title: Emotions in primary care: Are there cultural differences in the expression of cues and concerns?
abstract: OBJECTIVE
  This study compared native-Dutch and Turkish-Dutch patients' expressions of emotional cues/concerns and GPs' responses to these cues/concerns. Relations between patient's cues/concerns and GPs' perceptions of the patient's health complaint were examined too.
  
  
  METHODS
  82 audiotaped encounters with native-Dutch and 38 with Turkish-Dutch GP patients were coded using the VR-CoDES and VR-CoDES-P. Patients filled out a survey before each consultation to assess their cultural identification, Dutch language proficiency and health-related variables. GPs filled out a survey after each consultation to assess their perceptions of the patient's health complaint.
  
  
  RESULTS
  Turkish-Dutch patients expressed more cues than native-Dutch patients, which was explained by higher worries about their health and worse perceived general health. GPs responded more often with space-providing responses to Turkish-Dutch patients compared to native-Dutch patients. Turkish-Dutch patients' cue expression strongly influenced GPs' perceptions about the presence of psychosocial problems.
  
  
  CONCLUSIONS
  Migrant patient-related factors influence the amount of emotional cue expression in primary care. GPs perceive these cues as indicating the presence of psychosocial problems and provide space for patients to elaborate on their emotional distress.
  
  
  CONCLUSIONS
  GPs should be trained in using more affective communication techniques to enhance elicitation of the underlying reasons for migrant patients' enhanced emotional cue expression.
authors.affiliation: Department of Communication Science, Amsterdam School of Communication Research, University of Amsterdam, The Netherlands. Electronic address: b.c.schouten@uva.nl.
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Schouten
authors.affiliation: Department of Communication Science, Amsterdam School of Communication Research, University of Amsterdam, The Netherlands.
authors.forename: Sanne
authors.initials: S
authors.lastname: Schinkel
mesh_terms: D000328:Adult; D003142:Communication; D003463:Cues; D003469:Culture; D054242:Emigrants and Immigrants / Q000523:psychology; D004644:Emotions; D005260:Female; D058005:General Practitioners / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011795:Surveys and Questionnaires; D014743:Videotape Recording
keywords: Cues; General practice; Immigrants; Intercultural communication; Patients’ emotions; Turkish patients