We apply the Communication Theory of Identity to investigate how patients display their ethnic identities during intercultural patient—provider interactions. Ethnic identity displays play a large part in reflecting patients’ and providers’ assumptions about the other, as well as their communicative needs. We collected paper-and-pencil responses from a convenience sample of providers and their patients, and conducted a constant comparative analysis of their open-ended reports of a recent intercultural medical interview. The results revealed how both parties viewed their roles in intercultural medical encounters and how they looked for accommodative behaviors from the other party. We draw implications for new applications and future developments of the Communication Theory of Identity and Communication Accommodation Theory.
Andrulis, D.P. ( 2003). Reducing racial and ethnic disparities in disease management to improve health outcomes. Disease Management & Health Outcomes, 11(12), 789-800. doi:1173-8790/03/0012-0789
2.
Barone, T.L. ( 2010). Culturally sensitive care 1969-2000: The Indian Chicano Health Center. Qualitative Health Research, 20, 453-464. doi:10.1177/1049732310361893
3.
Betancourt, J.R., Green, A.R., Carrillo, J.E., & Ananeh-Firempong, O. (2003). Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports, 118, 293-302. Retrieved from http://www.publichealthreports.org/archives/issueopen.cfm?articleID=1277
4.
Brown, J.D., & Scholl, J.C. ( 2006, August). A qualitative comparison of patients’ and providers’ ethnic identity displays. Proceedings of the Annual Congress of the Americas, Lima, Peru.
5.
Castillo-Carniglia, A., Weisstaub, S.G., Aquirre, P., Aguilar, A.M., & Araya, M. ( 2010). Identifying cultural representations of families and the health team to improve the management of severe malnutrition in childhood . Qualitative Health Research, 20, 524-530. doi:10.1177/1049732310361465
6.
Chiu, L. ( 2004). Minority ethnic women and cervical screening: A matter of action or research?Primary Health Care Research and Development , 5, 104-116. doi:10.1191/ 1463423604pc172oa
7.
Chung, L.C., & Ting-Toomey, S. (1999). Ethnic identity and relational expectations among Asian Americans. Communication Research Reports, 16(2), 157-166.
8.
Cline, R.J., & McKenzie, N.J. (1998). The many cultures of health care: Difference, dominance, and distance in physician-patient communication . In L. Jackson & B. Duffy (Eds.), Health communication research: A guide to developments and directions (pp.57-74). Westport, CT: Greenwood Press.
9.
Collier, M.J., & Thomas, M. ( 1988). Cultural identity: An interpretive perspective. In Y. Y. Kim & W. B. Gudykunst (Eds.), Theories in intercultural communication (pp. 99-120). Thousand Oaks, CA: Sage.
10.
Colón , M. ( 2005). Hospice and Latinos: A review of the literature. Journal of Social Work & End-of-Life in Palliative Care, 1(2), 27-43.
11.
Cristancho, S., Garces, D.M., Peters, K.E., & Mueller, B.C. ( 2008). Listening to rural Hispanic immigrants in the Midwest: A community-based participatory assessment of major barriers to health care access and use. Qualitative Health Research, 18, 633-646. doi:10.1177/1049732308316669
12.
Daley, C.M., James, A.S., Ulrey, E., Joseph, S.Talawyma, A., Choi, W.S., . . . Coe, M.K. ( 2010). Using focus groups in community-based participatory research: Challenges and resolutions. Qualitative Health Research, 20, 697-706. doi:10.1177/1049732310361468
13.
Gao, G., Burke, N., Somkin, C.P., & Pasick, R. ( 2009). Considering culture in physician-patient communication during colorectal cancer screening. Qualitative Health Research , 19, 778-789. doi:10.1177/1049732309335269
14.
Geer, J.G. ( 1991). Do open-ended questions measure "salient" issues? Public Opinion Quarterly, 55, 360-370.
15.
Giles, H. & Wiemann, J.M. ( 1987). Language, social comparison and power. In C. R. Berger & S. H. Chaffee (Eds.), The handbook of communication science (pp. 350-384). Newbury Park, CA: Sage.
16.
Guba, E.G. ( 1978). Toward a methodology of naturalistic inquiry in educational evaluation. CSE Monograph Series in Evaluation No.8. Los Angeles, CA: University of California, Los Angeles, Center for the Study of Evaluation .
17.
