title: Culture and medical decision making: Healthcare consumer perspectives in Japan and the United States.
abstract: OBJECTIVE
  Two studies identified core value influences on medical decision-making processes across and within cultures.
  
  
  METHODS
  In Study 1, Japanese and American 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, American 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 United States. Power distance effects negatively predicted desire for decision-making influence only in the United States. For Study 2, high (low) interdependents and women (men) in the United States felt that a colorectal cancer screening decision aid helped prepare them more (less) for a medical consultation. Low interdependent men 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, whereas American 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 and across cultures and suggests that individually tailored versions of decision aids may optimize decision preparedness.
authors.affiliation: Department of Marketing.
authors.forename: Dana L
authors.initials: DL
authors.lastname: Alden
authors.affiliation: Department of Marketing.
authors.forename: John M
authors.initials: JM
authors.lastname: Friend
authors.affiliation: Department of Marketing.
authors.forename: Angela Y
authors.initials: AY
authors.lastname: Lee
authors.affiliation: Department of Social Psychology.
authors.forename: Marieke
authors.initials: M
authors.lastname: de Vries
authors.affiliation: Department of Medicine.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Osawa
authors.affiliation: Department of Marketing.
authors.forename: Qimei
authors.initials: Q
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000066491:Clinical Decision-Making; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000523:psychology; D003469:Culture; D003657:Decision Making; D003661:Decision Support Techniques; D055088:Early Detection of Cancer / Q000523:psychology; D005006:Ethnicity; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology*; D012945:Social Values / Q000208:ethnology*; D011795:Surveys and Questionnaires; D014481:United States