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Utrecht University

Short biography Hans (J.A.M.) Harmsen, PhD, MD (GP)

Hans Harmsen is working as a GP in Rotterdam since 1980 in a multicultural neigbourhood. As a trainer of GP's he allied with the department of General Practice of the ErasmusMC in Rotterdam. Since 1999 he is also working par time at the same institute; first in research and since 2005 in GP training. His field of research is on intercultural communication. In 2003 he got his PhD by defending the thesis: 'When cultures meet in medical practice'. In 2004 he got the Telesphorus price of the Dutch College of General Practitioners for his thesis. The primay care given to patients from non-western ethnic minorities and the differences and disparities in care compared with the (mostly Dutch born) western patients has his interest as well in daily practice and GP education as in research.

Hans Harmsen

Department of General Practice, ErasmusMC, University Medical Centre Rotterdam The Netherlands. POB1738

Family doctor's practice
Wolphaertsbocht 109
3082 AG Rotterdam
Phone: +31 10 4290986
Mobile: +31 6 20976080
Fax.: +31 104298228


  • 1. Harmsen, J. (2003). When cultures meet in medical practice. Improvement in intercultural communication evaluated. Rotterdam, Erasmus University (Erasmus MC): 153.
  • 2. Harmsen, J. (2004). "Allochtone patienten op het spreekuur." Patient Care: 201-5.
  • 3. Harmsen, J. and M. Bruijnzeels (2005). "Etnisch-cultureel verschillende patiënten op het spreekuur, maakt het wat uit?" Huisarts en Wet. 48: 166-170.
  • 4. Harmsen, J. A., R. M. Bernsen, et al. (2005). "Assessment of mutual understanding of physician patient encounters: development and validation of a Mutual Understanding Scale (MUS) in a multicultural general practice setting." Patient Educ Couns. 59(2): 171-81. Epub 2004 Dec 21.
  • 5. Harmsen, J. A. M. (2002). "Problemen tussen huisartsen en allochtone patienten." Modern Medicine(4): 33-35.
  • 6. Harmsen, J. A. M., R. M. D. Bernsen, et al. (2005). "Impact of culture on perceived quality of care and satisfaction with the general practitioner." submitted.
  • 7. Harmsen, J. A. M., R. M. D. Bernsen, et al. (2001). "Werkbelasting van huisartsen: objectieve toename in 9 praktijken in Rotterdam en omgeving, 1992-1997 en een extrapolatie naar 2005 [Dutch: Workload of GPs: An objectively observed increase in 9 practices in the Rotterdam region, 1992-1997and extrapolation to 2005]." Ned Tijdschr Geneeskd 145(23): 1114-1118.
  • 8. Harmsen, J. A. M., R. M. D. Bernsen, et al. (2006). "Cultural dissimilarities in general practice:Development and validation of a patient's cultural background scale." J Immigr Health 8((april)): 115-24.
  • 9. Harmsen, J. A. M., R. M. D. Bernsen, et al. (2005). "Does an educational intervention in general practice decrease differences in quality of care between patients with a Western and non-Western cultural background?" Br J Gen Pract 55: 343-50.
  • 10. Harmsen, J. A. M., M. A. Bruijnzeels, et al. (1999). "Allochtone kinderen op het spreekuur. Communicatie tussen huisarts en allochtone ouders [Dutch: GP consultations with ethnic minority children. Communication between parents and the general practitioner]." Huisarts Wet 42(5): 211-215.
  • 11. Harmsen, J. A. M., L. Meeuwesen, et al. (2003). "When cultures meet in general practice: intercultural differences between GPs and parents of child patients." Patient Educ Couns 51: 99-106.
  • 12. Hilhorst, M., H. Harmsen, et al. (2004). "Culturele vaardigheden moet je trainen. Ervaringen uit de praktijk." Tijdschrift voor gezondheidszorg & ethiek (TGE) 14(4): 121-123.
  • 13. Schouten, B. C., L. Meeuwesen, et al. (2005). "The impact of an intervention in intercultural communication on doctor-patient interaction in The Netherlands." Patient Educ Couns. 58(3): 288-95.
  • 14. van Wieringen, J. C., J. A. Harmsen, et al. (2002). "Intercultural communication in general practice." Eur J Public Health 12(1): 63-6


