Worldwide migration induces multicultural contacts in societies, including health care. However, multicultural contacts and communication are often complicated by language barriers, and obstructions are caused by different culturally defined views and perceptions.1 Consequently, the physician–patient relationship may also be affected.2-4 According to Kleinman, both physician and patient need to exchange each other's perceptions about the patient's illness (their ‘explanatory models’) in order to achieve understanding and agreement about diagnosis and treatment.5 Lack of understanding and agreement is assumed to lead to less compliance and a reduction in perceived quality of care.1-2 Kleinman also argued that ‘uncovering and solving discrepancies in explanatory models’ between physician and patient is determined by mutual understanding between them, as well as by general feelings, such as patient satisfaction and the patient's feeling that the physician has been considerate.6-9 Misunderstanding and patient dissatisfaction tended to increase when the cultural gap between physician and patient was wider.6,10,11
How this fits in
Cultural differences between GPs and patients increase the chance of miscomprehension and can lead to patient non-compliance with treatment. A double educational intervention given to both physician and patient aimed to improve their intercultural communication, reduce their mutual misunderstanding and improve patients' perception of the quality of care. This intervention effect occurs only 6 months after GP training and is probably due to the slow changing of attitudes and communication style. The effect is the strongest in consultations with non-Western patients, who live between the traditional culture of their country of origin and Western culture. This is also the group of patients with the greatest improvement in comprehension with their physician.
By improving communication during the consultation ‘discrepancy in explanatory models’ can be reduced in order to achieve better mutual understanding and consequently better perceived care and patient compliance; this improvement can be achieved by instruction and training in communication of both physician and patient.12-13
The aim of this study is to assess the effect of an educational intervention on intercultural communication given to both GPs and patients (both Western and non-Western countries of origin) on mutual understanding and perceived quality of care.
The intervention aims to reduce differences in mutual understanding and perceived quality of care in consultations with patients of different native origins and its effect was assessed using a randomised controlled trial. We hypothesise that an educational intervention on intercultural communication, given to both GP and patient, could decrease inequalities in care between Western and non-Western patients.
