What Satisfies Parents of Pediatric Patients in China: A Grounded Theory Building Analysis of Online Physician Reviews

Collaborative Care and Healthcare Usage in Families with Pediatric Patients During COVID-19: A Secondary Analysis of National Survey of Children's Health (NSCH) Data

One of the most detrimental side effects of the COVID-19 pandemic is the needed but not received care. Forgone health care affects the general public, but particularly children with special care needs. Previous research focused on non-modifiable factors, such as demographic background and insurance coverage. Based on Politi and Street's model of collaborative decision-making, we explored how two modifiable communication factors contributed to the prevention of forgone pediatric care during the COVID-19 pandemic. Using a nationally representative sample (n = 10845) from the 2020 National Survey of Children's Health (NSCH) survey, we found that health-care providers' family-centered communication and shared decision-making may reduce the possibility of forgone care through improved satisfaction with providers' communication. For children with mental health needs, providers' family-centered communication may also stimulate family's capacity to openly communicate, leading to better involvement in care and timely health care seeking. This helps to address COVID-related uncertainty, prevent higher health-care expenditures, and reduce negative health outcomes.

Consulting doctors online after offline treatment: investigating the effects of online information on patients' effective use of online follow-up services

Introduction

The use of online follow-up services (OFUS) is becoming an increasingly important supplement to hospital care. Through OFUS, patients can find their doctors in online health communities (OHCs) and receive remote medical follow-ups after hospital treatment. However, the rate of effective use of OFUS by current patients is still low, and there is an urgent need for research to investigate the online information factors that affect patients' effective use of OFUS.

Methods

Based on the elaboration likelihood model (ELM) of persuasion and an analysis of a panel dataset including 3,672 doctors in a leading OHC in China, this study explores how online information from doctors' knowledge contributions and patient feedback influences patients' effective use of OFUS.

Results

The results show that both doctors' knowledge contributions and patient feedback positively influence patients' effective use of OFUS. Doctors' paid knowledge contributions and patients' paid feedback have stronger persuasive effects than doctors' free knowledge contributions and patients' free feedback, respectively. Moreover, there is a substitutional relationship between doctors' paid and free knowledge contributions and between patients' paid and free feedback in influencing patients' effective use of OFUS.

Discussion

The findings of this study suggest that OHC platforms and healthcare providers should account not only for the persuasive effects of doctors' knowledge contributions and patient feedback but also for influential differences and relationships between the types of doctors' knowledge contributions and patient feedback to better persuade patients to effectively use OFUS.

When Culture Matters: Using Compliments and Complaints to Define and Influence Chinese Patients' Satisfaction

Despite patients' cultural background influencing their satisfaction with medical care the majority of studies draw on assumptions and models from the Western world. We move attention to the East Asian world by investigating the attributes of Chinese patients' satisfaction with their hospital in-patient care. Our research design is an exploratory qualitative study of 577 incidents of Chinese hospital in-patients' complaints and compliments. The data were drawn from a sample of reports of patients' satisfaction with their care in a district general hospital over a five-year period. Analysis focused on satisfactory and dissatisfactory events to derive attributes involved. We find patients in Chinese culture evaluate satisfaction with their care using eight attributes: professionalism, efficiency, chīn-chièh, respect, patience, responsibility, value and ethics. We explore how Chinese patients' values and beliefs toward medicine and care-giving construct distinct meanings around these attributes. By synthesizing our findings with those in the literature we propose generic attributes which can form the basis of measures of Chinese patient satisfaction and inform training in cultural competence.

Exploring the Effects of Online Physician Voice Pitch Range and Filled Pauses on Patient Satisfaction in Mobile Health Communication

The convenience of mobile devices has driven the widespread use of voice technology in mobile health communication, significantly improving the timeliness of online service. However, the issue of listening to therapeutic content, which requires great cognitive effort and may exceed the patient's information processing capacity (i.e., information overload), is of concern. Based on information processing theory, this study reports how online physicians' voice characteristics (pitch range and filled pauses) affect patient satisfaction. We obtained 10,585 mobile voice consultation records of 1,416 doctors from China's largest mHealth platform and analyzed them using audio mining and empirical methods. Results showed that pitch range (β = 0.0539, p < .01) and filled pauses (β = 0.0365, p < .01) in doctors' voice positively influenced online patient satisfaction. However, the effect of filled pauses becomes weaker for patients with higher health literacy and higher disease risk. This suggests that there is heterogeneity in the way different patients process audio information. This study provides important insights for guiding online physician behaviors, enhancing patient satisfaction, and improving mobile health platform management.

