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Exploring cultural values (EPhMRA Asia 2013)

In this presentation, we explored the cultural values framework developed by professor Geert Hofstede and looked at how these cultural values influence healthcare in general as well as healthcare practitioners and patients.

on 13 October 2014

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Transcript of Exploring cultural values (EPhMRA Asia 2013)

Exploring cultural values
Considering cultural values
The extent to which a society is risk-averse or can tolerate environment ambiguity
Sources & references

Ping Fang, Jill M. Norvilitis Perceptions of ADHD in China and the United States: A Preliminary Study, Journal of Attention Disorders November 2005 9: 413-424,

Geert Hofstede, Gert Jan Hofstede, Michael Minkov, Cultures and Organizations: Software of the Mind. Revised and Expanded 3rd Edition. New York: McGraw-Hill USA, 2010

Cultural values: Definition & implications in healthcare
Power distance
Uncertainty avoidance
Long-term orientation
Indulgence vs. restraint

Case study: Comparing scores across 3 countries
China, Japan, Philippines

What it means for researchers
6 key dimensions
Power distance
The extent to which the less powerful members of institutions and organizations within a country expect and accept that power is distributed unequally
Uncertainty avoidance
Long-term orientation
Indulgence vs. restraint
Defines the degree of interdependence a society maintains among its members.
Implications in healthcare
In highly individualistic countries:
Higher share of both public and private income spent on healthcare
Individuals with disabilities are encouraged to live a ‘normal life’ as much as possible
Implications in healthcare
High uncertainty avoidance has been linked to:
Less eye contact during medical consultations
Higher likelihood of getting a prescription
Lower nurse/doctor ratio

The extent to which competition and assertiveness are deemed masculine values and opposed to caring and quality of life, deemed feminine values
The extent to which a society shows a pragmatic future-oriented perspective rather than a conventional historical short-term point of view.
So what are the scores?
Implications in healthcare
In high PDI countries:
Doctors tend to lead the consultation
Consultations may be shorter
Use of antibiotics may be greater
Less blood transfusions
The extent to which societies allow relatively free gratification of basic needs and human drives or regulates these gratifications by strict social norms
In high indulgence countries:
People tend to feel healthier
Higher level of self-reported happiness
Lower percentage of death from cardiovascular diseases
Implications in healthcare
Differences in genders’ role perceptions may lead to differing beliefs and/or behaviors towards conditions and their management
There may be greater differences between genders on the way patients cope with their condition
Extended family and different circles of influence can play a great role
Research should create a sense of belonging

High uncertainty avoidance
Respondents may not feel comfortable in unstructured or novel situations
Researchers should be very clear about the research objectives and methodology to gain trust
Very high power distance
Strong sense of hierarchy may be observed
Build rapport by showing empathy to understand what drives behaviors
Short term orientation
Respondents may focus on facts and have established beliefs
Emphasis on research objectives
Low uncertainty avoidance
& restraint orientation
Respondents may accept different viewpoint and thus not be used to express emotions
Research can use projective techniques to explore certain situations
Cultural values in a specific therapy area
Perceptions of ADHD in the US and China

Ping Fang, Jill M. Norvilitis Perceptions of ADHD in China and the United States: A Preliminary Study, Journal of Attention Disorders November 2005 9: 413-424,
Detailed packaging

List of medications

Reducing uncertainty in Japan

Example of detailed & illustrated prescriptions

Short-term orientation in the Philippines

Pharmacists as a first point of contact

Recent research has highlighted that pharmacists are often used as first point of contact by patients
Pharmacists may be easier to reach than doctors
More available
Less expensive
Closer to patient’s home
Respondents tend to
Disagree that ‘ADHD is biology based’
Disagree that children with ADHD need to do more/try harder
Disagree that parents of children with ADHD don’t know how to control their children
Both hyperactivity and inattention are used for diagnosis
More than 80% think medication is overused
More than 60% think medication should be used only as a last resort
Perceptions of ADHD in the US
Participants were generally skeptical about ADHD
No specific responsibility for dealing with the condition
Cultural values: A definition
The collective programming of the mind distinguishing the members of one group or category of people from another
What do these scores mean in practice?
‘Restraint’ values lead to greater recognition of hyperactive behaviors
Collectivist values suggest it is everyone’s responsibility to deal with the condition
Perceptions of ADHD in China
Main criteria for diagnosis is hyperactivity

Respondents tend to agree with:
ADHD is biology based
Children with ADHD need to try harder
Parents of children with ADHD just don’t know how to control their children
It is schools’ job to instil discipline when parents have failed
What does it mean for research?
Through questionnaires sent to school teachers and psychology students, researchers have identified potential differences in attitudes towards ADHD
For better results, tailor your marketing and research programs to local cultural values
Adapted from the presentation given in November 2013 at the EphMRA Asia conference in Singapore
Full transcript