The fight against COVID-19 and the restoration of trust in Chinese medical professionals

Impact of COVID-19 Vaccine Persuasion Strategies on Social Endorsement and Public Response on Chinese Social Media

Persuading the public to get vaccinated against infectious diseases is critical and carries profound implications for preparing for future pandemics. This study examined whether and how persuasion strategies employed in pro-vaccine messages affect social endorsement and audience stance toward the COVID-19 vaccine expressed in comments on Chinese social media. Through manual coding and pre-trained BERT model, we analyzed 1,500 Weibo posts focused on COVID-19 vaccination persuasion and 238,201 associated comments. Results showed that medical experts succeeded in eliciting heightened social endorsement and receiving more pro-vaccine comments. Posts that employed negative emotional appeal were less likely to be liked or receive pro-vaccine comments. Besides, vaccine persuasion messages presented in a narrative format or emphasizing vaccine efficacy garnered significantly more likes but did not significantly receive more pro-vaccine comments. Discussing domestic issues or employing joy appeal received more pro-vaccine comments. These results offer valuable insights for health practitioners and communicators, highlighting more effective persuasion strategies for engaging citizens in vaccine-related discussions on social media. This study underscores the importance of leveraging persuasion tactics on social media to foster vaccination uptake and better prepare us for handling future pandemics.

Impact Analysis of COVID-19 Pandemic on Hospital Reviews on Dianping Website in Shanghai, China: Empirical Study

BACKGROUND

In the era of the internet, individuals have increasingly accustomed themselves to gathering necessary information and expressing their opinions on public web-based platforms. The health care sector is no exception, as these comments, to a certain extent, influence people's health care decisions. During the onset of the COVID-19 pandemic, how the medical experience of Chinese patients and their evaluations of hospitals have changed remains to be studied. Therefore, we plan to collect patient medical visit data from the internet to reflect the current status of medical relationships under specific circumstances.

OBJECTIVE

This study aims to explore the differences in patient comments across various stages (during, before, and after) of the COVID-19 pandemic, as well as among different types of hospitals (children's hospitals, maternity hospitals, and tumor hospitals). Additionally, by leveraging ChatGPT (OpenAI), the study categorizes the elements of negative hospital evaluations. An analysis is conducted on the acquired data, and potential solutions that could improve patient satisfaction are proposed. This study is intended to assist hospital managers in providing a better experience for patients who are seeking care amid an emergent public health crisis.

METHODS

Selecting the top 50 comprehensive hospitals nationwide and the top specialized hospitals (children's hospitals, tumor hospitals, and maternity hospitals), we collected patient reviews from these hospitals on the Dianping website. Using ChatGPT, we classified the content of negative reviews. Additionally, we conducted statistical analysis using SPSS (IBM Corp) to examine the scoring and composition of negative evaluations.

RESULTS

A total of 30,317 pieces of effective comment information were collected from January 1, 2018, to August 15, 2023, including 7696 pieces of negative comment information. Manual inspection results indicated that ChatGPT had an accuracy rate of 92.05%. The F1-score was 0.914. The analysis of this data revealed a significant correlation between the comments and ratings received by hospitals during the pandemic. Overall, there was a significant increase in average comment scores during the outbreak (P<.001). Furthermore, there were notable differences in the composition of negative comments among different types of hospitals (P<.001). Children's hospitals received sensitive feedback regarding waiting times and treatment effectiveness, while patients at maternity hospitals showed a greater concern for the attitude of health care providers. Patients at tumor hospitals expressed a desire for timely examinations and treatments, especially during the pandemic period.

CONCLUSIONS

The COVID-19 pandemic had some association with patient comment scores. There were variations in the scores and content of comments among different types of specialized hospitals. Using ChatGPT to analyze patient comment content represents an innovative approach for statistically assessing factors contributing to patient dissatisfaction. The findings of this study could provide valuable insights for hospital administrators to foster more harmonious physician-patient relationships and enhance hospital performance during public health emergencies.

Effect of Perspective-Taking on Trust Between Doctors and Patients: A Randomized Controlled Trial

Tension between doctors and patients as a social problem has existed for a long time; thus far, there is no good solution. From the perspective of trust between doctors and patients, this research studies the relieving effect of perspective-taking interventions on the tension between doctors and patients. This study used a randomized, single-blind online experiment. 133 participants were randomly divided into an intervention group (n = 67) and control group (n = 66). Participants were asked to complete writing tasks from the doctor's perspective. Patients' trust in doctors was measured at 3 time points: before intervention, immediately after intervention, and 10 days after the intervention. Findings showed a significant interaction effect between time measurement and group. In the intervention group, a pairwise comparison of time measurements showed a significant difference between T1 and T2. Perspective-taking interventions can improve patients' trust in doctors, but this effect diminishes over time.