Gudykunst, W.B., & Hammer, M.R. ( 1987). The influence of ethnicity, gender, and dyadic composition on uncertainty reduction in initial interactions. Journal of Black Studies, 18(2), 191-214.
18.
Hailey, B.J., Pargeon, K., & Crawford, V. ( 2000). Can healthcare providers at a university health clinic predict patient satisfaction? Journal of American College Health, 49(3), 111-117.
19.
Hajek, C., Villigran, M., & Wittenberg-Lyles, E. (2007). The relationships among perceived physician accommodation, perceived outgroup typicality, and patient inclinations toward compliance. Communication Research Reports , 24(4), 293-302.
20.
Hecht, M.L. ( 1978). The conceptualization and measurement of interpersonal communication satisfaction. Human Communication Research, 4, 253-264.
21.
Hecht, M.L. ( 1993). 2002-A research odyssey: Toward the development of a communication theory of identity. Communication Monographs , 60, 76-82.
22.
Hecht, M.L., Collier, M.J., & Ribeau, S.A. ( 1993). African American communication: Ethnic identity and cultural interpretation. Newbury Park, CA: Sage.
23.
Hecht, M.L., & Faulkner, S.L. (2000). Sometimes Jewish, sometimes not: The closeting of JewishAmerican identity. Communication Studies, 51(4), 372-387.
24.
Hecht, M.L., Faulkner, S.L., Meyer, C.R., Niles, T.A., Golden, D., & Cutler, M. ( 2002). Looking through Northern Exposure at Jewish American identity and the communication theory of identity. Journal of Communication, 52(4), 852-869. doi:10.1111/j.1460-2466.2002.tb02577.x
25.
Hecht, M.L., Jackson, R.L., & Pitts, M. ( 2005). Culture: Intersection of intergroup identity theories . In A. Reyes (Ed.), Intergroup communications: Multiple perspectives (pp. 121-132). Newbury Park, CA: Sage.
26.
Hecht, M.L., Jackson, R.L., & Ribeau, S. ( 2003). African American communication: Exploring identity and culture (2nd ed.). Mahwah, NJ : Lawrence Erlbaum.
27.
Hecht, M.L., Ribeau, S., & Alberts, J.K. ( 1989). An Afro-American perspective on interethnic communication . International Journal of Intercultural Relations, 14, 31-55.
28.
Heinz, B. ( 2001). ‘Fish in the river’: Experiences of bicultural bilingual speakers. Multilingua, 20(1), 85-108.
29.
Hogg, M.A., & Reid, S.A. ( 2006). Social identity, self-categorization, and the communication of group norms. Communication Theory, 16, 7-30. doi:10.1111/j.1468-2885 .2006.00003.x
30.
Howard, D.L., Konrad, T.R., Stevens, C., & Porter, C.Q. ( 2001). Physician-patient racial matching, effectiveness of care, use of services, and patient satisfaction. Research on Aging , 23(1), 83-108.
31.
Hsieh, E., Ju, H., & Kong, H. ( 2010). Dimensions of trust: The tensions and challenges in provider-interpreter trust. Qualitative Health Research, 20, 170-181. doi:10.1177/1049732309349935
32.
Hughes, P.C., & Baldwin, J.R. ( 2002a). Black, White, and shades of gray: Communication predictors of "stereotypic impressions." Southern Communication Journal , 68(1), 40-56.
33.
Hughes, P.C., & Baldwin, J.R. ( 2002b). Communication and stereotypical impressions. Howard Journal of Communications, 13, 113-128.
34.
Jung, E., & Hecht, M.L. ( 2004). Elaborating the communication theory of identity: Identity gaps and communication outcomes. Communication Quarterly, 52(3), 265-283.
35.
Kong, E., Deatrick, J.A., & Evans, L.K. ( 2010). The experiences of Korean immigrant caregivers of non-English-speaking older relatives with dementia in American nursing homes. Qualitative Health Research, 20, 319-329. doi:10.1177/1049732309354279
36.
Lindlof, T.R., & Taylor, B.C. ( 2002). Qualitative communication research methods (2nd ed.). Thousand Oaks, CA: Sage.
37.
MacRae, H. ( 2010). Managing identity while living with Alzheimer’s disease. Qualitative Health Research, 20, 293-305. doi:10.1177/1049732309354280
38.
McBride-Henry, K. ( 2010). The influence of the "they": An interpretation of breastfeeding culture in New Zealand. Qualitative Health Research, 20, 768-777. doi:10.1177/ 1049732310364220
39.
