title: When the world is closing in: effects of perceived room brightness and communicated threat during patient-physician interaction.
abstract: OBJECTIVE
  The study proposes that room brightness creates impressions of a more spacious environment and that this perception positively impacts feelings and behaviors during high-threat conversations in particular.
  
  
  BACKGROUND
  To a large extent healthcare providers depend on their patients' willingness to disclose information. In addition to characteristics related to the physician and topic of conversation, research indicates that environmental factors influence patients' affective experiences and self-disclosure.
  
  
  METHODS
  A two-factor between-subjects experimental design was used in which participants (n = 90) were presented with a scenario describing a patient-physician encounter varying in communicated threat. Subsequently, participants were exposed to a picture in which room brightness was manipulated. Next, patient comfort, experienced spaciousness, and self-disclosure intentions were measured.
  
  
  RESULTS
  An effect of brightness was found on affective experiences and self-disclosure intentions. In addition, the predicted interaction was obtained between brightness and communicated threat on these measures. Analyses confirmed that perceived spaciousness mediates the relationship between room brightness and self-disclosure intentions.
  
  
  CONCLUSIONS
  The study confirms that brightness impacts self-disclosure intentions. Additionally, this relationship is influenced by psychological circumstances, with a more pronounced need for spaciousness when in an anxious state of mind. The results suggest that the physical environment can be used as a tool to improve active participation. In addition, the results stress the importance of attending to the patient's state of mind in creating the right atmosphere.
  
  
  BACKGROUND
  Lighting, patients, physicians, satisfaction.
authors.affiliation: CORRESPONDING AUTHOR: Vanessa Okken, University of Twente, Department of Corporate and Marketing Communication, P.O. Box 217, 7500 AE Enschede, The Netherlands; v.s.okken@utwente.nl; 0031 53 489 3287, 0031 53 489 4259 (fax).
authors.forename: Vanessa
authors.initials: V
authors.lastname: Okken
authors.forename: Thomas
authors.initials: T
authors.lastname: van Rompay
authors.forename: Ad
authors.initials: A
authors.lastname: Pruyn