Analysis on the relationship between professional identity and turnover intention among general practitioners: The mediating role of job burnout

OBJECTIVE

We aimed to understand the current situation and contributory factors associated with professional identity, turnover intention and job burnout among general practitioners (GPs) in eastern, central and western China.

METHODS

A total of 3244 GPs from community health service institutions in 12 provinces of China were recruited, from October 2017 to February 2018. Demographic information such as sex, region and mode of employment was sought, and issues regarding job burnout, professional identity and turnover intention of GPs were measured with the corresponding scale, and softwares such as SPSS and AMOS were used. T-test, analysis of variance, and covariance matrix were used for analysis.

RESULTS

The average total scores of job burnout, turnover intention and professional identity of GPs in China were 44.12, 15.07 and 51.23, respectively. The results of intermediary effect analysis showed that in the GPs group, there were differences in the distribution of the three indicators. Professional identity had a significant negative effect on job burnout (β = -0.373), while job burnout had a significant positive effect on turnover intention (β = 0.528), and job burnout had an indirect effect in the relationship between professional identity and turnover intention. Job burnout played an intermediary role in professional identity and turnover intention.

CONCLUSIONS

The turnover intention of GPs in China has improved, but it is still at a high level. Job burnout plays an intermediary role between professional identity and turnover intention.

Perceived a community with shared future for doctor-patient and benefit finding: a moderated mediation model

BACKGROUND

Under the background that the concept of a community with shared future for mankind has been advocated, the doctor-patient relationship has rapidly sublimated into a community with shared future for doctor-patient. The purpose of this study was to analyze the changes and relationships of anxiety, perceived a community with shared future for doctor-patient (PCSF), health self-consciousness (HSC) and benefit finding (BF) in the outbreak stage of COVID-19 and in the stable stage of COVID-19.

METHODS

The questionnaire consisted of a self-designed health self-consciousness scale, perceived a community with shared future for doctor-patient scale, revised 7-item generalized anxiety disorder scale and benefit finding scale. Questionnaires were administered in the outbreak stage of COVID-19 and in the stable stage of COVID-19 to address public anxiety, BF, and trust between medical staff and patients.

RESULTS

Risk perception will increase anxiety in public, and the public who trust medical staff and the ability of the government to prevent and control the epidemic will have a higher PCSF. Compared with those in the outbreak stage of COVID-19, PCSF, HSC and BF all decreased in the stable stage of COVID-19. HSC partly plays a mediating role in the process of the influence of PCSF and BF (95% CI = [0.3785, 0.5007], [0.2357, 0.3695], P < .001). The R-value of the model in the outbreak stage of COVID-19 and in the stable stage of COVID-19 were 0.555 and 0.429, and the value of R² was 0.308 and 0.184 respectively (P < .001). In the stable stage of COVID-19, the coefficient of anxiety ✕ PCSF is negative. The B values of anxiety and PCSF are positive, and the moderating effect is negative (P = .038). Anxiety has a negative moderating effect between PCSF and HSC, indicating that anxiety will weaken the positive impact of PCSF on HSC. It means that there exists a substitution relationship between anxiety and PCSF.

CONCLUSIONS

The common goal of medical staff and patients is health, and health is the premise of the meaning of life. Vigorously advocating for PCSF can not only promote a harmonious doctor-patient relationship, but also establish a good HSC and improve the understanding of the meaning of life in the public. Furthermore, if the common concept of a community with a shared future for doctor-patient is integrated into the values of life, it may be more stable and long-term to maintain a good doctor-patient relationship. In addition, we should guard against the influence of high-level anxiety on the path of meaning perception.

Effects of connection-based physician-patient relationships on perceptions of outcome: A vignette experiment

OBJECTIVES

To investigate the effects of media reports of medical outcomes and connection-based medicine on trust in physicians. In "connection-based medicine," people use personal connections to obtain better medical resources.

METHODS

Vignette experiments were used to investigate attitudes toward physicians among 230 cancer patients and their families (Sample 1) and a cross-validated sample of 280 employees from various industries (Sample 2).

