THE ROUGH GUIDE TO PSYCHOLOGYRelated to this, there’s evidence that the warnings on cigarette packs
could actually encourage some people to smoke. Jochim Hansen at
Basle University found that smokers who saw their habit as important
to their self-esteem (for example, they agreed with statements such as
“smoking allows me to feel valued by others”) were made to feel more
positive about smoking by death-related warnings on packs than by
neutral warnings (such as “smoking makes you unattractive”). Hansen
argued that this was because thoughts of death can make us seek ways
to boost our self-esteem (an effect explained by Terror management
theory, see p.227), and for some smokers that’s exactly what the act of
smoking provides.
Bedside manner
Traditionally, doctors were expected to assume a “paternalistic”
approach to patients. They were seen as the authoritative expert who
would make your symptoms go away. Today, the ideal doctor-patient
relationship is expected to be far more egalitarian. They are the
experts in diagnosis and treatment, but the patient is the expert on
symptoms and concerns. There’s also a greater emphasis on involving
patients in decision-making – a laudable aim, although many studies
show patients prefer their doctor to take ultimate responsibility for
medical decisions.
Patients do, however, want plenty of information, and countless
surveys have shown that doctors tend to underestimate this. There’s
also often a mismatch between the kind of technical information the
doctor provides – for example, about the disease stage and category- and the practical information that a patient seeks (such as degrees
of pain and the chances of recovery). Thanks to the amount of health
information available on the Internet, how doctors and patients
communicate has become a pressing issue, and new research is
needed to find out the best way forward.
Striking the right balance in communication isn’t an easy task for
doctors. If they are over-dependent on medical jargon, patients can
find it difficult to understand. Conversely, if they are too colloquial – for
example asking patients to “wee” for a urine sample – they can be seen
as patronizing. A study published in the early-1990s, by Jan Hadlow
at the Polytechnic of East London and Marian Pitts at the University
of Zimbabwe, found that it was the language of psychology-related
conditions, words such as “depression” and “migraine”, that tended to
cause the most confusion between doctors and patients – presumably
because many such terms have everyday meanings alongside their
medical usage.