When the world is closing in: Effects of perceived room brightness and communicated threat during patient-physician interaction

OBJECTIVE: The study proposes that room brightness creates impressions of a more spacious environment and that this perception positively impacts feelings and behaviors during high-threat conversations in particular.\ud \ud BACKGROUND: To a large extent healthcare providers depend on their patients' willingness to disclose information. In addition to characteristics related to the physician and topic of conversation, research indicates that environmental factors influence patients' affective experiences and self-disclosure.\ud \ud METHODS: A two-factor between-subjects experimental design was used in which participants (n = 90) were presented with a scenario describing a patient-physician encounter varying in communicated threat. Subsequently, participants were exposed to a picture in which room brightness was manipulated. Next, patient comfort, experienced spaciousness, and self-disclosure intentions were measured.\ud \ud RESULTS: An effect of brightness was found on affective experiences and self-disclosure intentions. In addition, the predicted interaction was obtained between brightness and communicated threat on these measures. Analyses confirmed that perceived spaciousness mediates the relationship between room brightness and self-disclosure intentions.\ud \ud CONCLUSIONS: The study confirms that brightness impacts self-disclosure intentions. Additionally, this relationship is influenced by psychological circumstances, with a more pronounced need for spaciousness when in an anxious state of mind. The results suggest that the physical environment can be used as a tool to improve active participation. In addition, the results stress the importance of attending to the patient's state of mind in creating the right atmospher

Determinants of perceived severity of hypertension and drug-compliance in mildly hypertensive patients.

Background:Severity of illness is not an important determinant of drug-compliance. In this paper we hypothesize that the perceived severity of illness rather than the true severity of illness is a determinant of drug-compliance. If this is true, then it will be worthwhile for physicians to look for factors determining this perceived severity of illness. Objectives: (I) To test in a prospective survey whether this hypothesis can be confirmed in mildly hypertensive patients, and (II) to identify factors determining their perceived severity of illness. Methods: 450 patients were invited to participate in a prospective survey if their systolic blood pressure had been between 140 and 170 mm Hg and their diastolic blood pressure between 90 and 100 mm Hg despite treatment, for at least three clinic visits. Based on previously published data three factors possibly contributing to the perceived severity of hypertension were identified: (1) objective medical information, (2) expected physical symptoms, and (3) a positive social identification with fellow-patients. These factors were used as independent determinants in a multiple linear regression model with perceived severity of hypertension as outcome variable. Subsequently, this outcome variable together with patient characteristics was used as an independent variable in a multiple logistic regression model with drug-compliance as outcome variable. Results: 176 patients, mean age 62 years, 52% females, completed the study. In the multiple linear regression analysis all of the three identified factors were statistically significant predictors of the perceived severity of hypertension with betavalues from 0.22 to 0.26, and p-values between 0.031 and 0.004. The multiple logistic regression analysis demonstrated that, after adjustment for gender, age, school, and general health status, the perceived severity of hypertension was a significant determinant of drug-compliance at p = 0.040. Discussion: The present study shows what information patients use to conclude on the level of their blood pressure being too high or not. This information can be used to better understand the patients ideas about health and possibly to influence these ideas. Patients conclusion about the level of their blood pressure predicted their drug-compliance. Our study increased insight into the psychology of the patient and the results may be helpful to physicians in order to further understand and influence patient behaviors, particularly, adherence to antihypertensive medication

Room to move: on spatial constraints and self-disclosure during intimate conversations

The tendency to disclose information is affected by several factors, including the environment in which a conversation takes place. The study reported investigates the effect of spaciousness impressions on self-disclosure during interviews on intimate lifestyle-related topics comprising substance intake, sexuality, and emotions. To influence perceived spaciousness, desk size (interpersonal space) and room size (architectural space) were manipulated. The results show that room size in particular affects self-disclosing behavior with increases in architectural space positively affecting self-disclosure. However, the effects obtained varied considerably across the different topics, and decreases in interpersonal space hampered self-disclosure on sexuality-related topics. Furthermore, nonverbal measures revealed that readjustments of posture, interpersonal distancing, and refrains from establishing eye contact are used to counteract space intrusions