Amanda Whittal

• Current societal shifts are moving us into an increasingly globalized world. For such changes to be successful, a deeper understanding of individuals and their behaviours is required. A key area where such an understanding is lacking is in the relationship and communication between doctors and immigrant patients, which is often challenging and can negatively influence the patients (Ng, 2011). This thesis explores attitudes of immigrant patients and host culture doctors towards immigrants, and how these attitudes interrelate with immigrants’ health behaviours and quality of life. Main theoretical assumptions include the notion that attitudes toward and from members of a host culture can influence a migrant's behaviours, as proposed by Berry's acculturation orientations (Berry, 1998, 2001), and that behaviour change depends on environment, people and behaviour (Bandura, 1986; Ward & Geeraert, 2016). Acculturation orientations of immigrant patients and their host culture doctors towards immigrant patients are examined for effects on (1) perceived quality of care, (2) immigrants’ health behaviours, and (3) immigrants’ quality of life. Measures were collected via interviews, medical visit video recordings, and questionnaires; health behaviours included nutrition, physical activity, and medical advice adherence, while quality of life was measured via the World Health Organization Quality of Life Instrument (WHOQOL) (WHO, 1991). Semi-structured qualitative interviews were conducted to assess similar topics in greater depth. Qualitative (Thematic Analysis and the Verona Coding System) and quantitative (ANOVA, regression and structural equation modelling) analyses were used. These investigations provide insights into how increased contact between cultures may impact health on an individual level, and how misunderstandings can be acknowledged and potentially intervened upon, to minimize detrimental effects and foster improved functioning for diverse members of society.