IDEAL AFFECT MEDIATES AGE-RELATED CULTURAL DIFFERENCES IN PHYSICIAN PREFERENCE

Purpose: It is unclear which cultural factors contribute to cultural variation in patient satisfaction with their physicians. Because research suggests culture shapes the emotions we want to feel (ideal affect), which in turn shape our preferences, we examined whether cultural variation in ideal affect relates to physician preference.

Method: Tsai et al. (2009) found cultural variation in how much we value excitement and other high arousal positive (ideal HAP) states across age: European American (EA) younger and older adults valued these states similarly; Chinese American (CA) younger adults valued them more than older. Thus, we predicted that while EA older and younger adults will equally prefer a physician that promotes HAP states, CA younger adults will have a greater preference than older. Moreover, we predicted that ideal HAP will mediate the ageXculture interaction of “HAP physician” preference. At Time1, 135 participants (47% CA; 53% older [65-83], 47% younger [21-35]) rated how often they ideally want to and actually feel HAP states in a typical week. At Time2, participants rated a hypothetical physician promoting HAP states compared to one promoting low arousal positive states (e.g., calm). Physicians were matched by ethnicity. Participants rated each physician along several indices (e.g., trust/comfort/knowledge) to provide an overall physician preference rating.

Result: We performed a mediation analysis to determine whether ideal HAP accounted for cultural and age-related differences in physician preference, controlling for actual HAP. First, we regressed HAP physician preference onto age, culture, and ageXculture and found a significant ageXculture interaction, p=0.056: While there was no age difference in HAP physician preference among EAs, younger CAs had a greater preference than older, p=0.037. We then regressed ideal HAP onto age, culture, and ageXculture and found a significant ageXculture interaction, p=0.015. Consistent with physician preference, there was no age difference in ideal HAP among EAs, while younger CAs valued HAP more than older, p=0.004. Finally, we regressed HAP physician preference onto age, culture, ideal HAP and ageXculture. Here, the ageXculture interaction was no longer significant, p=0.171, while ideal HAP was significant, p<0.001 and partially mediated the ageXculture interaction, p=0.06.

Conclusion: Our findings suggest cultural variation in physician preference is partly due to ideal affect.  By tailoring communication with diverse groups of patients according to their ideal affect, physicians may enhance patient satisfaction.