RESULTS

For both samples, negative media reports were associated with lower trust in physicians; when the reports were positive, the participants generally perceived physicians as more competent and trustworthy. However, with negative reports, patients and families perceived connection-based physicians as less right and professional than non-connection-based physicians; the public (represented by the employee sample) perceived connection-based physicians as less right than non-connection-based physicians and negative outcomes to be caused more by connection-based physicians than non-connection-based physicians.

CONCLUSIONS

Medical reports can influence the perception of a physician's traits, which are important for trust. Positive reports promote evaluation of Rightness, Attribution, and Professionalism, whereas negative results may elicit the opposite effect, especially for connection-based physicians.

PRACTICAL IMPLICATIONS

Positive media images of physicians can help facilitate trust. Connection-based medical treatment should be reduced to improve access to medical resources in China.

Public trust of physicians in China improved since the COVID-19 pandemic Began

RATIONALE

Public trust in physicians had declined in China for decades before the COVID-19 pandemic. During the COVID-19 pandemic, frontline physicians have experienced high work volume despite a high risk of COVID-19 infection. The willingness of physicians to treat COVID patients with a high risk of exposure to the infection may have improved public trust in physicians.

OBJECTIVE

This study analyzes how public trust in physicians has changed since the pandemic started using a nationally representative survey.

METHODS

We used the China Family Panel Studies (CFPS), with 179,123 respondents 10 years or older who were eligible to answer the question on public trust in physicians from 2012 to 2020. Public trust has been measured by an 11-point Likert scale. A quasi pre-post study design using a segmented regression impact model was used to evaluate the impact of the COVID-19 pandemic on public trust in physicians.

RESULTS

At the start of the observation period, the average public trust score was 6.86 out of 10.00. The immediate unadjusted change of mean score for public trust during COVID-19 was significantly higher (Coef. = 0.361; 95% CI = 0.359, 0.364). Moreover, a significant increase in the unadjusted trend during the COVID-19 pandemic was observed in the mean score for public trust (Coef. = 0.005; 95% CI = 0.004, 0.006). The results were similar to the estimates obtained when we adjusted for demographic characteristics and health status.

CONCLUSIONS

The mean score for public trust increased during the COVID-19 pandemic. This study provides a new perspective on restoring public trust in physicians, a significant concern of the Chinese healthcare system. During the COVID-19 pandemic, social and mainstream media helped to establish the "good doctor" image, which may have improved patients' trust in physicians. Improving health literacy through effective communication and education may help increase public trust in physicians.

Current Status of Intergroup Threats Perceived by Chinese Physicians and Its Association with Organizational Psychology, Behavior, and Well-Being during the COVID-19 Pandemic: A Cross-Sectional Survey

(1) Background: Chinese physicians have encountered serious physical and verbal attacks in recent decades due to poor patient−physician relationships, leading to a broad spectrum of negative consequences. This study aims to assess the status of intergroup threats perceived by physicians and explore its association with organizational psychology, behavior, and well-being during the COVID-19 pandemic. (2) Methods: We conducted a cross-sectional online survey with physicians from November to December 2020 in three provinces: Heilongjiang Province, Henan Province, and Zhejiang Province, in China. A total of 604 physicians were recruited to complete an anonymous questionnaire. There were 423 valid questionnaires. (3) Results: We developed a 25-item intergroup threat scale with four dimensions: interest damage, performance impairment, value derogation, and unjust sentiment. Internal consistency reliability analyses showed that the four dimensions and overall scale exhibited high internal consistency (0.756−0.947). Additionally, the average scores for physicians’ perceived overall intergroup threat, interest damage, performance impairment, value derogation, and unjust sentiment were 4.35 ± 0.51, 4.24 ± 0.73, 4.33 ± 0.58, 4.22 ± 0.65, and 4.53 ± 0.55, respectively. Moreover, this study shows that the intergroup threats perceived positively by physicians were associated with psychological stress (β = 0.270, p < 0.01), emotional exhaustion (β = 0.351, p < 0.01), turnover intention (β = 0.268, p < 0.01), and defensive medical behavior (β = 0.224, p < 0.01), and were negatively associated with job satisfaction (β = −0.194, p < 0.01) and subjective well-being (β = −0.245, p < 0.01). (4) Conclusions: The newly developed scale in this study is a reliable tool for measuring intergroup threats perceived by Chinese physicians. Physicians in China were suffering high-level intergroup threats during the anti-COVID-19 pandemic, which has a significant impact on damage to organizational psychology, behavior, and well-being. Intergroup threats perceived by physicians not only enlarged the risk of emotional exhaustion and psychological stress but also threatened organizational well-being. Moreover, greater intergroup threats were associated with a lower job satisfaction, more frequent defensive medical behavior, and a higher turnover intention for physicians. The results of this study suggest that essential intervention and governance measures should be considered to protect physicians’ well-being and benefits in China, which are urgently needed.