Short biography L. Meeuwesen

Ludwien Meeuwesen is a social psychologist, and associate professor at the Interdisciplinary Social Science Department at Utrecht University, The Netherlands. In 1988 she got her Ph.D., writing a dissertation on doctor-patient communication. She has been a research fellow at the Dept. of General Linguistics and the Dept. of Clinical Psychology at Nijmegen University, and at the Academic Hospital of the Free University at Amsterdam. Since 1991 she is lecturer at the Dept. of Interdisciplinary Social Science at Utrecht University, and since 2002 she is associate professor.

Her specialization is research on communication in health care: doctor-patient communication, communication between health care providers, intercultural communication in health care, and family communication. These studies are based mainly on detailed transcripts of audio- and/or videotapes. Besides, she has done research on issues regarding women and health(care) (gender differences in language use, gender differences in health complaints, diagnosis and care). Recently she performed an interdisciplinary survey research on the issue of social contacts, social isolation and loneliness in modern society (life events, personal competences, health issues, neighborhoods and social participation).

Ludwien Meeuwesen, Ph.D.
Associate professor
Utrecht University
Interdisciplinary Social Science Department
P.O. Box 80.140
3508 TC Utrecht
The Netherlands

Tel. +31 30 253 6729
Fax +31 30 253 4733

Publications (selection)

