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Feng X, Li P, Hao X, Peng Y, Zhou R, Li W, Chen G, Zhu T. What are the frequent complaints voiced by inpatients and physicians amidst the emerging infectious diseases? - An illustrative instance of the COVID-19. BMC Infect Dis 2024; 24:792. [PMID: 39112945 PMCID: PMC11304773 DOI: 10.1186/s12879-024-09680-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 07/29/2024] [Indexed: 08/11/2024] Open
Abstract
INTRODUCTION Emerging infectious diseases (EIDs) can disrupt the healthcare system, causing regulatory changes that affect the healthcare-seeking process and potentially increase patient-physician dissatisfaction. This study aimed to collect and analyze patients' and physicians' complaints during an EID outbreak to inform potential clues regarding medical quality and patient safety enhancement in future dealing with EIDs, employing text mining methodologies. METHODS In this descriptive study, complaint records from January 2020 to February 2023 at West China Hospital, a national medical facility in China, were analyzed. Patient and physician complaints have been retrospectively retrieved from the record from the medical department, and then categorized into distinct groups based on reporting reasons, encompassing COVID-19-related policies, healthcare access, availability of medical resources, and financial concerns. RESULTS During the COVID-19 pandemic, 541 COVID-19-related complaints were identified: 330 (61.00%) from patients and 211 (39.00%) from physicians. The monthly volume of complaints fluctuated, starting at 10 in 2020, peaking at 21 in 2022, and dropping to 14 in 2023. Most complaints from inpatients were expressed by older males aged 40 to 65 (38.82%, 210/541). The primary source of complaints was related to mandatory COVID-19 policies (79.30%, 429/541), followed by concerns regarding timely healthcare services (31.61%, 171/541). Few complaints were expressed regarding the insufficiency of medical resources (2.77%, 15/541) and the high costs (4.25%, 23/541). The frequency of complaints expressed by doctors and patients in the emergency department was higher compared with other departments (24.58%, 133/541). CONCLUSIONS Increased complaints may serve as a primitive and timely resource for investigating the potential hazards and drawbacks associated with policies pertaining to EIDs. Prompt collection and systematical analysis of patient and physician feedback could help us accurately evaluate the efficacy and repercussions of these policies. Implementing complaints-based assessment might improve care standards in forthcoming healthcare environments grappling with EIDs.
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Affiliation(s)
- Xixia Feng
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, Sichuan University, Chengdu, Sichuan, China
- West China Hospital, The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, Sichuan University, Chengdu, Sichuan, China
| | - Peiyi Li
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, Sichuan University, Chengdu, Sichuan, China
- West China Hospital, The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, Sichuan University, Chengdu, Sichuan, China
| | - Xuechao Hao
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, Sichuan University, Chengdu, Sichuan, China
- West China Hospital, The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, Sichuan University, Chengdu, Sichuan, China
| | - Yalan Peng
- Department of Medical General, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ruihao Zhou
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, Sichuan University, Chengdu, Sichuan, China
- West China Hospital, The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, Sichuan University, Chengdu, Sichuan, China
| | - Weimin Li
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- West China Hospital, President's Office, Sichuan University, Chengdu, Sichuan, China
| | - Guo Chen
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
- Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, Sichuan University, Chengdu, Sichuan, China.
- West China Hospital, The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, Sichuan University, Chengdu, Sichuan, China.
| | - Tao Zhu
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
- Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, Sichuan University, Chengdu, Sichuan, China.
- West China Hospital, The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, Sichuan University, Chengdu, Sichuan, China.
