title: Trust and Perceptions of Physicians' Nonverbal Behavior Among Women with Immigrant Backgrounds.
abstract: Previous findings suggest immigrant patients have lower trust in their physicians, and perceive nonverbal communication differently compared to non-immigrant patients. We tested discrepancies in trust and the impact of non-verbal behavior between immigrants and non-immigrants in The Netherlands. Nonverbal communication of an oncologist was systematically varied in an experimental video vignettes design. Breast cancer patients (n = 34) and healthy women (n = 34) viewed one of eight video versions and evaluated trust and perceived friendliness of the oncologist. In a matched control design, women with immigrant and non-immigrant backgrounds were paired. Immigrant women reported stronger trust. Nonverbal communication by the oncologist did not influence trust differently for immigrants compared to for non-immigrants. However, smiling strongly enhanced perceived friendliness for non-immigrants, but not for immigrants. Immigrant patients' strong trust levels may be formed a priori, instead of based on physicians' communication. Physicians may need to make extra efforts to optimize their communication.
authors.affiliation: Department of Medical Psychology - Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands. M.A.Hillen@amc.uva.nl.
authors.forename: Marij A
authors.identifier: http://orcid.org/0000-0001-5724-7934
authors.initials: MA
authors.lastname: Hillen
authors.affiliation: Department of Medical Psychology - Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands.
authors.forename: Hanneke C J M
authors.initials: HCJM
authors.lastname: de Haes
authors.affiliation: Department of Medical Psychology - Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands.|Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, The Netherlands.
authors.forename: Mathilde G E
authors.initials: MGE
authors.lastname: Verdam
authors.affiliation: Department of Medical Psychology - Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands.
authors.forename: Ellen M A
authors.initials: EMA
authors.lastname: Smets
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000208:ethnology*; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009426:Netherlands; D009633:Nonverbal Communication / Q000523:psychology*; D000072103:Oncologists / Q000523:psychology; D010465:Perception; D010817:Physician-Patient Relations; D012904:Smiling; D012959:Socioeconomic Factors; D035502:Trust / Q000523:psychology*; D014743:Videotape Recording
keywords: Cross-cultural comparison; Immigrants; Nonverbal communication; Oncology; Trust