11032203
references.citation: J Am Board Fam Pract. 2002 Jan-Feb;15(1):25-38
references.pmid: 11841136
references.citation: Patient Educ Couns. 2007 Aug;67(3):315-8
references.pmid: 17478072
references.citation: J Gen Intern Med. 2012 Nov;27(11):1528-43
references.pmid: 22700392
references.citation: Patient Educ Couns. 2006 Jul;62(1):38-45
references.pmid: 15964736
references.citation: Med Care. 2013 Mar;51(3):e16-21
references.pmid: 22498688
references.citation: Surgery. 2002 Jul;132(1):5-9
references.pmid: 12110787
references.citation: Patient Educ Couns. 2013 Mar;90(3):399-404
references.pmid: 21414737
references.citation: Med Educ. 2013 Sep;47(9):923-31
references.pmid: 23931541
references.citation: JAMA. 2002 Aug 14;288(6):756-64
references.pmid: 12169083
references.citation: Behav Med. 1998 Summer;24(2):81-8
references.pmid: 9695899
references.citation: J Fam Pract. 2000 Sep;49(9):805-7
references.pmid: 11032204
references.citation: Arch Intern Med. 1999 May 24;159(10):1069-75
references.pmid: 10335683
references.citation: Health Psychol. 1992;11(1):61-6
references.pmid: 1559536
references.citation: Med Care. 2008 Dec;46(12):1212-8
references.pmid: 19300310
references.citation: Soc Sci Med. 1991;32(11):1301-10
references.pmid: 2068614
references.citation: J Gen Intern Med. 1989 Jan-Feb;4(1):23-30
references.pmid: 2644407
references.citation: J Clin Oncol. 1999 Jan;17(1):371-9
references.pmid: 10458256
references.citation: Psychol Aging. 2002 Sep;17(3):443-452
references.pmid: 12243386
references.citation: Patient Educ Couns. 2009 Sep;76(3):348-55
references.pmid: 19647969
references.citation: Med Care. 1997 Nov;35(11 Suppl):NS58-68
references.pmid: 9366880
references.citation: J Gen Intern Med. 2005 Jun;20(6):531-5
references.pmid: 15987329
references.citation: Patient Educ Couns. 2002 Dec;48(3):217-24
references.pmid: 12477606
references.citation: Patient Educ Couns. 2008 Sep;72(3):374-81
references.pmid: 18656322
references.citation: Patient Educ Couns. 2011 Jan;82(1):49-57
references.pmid: 20371157
references.citation: J Gen Intern Med. 2006 Jan;21 Suppl 1:S28-34
references.pmid: 16405706
references.citation: CMAJ. 1995 May 1;152(9):1423-33
references.pmid: 7728691
references.citation: Patient Educ Couns. 2010 Sep;80(3):315-20
references.pmid: 20638813
references.citation: Med Care. 1987 May;25(5):437-51
references.pmid: 3695654