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Gao Y, Yang Y, Wang S, Zhang W, Lu J. Has China's hierarchical medical system improved doctor-patient relationships? HEALTH ECONOMICS REVIEW 2024; 14:54. [PMID: 39023676 PMCID: PMC11256484 DOI: 10.1186/s13561-024-00520-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 06/14/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND AND OBJECTIVE Developing harmonious doctor-patient relationships is a powerful way to promote the construction of a new pattern of medical reform in developing countries. We aim to analyze the effects of China's hierarchical medical system on doctor-patient relationships, thus contributing to China's medical and health system reform. METHODS With panel data on prefectural-level cities in China from 2012 to 2019, we used a time-varying difference-in-differences model to evaluate the effect of hierarchical medical treatment policy. RESULTS Hierarchical medical treatment policies can significantly improve doctor-patient relationships, and this conclusion is supported by various robustness tests. And improving doctor-patient relationships can be indirectly realized by the optimization of resource allocation and saving of medical costs. In addition, the marginal effect of the pilot policy on doctor-patient relationships decreased with age within the city population. In focal cities and cities with high levels of fiscal spending on health care, the effect of the pilot policy on doctor-patient relationships was stronger. CONCLUSION While reinforcing the literature on the doctor-patient relationship, this study also provides a reference for further exploration of the pilot policy of hierarchical medical treatment and the development of new medical and health system reform in developing countries.
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Affiliation(s)
- Yang Gao
- School of Economics and Management, Northwest University, Xi'an, Shaanxi, China
- School of Economics, Qufu Normal University, Rizhao, Shandong, China
| | - Yang Yang
- School of Economics, Qufu Normal University, Rizhao, Shandong, China
| | - Shoupeng Wang
- School of Economics and Management, Northwest University, Xi'an, Shaanxi, China
| | - Wenqian Zhang
- School of Economics, Qufu Normal University, Rizhao, Shandong, China
| | - Jiao Lu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xianning West Road 28#, Xi'an, 710049, Shaanxi, China.
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Li H, Li L, Liu T, Tan M, He W, Luo Y, Zhong X, Zhang L, Sun J. Risk management and empirical study of the doctor-patient relationship: based on 1790 litigation cases of medical damage liability disputes in China. BMC Health Serv Res 2024; 24:521. [PMID: 38664671 PMCID: PMC11044444 DOI: 10.1186/s12913-024-10952-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 04/04/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Compensation for medical damage liability disputes (CMDLD) seriously hinders the healthy development of hospitals and undermines the harmony of the doctor-patient relationships (DPR). Risk management in the DPR has become an urgent issue of the day. The study aims to provide a comprehensive description of CMDLD in China and explore its influencing factors, and make corresponding recommendations for the management of risks in the DPR. METHODS This study extracted data from the China Judgment Online - the official judicial search website with the most comprehensive coverage. Statistical analysis of 1,790 litigation cases of medical damage liability disputes (COMDLD) available from 2015 to 2021. RESULTS COMDLD generally tended to increase with the year and was unevenly distributed by regions; the compensation rate was 52.46%, the median compensation was 134,900 yuan and the maximum was 2,234,666 yuan; the results of the single factor analysis showed that there were statistically significant differences between the compensation for different years, regions, treatment attributes, and trial procedures (P < 0.05); the correlation analysis showed that types of hospitals were significantly negatively associated with regions (R=-0.082, P < 0.05); trial procedures were significantly negatively correlated with years (R=-0.484, P < 0.001); compensat- ion was significantly positively correlated with years, regions, and treatment attributes (R = 0.098-0.294, P < 0.001) and negatively correlated with trial procedures (R=-0.090, P < 0.01); regression analysis showed that years, treatment attributes, and regions were the main factors affecting the CMDLD (P < 0.05). CONCLUSIONS Years, regions, treatment attributes, and trial procedures affect the outcome of CMDLD. This paper further puts forward relevant suggestions and countermeasures for the governance of doctor-patient risks based on the empirical results. Including rational allocation of medical resources to narrow the differences between regions; promoting the expansion and sinking of high-quality resources to improve the level of medical services in hospitals at all levels; and developing a third-party negotiation mechanism for medical disputes to reduce the cost of medical litigation.