Olson, T., & Anders, R.L. ( 2000). Ethnicity, marginalization, and mental illness in Hawaii . Disability & Society, 15(3), 463-473.
40.
Orbe, M.P. ( 2004). Negotiating multiple identities within multiple frames: An analysis of first-generation college students. Communication Education, 53(2), 131-149.
41.
Palomares, N.A. ( 2004). Gender schemasticity, gender identity salience, and gender-linked language use. Human Communication Research, 30(4), 556-588. doi:ica_proceeding _11438.PDF
42.
Palomares, N.A. ( 2008). Explaining gender-based language use: Effects of gender identity salience on references to emotion and tentative language in intra- and intergroup contexts. Human Communication Research, 34, 263-286. doi:10.1111/ j.1468-2958.2008.00321.x
43.
Press, A.L., & Cole, E.R. ( 1995). Reconciling faith and fact: Pro-life women discuss media, science and the abortion debate. Critical Studies in Mass Communication, 12, 380-402.
44.
Safeer, R.S., & Keenan, J. ( 2005). Health literacy: The gap between physicians and patients . American Family Physician, 72(3), 463-468.
45.
Scholl, J.C., Heuman, A.N., & Hughes, P.C. ( 2009). Whiteness and dialectic tensions of patient-centeredness and Latinos’ end-of-life care experiences. Unpublished manuscript.
46.
Simons, L., Lathlean, J., & Squire, C. ( 2008). Shifting the focus: Sequential methods of analysis with qualitative data. Qualitative Health Research, 18, 120-132. doi:10.1177/1049732307310264
47.
Skuladottir, H., & Halldorsdottir, S. (2008). Women in chronic pain: Sense of control and encounters with health professionals. Qualitative Health Research, 18, 891-901. doi:10.1177/ 1049732308318036
48.
Smith-DiJulio, K., Windsor, C., & Anderson, D. ( 2010). The shaping of midlife women’s views of health and health behaviors. Qualitative Health Research, 20, 966-976. doi:10.1177/ 1049732310362985
49.
Spitzberg, B.H., Canary, D.J., & Cupach. W.R. ( 1994). A competence-based approach to the study of interpersonal conflict. In D. D. Cahn (Ed.), Conflict in personal relationships (pp. 183-202). Hillsdale, NJ: Erlbaum.
50.
Spitzberg, B.H., & Cupach. W.R. ( 1984). Interpersonal communication competence. Newbury Park, CA: Sage.
51.
Strauss, A., & Corbin, J. ( 1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). Thousand Oaks, CA: Sage.
52.
Street, R.L., & Giles, H. ( 1982). Speech accommodation theory: A social cognitive approach to language and speech behavior. In M. Roloff and C. R. Berger (Eds.), Social cognition and communication (pp. 193-226). Beverly Hills, CA: Sage.
53.
Ting-Toomey, S. ( 1981). Ethnic identity and close friendship among Chinese-American students. International Journal of Intercultural Relations , 5, 383-406.
54.
Ulrey, K.L., & Amason, P. ( 2001). Intercultural communication between patients and health care providers: An exploration of intercultural communication effectiveness, cultural sensitivity, stress, and anxiety. Health Communication , 13(4), 449-463.
55.
United States Census Bureau. (2006). 2006 American community survey data: Origins and language. Retrieved from www.factfinder.census.gov
56.
van Servellen, G. ( 2009). Communication skills for the health care professional: Concepts, practice, and evidence. Sudbury, MA: Jones and Bartlett.
57.
Ward, E.C., Clark, L., & Heidrich, S. ( 2009). African American women’s beliefs, coping behaviors, and barriers to seeking mental health services. Qualitative Health Research, 19, 1589-1601. doi:10.1177/1049732309350686
58.
Wenger, D.C.K. ( 2003). Improving cross-cultural communications between physicians and patients. Academic Physician & Scientist, 1-5.
59.
Witte, K., & Morrison, K. ( 1995). Intercultural and cross-cultural health communication: Understanding people and motivating healthy behaviors. In R. L. Wiseman (Ed.), Intercultural communication theory (pp. 216-246). Thousand Oaks, CA: Sage.
60.
Yehya, N.A., & Dutta, M.J. ( 2010). Health, religion, and meaning: A culture-centered study of Druze women. Qualitative Health Research, 20, 845-858. doi:10.1177/1049732310362400