The effects of the COVID-19 pandemic, risk perception, and perceived social support on public trust in physicians in China: A latent transition analysis

A population-based, longitudinal study was conducted among 29 provinces in mainland China to investigate how public trust in physicians (PTP) changed since the outbreak of COVID-19 and how the resulting lockdown and social support contributed to its restoration. The baseline sample (n = 3,233) was obtained during the period of the most rapid progression of COVID-19 (February 1 to 9, 2020, T1). Follow-up (n = 1,380) took place during the recovery period (March 17 to 24, T2). Latent profile models and a latent transition model were estimated. Participants were classified into either a moderate trust (21% at T1; 45% transition into high at T2) or a high trust (79% at T1; 88% remained in the high group) group in the latent profile. A latent transition from moderate to high trust was observed in locked-down regions and among those with higher social support. Social support moderated the transition from low to high trust. The current study showed that the epidemic outbreak and lockdown experience in China were associated with increased PTP; furthermore, public trust can be restored during a public health emergency. Attention should be paid to assure that social support and risk management strategies maintain PTP.

Doctor-patient relationship improved during COVID-19 pandemic, but weakness remains

OBJECTIVE

To assess the quality of the doctor-patient relationship (DPR) in China and possible influencing factors during the COVID-19 period from the patient's perspective.

METHODS

An online survey was carried out nationwide from March 12, 2020 to March 30, 2020 in China via a convenience sampling strategy. Patients who met the inclusion criteria were invited to complete a questionnaire regarding the quality of DPR, including sociodemographic information, the Patient-Doctor Relationship Questionnaire (PDRQ-9), and influencing factors for DPR during the pandemic.

RESULTS

A total of 1903 patients were included. Our result showed that participants had a higher PDRQ-9 score during the COVID-19 pandemic (4.18 ± 0.51) than that before the COVID-19 pandemic (3.86 ± 0.67). Importance-performance analysis (IPA) revealed that doctor-patient communication, patient satisfaction, consultation time, doctor's attitude, and medical knowledge were specific aspects that needed to be prioritized to improve the DPR. Multiple linear regression analysis suggested that positive media reports, telemedicine, and national policies had a significantly positive effect on the DPR during the pandemic (P < 0.05).

CONCLUSION

In general, the DPR had been improved during the COVID-19 pandemic. Our research found the key points that needed to be prioritized to improve the DPR during the pandemic, which may provide effective suggestions for building a harmonious DPR in the future.

Different variants of pandemic and prevention strategies: A prioritizing framework in fuzzy environment

In this trying time for the world battling different variants of the COVID'19 pandemic, different intervention strategies are being taken by government, to limit the spread of infection. Closing educational institutes, stay at home orders, campaigns for emphasis on vaccination, usage of medical mask and frequently sanitizing hands, etc. are the endeavors made by the authorities to decrease the number of cases in the country. In this regard, the contribution aims to help the decision-makers to identify a potential prevention strategy, based on public acceptance and intervention effectiveness. To achieve this objective, feasible judgments of professionals from three different sectors are brought together through meetings. Opinions, based on ten criteria, are recorded in linguistic form for prioritizing six alternatives. The linguistic terms are then evaluated and manipulated by entailing triangular fuzzy numbers and a group multi-criteria decision making (GMCDM) approach. After using the fuzzy analytical hierarchy process (F-AHP) for the complex decisions, the fuzzy VIšekriterijumsko KOmpromisno Rangiranje method (F-VIKOR) is utilized to attain the closest ideal stratagem. Consequently, through the ranking orders of defuzzified scores, intuitive preference of compromise solutions is suggested. The tactic gaining more priority with respect to the group utility to the majority and F-VIKOR index is complete lockdown for the short term. Furthermore, a comparison analysis is also added in the discussion to verify the attained prioritized outcomes. This comparative study is carried out through the technique for order of preference by similarity to ideal solution (TOPSIS), which evidently produces the same preference of alternatives. In addition, this strategy can be apparently discovered to be an effective strategy adopted by different countries in successfully decreasing the number of cases.