  • Schouten, B.C., & Meeuwesen, L. (2006). Culture and medical communication: A review of the literature. Patient Education and Counseling.
  • Harmsen, J.A.M., Bernsen, R.M.D., Meeuwesen, L., Dorreboom, G., Thomas, S., Pinto, D., & Bruijnzeels, M.A. (2006). Cultural dissimilarities in general practice: Development and validation of a patient’s cultural background scale. Journal of Immigrant and Minority Health, 8, 115-124.
  • Hortulanus, R., Machielse, A., & Meeuwesen, L. (2006). Social isolation in modern socie-ty. London: Routledge.
  • Harmsen, J.A.M., Bernsen, R.M.D., Meeuwesen, L., Pinto, D., & Bruijnzeels, M.A. (2005). Assessment of mutual understanding of physician patient encounters: Development and validation of a mutual understanding scale (MUS) in a multicultural general practice setting. Patient Education and Counseling, 59, 171-181.
  • Schouten, B., Meeuwesen, L. & Harmsen, J.H.M. (2005). The impact of an intervention in intercultural communication on doctor-patient interaction in The Netherlands. Patient Education and Counseling, 58, 288-295.
  • Harmsen, H., Bernsen, R., Meeuwesen, L., Thomas, S., Dorreboom, G, Pinto, D., & Bruijnzeels, M. (2005). The effect of an educational intervention on intercultural communication: Results of a randomised controlled trial. British Journal of General Practice, 55, 343-350.
  • Meeuwesen, L. (2005). An interactional approach of medical communication: Towards a ‘pas de deux’. Patient Education and Counseling, 56, 251-254.
  • Meeuwesen, L. (2003). Sequential analysis of the phasing of the medical interview. Epidemiologia e Psychiatria Sociale, 12, 124-129.
  • Harmsen, H., Meeuwesen, L., Wieringen, J. van, Bernsen, R., & Bruijnzeels, M. (2003). When cultures meet in general practice: Intercultural differences between GPs and parents of child patients. Patient Education and Counseling, 51, 99-106.
  • Tates, K., Meeuwesen, L., Elbers, E., & Bensing, J. (2002). "I've come for his throat": Roles and identities in doctor-parent-child communication. Child: Care, Health & Development, 28, 109-116.
  • Tates, K., Elbers, E., Meeuwesen, L., & Bensing, J. (2002). Doctor-parent-child relationships: A 'pas de trois'. Patient Education and Counseling, 48, 5-14.
  • Meeuwesen, L., Bensing, J., & Brink-Muinen, A. van den (2002). Communicating fatigue in general practice and the role of gender. Patient Education and Counseling., 48, 233-242.
  • Tates, K., Meeuwesen, L., Bensing, J., & Elbers, E. (2002). Joking or decisionmaking? Affective and instru-mental behaviour in doctor-parent-child communication. Psycho-logy and Health, 17, 281-295.
  • Meeuwesen, L., Hortulanus, R., & Machielse, A. (2001). Social contacts and social isolation: A typology. The Nether-lands' Journal of Social Sciences, 37, 132-154.
  • Tates, K., & Meeuwesen, L. (2001). Doctor-parent-child communication: A (re)v-iew of the literature. Social Science and Medicine, 56, 839-851.
  • Tates, K., & Meeuwesen, L. (2000). "Let mum have her say": Turntaking in doc-tor-parent-child communication. Patient Education and Counseling, 40, 151-162.
  • Meeuwesen, L., & Kaptein, M. (1996). Changing interactions in doctor-parentchild com-municati-on. Psychology and Health, 11, 787-795.
  • Meeuwesen, L., Huyse, F.J., Koopmans, G.T., & Heimans, J.J. (1996). Supervised integrated screening of low-back pain patients by a neurologist: A randomized clinical trial. General Hospital Psychiatry, 18, 385-394.
  • Meeuwesen, L., Huyse, F.J., Koopmans, G.T., Meiland, F.J.M, & Donker, A.J.M. (1994). Psychiatric consultations in medical outpatients with abdominal pain: Patient and physician effects. The International Journal of Psychiatry in Medicine, 24, 339-356.
  • Arrindell, W.A., Meeuwesen, L., & Huyse, F.J. (1991). The Satisfaction With Life Scale (SWLS): Psychometric properties in a non-psychiatric medical outpatients sample. Personality and Individual Differences, 12, 117-123.
  • Meeuwesen, L., Schaap, C., & Staak, C. van der (1991). Verbal analysis of doctor-patient communication. Social Science and Medicine, 32, 1143-1150.


Short biography Barbara Schouten

Barbara Schouten has a master in social psychology and a PhD in (social) dentistry. She has worked at several universities in The Netherlands on projects related to health communication. At present, she works as an assistant professor at the department of communication of the University of Amsterdam and as a post-doc researcher at Utrecht University at the department of interdisciplinary social sciences.

Brief summary of research:

For my PhD, I studied patients’ and dentists’ knowledge, attitudes, self-efficacy and self-reported behaviour concerning patients’ rights in the field of informed consent. Specifically, I studied the association between patients’ attitudes and their corresponding behaviour in two domains: information-seeking and decision-making. Furthermore, the influence of patients’ characteristics and dentists’ behaviour on patients’ behaviour was investigated, as was the influence of these variables on patients’ and dentists’ satisfaction with the dental encounter. Data were collected by means of questionnaires and observational methods, partly existing ones, partly self-constructed.

As a post-doc, I researched the impact of patients’ cultural background on communication processes between patients and general practitioners. I have carried out a literature review and assessed the effects of an educational intervention on intercultural communication on doctor-patient interaction, measured through observational data. Furthermore, I studied the impact of self-construals and conversational indirectness on needs for information disclosure and participation in medical decision-making. Currently, as a post-doc researcher I am working on investigating the course of medical communication in groups of patients from different cultural backgrounds in general practice, and its relationship with mutual understanding. Verbatim transcripts of medical interviews, both high and low in mutual understanding between general practitioner and patient, are used to analyse content and structure of the conversations. At the University of Amsterdam, my research work focuses on cultural differences in interpersonal communication.

Utrecht University