Effects of Participant Disclosure Tendencies and Physician Verbal Behavior on Participant Willingness to Disclose Facts: An Analogue Study

The current study attempts to explain some of the factors related to patient self-disclosure in the medical encounter, including gender dynamics, patient overall concealment tendency, and physician verbal behavior. Participants were asked to put themselves in the place of patients while listening to audio files of three staged doctor visits (no problem scenario, fatigue scenario, and diabetes scenario). The design of the study is a 2 (patient gender) x 2 (physician gender) x 3 (physician statement: symptom focused question, feeling focused question, or self-disclosure) factorial using perceived privacy and importance of facts and self-disclosure tendency as covariates. Participants' perceptions of the physician were measured, as well as their willingness to disclose specific information to this physician.

Results indicated that the experimental manipulation was indeed salient to the participants, and the proposed covariates were statistically useful. Initial analysis suggested that the no problem scenario was conceptually different from the other two scenarios. In the fatigue and diabetes scenarios, the feeling question resulted in greater likelihood of disclosure than did the symptom question. The self-disclosure statement resulted in the higher attractiveness ratings than did the symptom question in all three scenarios. Additional findings relating to gender were nearing critical significance levels. The findings did not support reciprocity theory in the medical encounter. There was support for the use of patient-centered interviewing methods to increase patient likelihood of disclosure. The strengths and limitations of analogue studies are discussed, as are recommendations for future studies, including studies with other cultural groups and patients with chronic or serious medical conditions.