General Perception of Doctor-Patient Relationship From Patients During the COVID-19 Pandemic in China: A Cross-Sectional Study

The doctor–patient relationship (DPR) is essential in the process of medical consultations and treatments. Poor DPR may lead to poor medical outcomes, medical violence against doctors, and a negative perception of the healthcare system. Little is known about how DPR is affected during this novel coronavirus disease 2019 (COVID-19) pandemic. This cross-sectional study aimed to explore the DPR during the COVID-19 pandemic. There were 1,903 participants in China (95% response rate) who were recruited during the pandemic online via convenience and snowball sampling. Several questionnaires were used to evaluate participants' attitudes toward DPR, including the Patient–Doctor Relationship Questionnaire (PDRQ-9), Chinese Wake Forest Physician Trust Scale (C-WFPTS), a survey on medical violence against doctors, factors that affect and improve DPR, and general trust in medical services. Results revealed that DPR improved, and doctor–patient trust increased compared to participants' retrospective attitude before the pandemic. In addition, patients' violence against doctors decreased during the pandemic. Better doctor–patient trust and lower violence toward doctors are related to better DPR. Furthermore, we found that the main factors that could improve DPR include communication between doctors and patients, medical technology and services, and medical knowledge for patients. This study helped to better understand DPR in China, which may contribute to future health policies and medical practices in order to improve DPR and doctor–patient trust.

The mediating effect of media usage on the relationship between anxiety/fear and physician-patient trust during the COVID-19 pandemic

OBJECTIVE

Our study explored whether and how media usage can mediate the path from anxiety and fear to physician-patient trust.

DESIGN

Study 1 was a population-based, longitudinal study using nationally representative data from 29 provinces in mainland China. The baseline sample (N = 3233) was obtained from February 1 to 9, 2020. Follow-up (N = 1380) took place during March 17 to 24, 2020. Study 2 was a machine learning-based sentiment analysis in which data were captured from Sina Weibo, a Chinese microblogging website, among the most popular official, unofficial, and health-related media accounts. The screened blogs from November to December 2019 and February to March 2020 were scored by Google APIs for positivity and magnitude.

MAIN OUTCOME MEASURES

Physician-patient trust.

RESULTS

Study 1 showed fear and anxiety affected changes in physician-patient trust through media usage, the indirect effect of which was 0.14 (0.03) and the 95% CI was [0.08, 0.19]. Study 2 indicated a more positive image of physicians after the outbreak compared to before [F (2, 3537) = 3.646, p = 0.026, partial η²=0.002].

CONCLUSION

The negative impact of anxiety and fear on physician-patient trust was mediated by media use, which can be explained by the more positive media image during the pandemic.

Doctor-Patient Relationship in the Eyes of Medical Professionals in China During the COVID-19 Pandemic: A Cross-Sectional Study

Background: Doctor-patient relationship (DPR) is very important for patient outcomes, especially during a public health emergency like the COVID-19 pandemic. However, few studies have evaluated DPR and related sentiments from medical professionals' perspectives. Thus, the aim of the study is to provide a better understanding of DPR from medical professionals' perspectives during the COVID-19 pandemic in China. Methods: A total of 979 medical professionals, including doctors, nurses, technicians, and other workers have completed a series of questionnaires to evaluate their attitudes toward DPR, trust, violence against doctors, factors that affected and improved DPR, and the importance of these factors on DPR. Analyses of variances (ANOVA) and linear regressions were used to analyze the effects of the pandemic, demographic variables, and various elements on DPR. Results: One-way ANOVA revealed a significant effect of education on recent DPR [F _{(2, 976)} = 6.17, p < 0.001 and trust at F _{(2, 976)} = 9.54, p < 0.001], indicating that individuals with higher level of education (bachelor's degree, Master's degree and above) showed poorer recent DPR and lower level of trust. The level of hospital also showed a significant effect on trust [F _{(5, 973)} = 3.79, p = 0.0021]. Cochran's Q test revealed a significant difference in factors that affected [Q₍₁₁₎ = 3,997.83, p < 0.001] and improved [Q₍₈₎ = 3,304.53, p < 0.001] DPR. Backward stepwise linear regressions revealed predictors for changes during [F _{(9, 969)} = 21.17, p < 0.001, R ² = 0.16], shortly after [F _{(7, 971)} = 54.98, p < 0.001, R ² = 0.28], and long after [F _{(10, 968)} = 37.83, p < 0.001, R ² = 0.29] the pandemic. Conclusions: Medical professionals' perceptions of DPR is important as they provide basis for the improvement in working environment of medical professionals and hospital visiting experience of patients, as well as healthcare policy making and preparation for future public health emergencies.