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Affiliation(s)
- Hui Li
- School of Health Care Management, Anhui Medical University, 230032, Hefei, China
| | - Limin Li
- School of Health Care Management, Anhui Medical University, 230032, Hefei, China
| | - Tong Liu
- School of Health Care Management, Anhui Medical University, 230032, Hefei, China
| | - Meiqiong Tan
- The Second Clinical Medical College, Anhui Medical University, 230032, Hefei, China
| | - Wanwan He
- The Second Clinical Medical College, Anhui Medical University, 230032, Hefei, China
| | - Yuzhu Luo
- The Second Clinical Medical College, Anhui Medical University, 230032, Hefei, China
| | - Xuerong Zhong
- The Second Clinical Medical College, Anhui Medical University, 230032, Hefei, China
| | - Liping Zhang
- School of Marxism, Anhui Medical University, 230032, Hefei, China.
| | - Jiangjie Sun
- School of Health Care Management, Anhui Medical University, 230032, Hefei, China.
- School of Management, Hefei University of Technology, 230039, Hefei, China.
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Xu H, Wang B. Humanization helps build a harmonious doctor-patient relationship. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20231497. [PMID: 38656015 DOI: 10.1590/1806-9282.20231497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 04/26/2024]
Affiliation(s)
- Haibo Xu
- Binzhou University, Department of Physical Education - Binzhou, China
| | - Baogui Wang
- Binzhou University, Department of Biological and Environmental Engineering - Binzhou, China
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Dai J, Lyu F, Yu L, Zhou Z, He Y. Medical service quality evaluation based on LDA and sentiment analysis: Examples of seven chronic diseases. Digit Health 2024; 10:20552076241233864. [PMID: 38465296 PMCID: PMC10921859 DOI: 10.1177/20552076241233864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 03/12/2024] Open
Abstract
Objective In this article, we investigate how chronic noncommunicable disease (CND) patients evaluate the medical service, and what obstacles exist in this process, which is useful for hospitals to improve efficiency and enhance patient satisfaction. Methods Based on the total number of CND patients in China, 7 CNDs were selected as the evaluation objects, and then selected the Haodaifu website as the data source, crawled 15,682 medical service reviews, then the 9 themes were analyzed by the LDA theme model. The evaluation index system of six indicators was constructed based on quality management theory. The binary long short-term memory model was used to analyze the sentiment, and the entropy-valued, TOPSIS and gray correlation model was implemented for medical service quality evaluation; the barrier model was used to find out the key factors limiting medical services. Results (a) Hypertension was rated at a good level in the degree of gray correlation closeness, bronchitis was rated at a low level and the rest were at an intermediate level. (b) The first two overall barriers were the hospitalization process and registration services which occupy about 30%, respectively. This implies that hospitals should focus on providing registration services and inpatient settings in the future. Conclusion To promote hospitals to provide better services for patients with CNDs and improve patient satisfaction with medical care. And it is necessary to optimize medical services fundamentally by optimizing the inpatient process and improving the registration process to improve efficiency.
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Affiliation(s)
- Jing Dai
- Faculty of Management and Economics, Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Fang Lyu
- Faculty of Management and Economics, Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Lin Yu
- Faculty of Management and Economics, Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Zixuan Zhou
- Faculty of Management and Economics, Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Yunyu He
- Department of Gynecology, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China
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Tan Y, Wang J, Chen H, Yang M, Zhu N, Yuan Y. Exploring the cultivation of psychological resilience in medical students from the perspective of doctor-patient relationship. MEDICAL TEACHER 2023:1-5. [PMID: 38146748 DOI: 10.1080/0142159x.2023.2295793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/13/2023] [Indexed: 12/27/2023]
Abstract
The current medical model has transitioned from the original biomedical treatment model to a bio-psycho-social model, where patients now have higher demands for service awareness. Consequently, doctor-patient relationships have become a crucial aspect of the contemporary medical process. Currently, psychological resilience among medical students in China tends to be at a moderately lower level. Medical students often exhibit poor psychological qualities in handling contradictions in doctor-patient relationships. Moreover, there is a lack of emphasis on the education of corresponding psychological qualities for medical students during the teaching process. This deficiency is highly disadvantageous for medical students in their future management of doctor-patient relationships. The article explores how to cultivate psychological resilience in medical students and enhance their ability to handle conflicts in doctor-patient relationships from the perspective of doctor-patient relationships. The author suggests that schools should place greater emphasis on the psychological resilience of medical students, change teaching methods, incorporate online education to enhance the mentalization level of medical students, and propose an eight-week mindfulness cognitive therapy program to improve psychological resilience. The intervention process should consider establishing positive coping mechanisms, promoting good interpersonal relationships among medical students, and regulating individual negative emotions. Through simulating doctor-patient scenarios, teachers should consciously train the psychological resilience of medical students, improve their cognition and thinking abilities, and accelerate their psychological health recovery.
