The effects of culture and self-construal on responses to threatening health information.

OBJECTIVE: The current studies examined if cultural and self-construal differences in self-enhancement extended to defensive responses to health threats. DESIGN: Responses to fictitious medical diagnoses were compared between Asian-Americans and European-North Americans in experiment 1 and between Canadians primed with an interdependent versus an independent self-construal in experiment 3. In experiment 2, the responses of Chinese and Canadians who were either heavy or light soft drink consumers were assessed after reading an article linking soft drink consumption to insulin resistance. MAIN OUTCOME MEASURE: The primary-dependent measure reflected participants' defensiveness about threatening versus nonthreatening health information. RESULTS: In experiment 1, all participants responded more defensively to an unfavourable than a favourable diagnosis; however, Asian-Americans responded less defensively than did European-North Americans. In experiment 2, all high soft drink consumers were less convinced by the threatening information than were low soft drink consumers; however, among high consumers, Chinese changed their self-reported consumption levels less than did European-Canadians. In experiment 3, interdependence-primed participants responded less defensively to an unfavourable diagnosis than did independence-primed participants. CONCLUSION: Defensive reactions to threatening health information were found consistently; however, self-enhancement was more pronounced in individuals with Western cultural backgrounds or independent self-construals.

Referring patients with chronic noncancer pain to pain clinics: survey of Ontario family physicians.

OBJECTIVE: To examine the factors associated with FPs' referrals of patients with chronic noncancer pain to a tertiary care pain clinic. DESIGN: A questionnaire-based survey; data were analyzed using univariate methods. SETTING: A tertiary care pain clinic in Toronto, Ont. Participants All FPs who referred patients to the clinic between 2002 and 2005. MAIN OUTCOME MEASURES: Variables explored included FPs' sex, age, and ethnic background, ethnicity of patient groups seen, and FPs' rationale or barriers influencing referrals to specialized pain clinics. RESULTS: The response rate was 32% (47 of 148 FPs). There were no statistically significant differences between respondents and non-respondents in sex, age, duration of practice, and university of graduation, or between the variables of interest and the referral patterns of those who did respond. The mean age of respondents was 50 years; 47% of the FPs identified themselves as Canadian; and one-third of the respondents indicated that they referred more than 30 patients to pain clinics each year. The 3 most frequently cited reasons prompting referral to pain clinics were requests for nerve blocks or other injections, desire for the expertise of the program, and concerns about opioids; the 3 most prevalent barriers were long waiting lists, patient preference for other treatments, and distance from the clinic. CONCLUSION: Although the results of our survey of FPs identify certain barriers to and reasons for referring patients to pain clinics, the results cannot be generalized owing to the small sample of FPs in our study. Larger studies of randomly selected FPs, who might or might not refer patients to pain clinics, are needed to provide a better understanding of chronic noncancer pain management needs at the primary care level.