Validity of patients' online reviews at direct-to-consumer teleconsultation platforms: a protocol for a cross-sectional study using unannounced standardised patients

INTRODUCTION

As direct-to-consumer teleconsultation (hereafter referred to as 'teleconsultation') has gained popularity, an increasing number of patients have been leaving online reviews of their teleconsultation experiences. These reviews can help guide patients in identifying doctors for teleconsultation. However, few studies have examined the validity of online reviews in assessing the quality of teleconsultation against a gold standard. Therefore, we aim to use unannounced standardised patients (USPs) to validate online reviews in assessing both the technical and patient-centred quality of teleconsultations. We hypothesise that online review results will be more consistent with the patient-centred quality, rather than the technical quality, as assessed by the USPs.

METHODS AND ANALYSIS

In this cross-sectional study, USPs representing 11 common primary care conditions will randomly visit 253 physicians via the three largest teleconsultation platforms in China. Each physician will receive a text-based and a voice/video-based USP visit, resulting in a total of 506 USP visits. The USP will complete a quality checklist to assess the proportion of clinical practice guideline-recommended items during teleconsultation. After each visit, the USP will also complete the Patient Perception of Patient-Centeredness Rating. The USP-assessed results will be compared with online review results using the intraclass correlation coefficient (ICC). If ICC >0.4 (p<0.05), we will assume reasonable concordance between the USP-assessed quality and online reviews. Furthermore, we will use correlation analysis, Lin's Coordinated Correlation Coefficient and Kappa as supplementary analyses.

ETHICS AND DISSEMINATION

This study has received approval from the Institutional Review Board of Southern Medical University (#Southern Medical Audit (2022) No. 013). Results will be actively disseminated through print and social media, and USP tools will be made available for other researchers.

TRIAL REGISTRATION

The study has been registered at the China Clinical Trials Registry (ChiCTR2200062975).

Development of the Chinese Version of the Physician Internalized Occupational Stigma Scale (PIOSS)

Background/Objective

Internalized occupational stigma may develop in physicians as a result of their identification with the public negative labels and stereotypes about them, and then internalization of them as a part of their self-concept. This study aims to develop the Physician Internalized Occupational Stigma Scale (PIOSS) and to examine its reliability and validity.

Methods

In study 1, the initial scale was used to investigate 356 physicians. While in study 2, a total of 346 physicians were investigated with the survey tools named the PIOSS, the Career Commitment Scale (CCS), the Workplace Well-Being Scale (WWBS), the Scale for the Doctor with Patient-doctor Relationship (DDPRQ-10), the Intent to Leave Scale (ILS) and the Occupational Disidentification Scale (ODS).

Results

The PIOSS includes 19 items divided into 3 dimensions: label identification, status loss, and career denial. The results of confirmatory factor analysis (CFA) reveal that the three-factor model fitted well (χ 2/df=2.574, RMSEA= 0.068, CFI= 0.931, IFI= 0.931, TLI= 0.919, PNFI= 0.762, PCFI= 0.795). The PIOSS total and each dimension scores were significantly negatively correlated with the CCS and the WWBS scores and remarkably positively associated with the DDPRQ-10, the ILS, and the ODS scores. Cronbach's α coefficients for the PIOSS total scale and dimensions ranged from 0.775 to 0.914, and split-half reliability coefficients ranged from 0.801 to 0.931. In addition, the PIOSS exhibited cross-gender invariance.

Conclusion

Having good reliability and validity, the PIOSS can serve as a valid tool for the assessment of physician internalized occupational stigma.