Culture, gender and health care stigma: Practitioners' response to facial masking experienced by people with Parkinson's disease.
Culture, gender and health care stigma: Practitioners' response to facial masking experienced by people with Parkinson's disease.
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DOI：
10.1016/j.socscimed.2011.05.008
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发表时间：
2011-07
影响因子：
5.4
通讯作者：
Ma, Hui-ing
中科院分区：
文献类型：
--
作者：
Tickle-Degnen, Linda;Zebrowitz, Leslie A.;Ma, Hui-ing
关键词：
帕金森氏病的面部掩蔽是面部肌肉组织的自动和控制表达运动的减少，产生冷漠，社交脱离或受损的认知状态的外观。西方文化的研究表明，从业者形成与患者掩蔽相关的负面偏见印象。关于面部表情的社会文化规范因文化和性别而异，但很少有研究研究这些因素对医生对面部表情不同的患者的反应的影响。本研究评估了掩蔽、文化和性别对医生对患者心理属性印象的影响。美国和中国台湾的从业人员（N=284）在访谈的视频剪辑中对12名白人美国人和12名亚洲台湾女性和男性患者进行了判断。每个患者组中有一半有中度的面部掩蔽，另一半有接近正常的表情。这两个国家的医生判断，与掩蔽程度较低的患者相比，掩蔽程度较高的患者更抑郁，更不善于社交，社会支持更少，认知能力更差。在判断美国患者的社交性时，医生更偏向于掩蔽，而美国医生对患者社交性的判断比台湾医生对掩蔽的反应更负偏。医师在判断台湾病患的认知能力与社交能力时，会因掩饰而产生更多的偏见，而台湾医师对病患认知能力的判断，在回应掩饰时，会比美国医师产生更多的负向偏见。高掩蔽的负面反应是更强的医生判断的女性比男性患者，特别是美国患者。研究结果表明，当地的文化价值观，以及种族和性别的刻板印象操作从业者的面部表情在临床印象形成的使用。
Facial masking in Parkinson’s disease is the reduction of automatic and controlled expressive movement of facial musculature, creating an appearance of apathy, social disengagement or compromised cognitive status. Research in western cultures demonstrates that practitioners form negatively biased impressions associated with patient masking. Socio-cultural norms about facial expressivity vary according to culture and gender, yet little research has studied the effect of these factors on practitioners’ responses toward patients who vary in facial expressivity. This study evaluated the effect of masking, culture and gender on practitioners’ impressions of patient psychological attributes. Practitioners (N=284) in the United States and Taiwan judged 12 Caucasian American and 12 Asian Taiwanese women and men patients in video clips from interviews. Half of each patient group had a moderate degree of facial masking and the other half had near-normal expressivity. Practitioners in both countries judged patients with higher masking to be more depressed and less sociable, less socially supportive, and less cognitively competent than patients with lower masking. Practitioners were more biased by masking when judging the sociability of the American patients, and American practitioners’ judgments of patient sociability were more negatively biased in response to masking than were those of Taiwanese practitioners. Practitioners were more biased by masking when judging the cognitive competence and social supportiveness of the Taiwanese patients, and Taiwanese practitioners’ judgments of patient cognitive competence were more negatively biased in response to masking than were those of American practitioners. The negative response to higher masking was stronger in practitioner judgments of women than men patients, particularly American patients. The findings suggest local cultural values as well as ethnic and gender stereotypes operate on practitioners’ use of facial expressivity in clinical impression formation.
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