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Affiliation(s)
- Yinuo Tan
- Department of Medical Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
- Cancer Center, Zhejiang University, Hangzhou, PR China
| | - Juan Wang
- Department of Medical Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
- Cancer Center, Zhejiang University, Hangzhou, PR China
| | - Haiyan Chen
- Cancer Center, Zhejiang University, Hangzhou, PR China
- Department of Radiation Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
| | - Mengyuan Yang
- Department of Medical Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
- Cancer Center, Zhejiang University, Hangzhou, PR China
| | - Ning Zhu
- Department of Medical Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
- Cancer Center, Zhejiang University, Hangzhou, PR China
| | - Ying Yuan
- Department of Medical Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
- Cancer Center, Zhejiang University, Hangzhou, PR China
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Li X, Ye J, Feng J, Chen Q, Qu G, Wan Z, Lei Z, Ferrier A, Jiang H, Zheng Y, Gan Y. Willingness to maintain contracts with family doctors among Chinese residents: results from one national cross-sectional study and a meta-analysis of 25 studies. Front Public Health 2023; 11:1162824. [PMID: 38186714 PMCID: PMC10770837 DOI: 10.3389/fpubh.2023.1162824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 12/01/2023] [Indexed: 01/09/2024] Open
Abstract
Background A number of studies have investigated the influencing factors regarding the renewal of contracts associated with Family Doctor Contract Services (FDCS) in different regions of China since it was officially implemented in 2009; however, none of the previous studies have been considered using a nationally representative sample in combination with a meta-analysis. Methods A multistage stratified sampling method was used to investigate participants' socio-demographic characteristics, health status, understanding, use, and evaluation of the FDCS, and their willingness to renew contracts in Eastern, Central, and Western China from September to November 2021. We searched the PubMed, Ovid Medline, CNKI, VIP, Wanfang, and SinoMed databases to retrieve previous studies related to the willingness of Chinese residents to renew contracts with their family doctor (FD), and a meta-analysis was performed to systematically summarize the willingness to maintain contracts and influencing factors. Results Among 2,394 residents, 2,122 (88.64%) were willing to renew their contracts. The mixed-effect logistic regression model results demonstrated that residents who (1) preferred primary health service institutions, (2) had a better knowledge of FDCS, (3) were more willing to visit primary health service after signing the contract with FDs, (4) were not intending to change FDs, (5) were satisfied with FDCS, and (6) trusted in FDs reported a higher level of willingness to maintain contracts with FDs. Our meta-analysis confirmed that older age, being married, having chronic diseases, choosing primary medical institutions for the first contact, having a good knowledge of FDCS/FDs, being satisfied with FDCS and the medical skills of FDs, and trusting FDs were all positively associated with residents' willingness to renew contracts (p < 0.05). Conclusion The willingness of consumers to maintain contracts with FDs in China varies in different areas. Giving priority services to groups of high need contributed to an improved rate of renewal. We suggest that in order to continue to increase annual contract renewal, it is necessary to strengthen consumer awareness through effective marketing and continue to work toward meeting consumer expectations, thereby increasing confidence and trust in FDCS.
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Affiliation(s)
- Xinyan Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jun Ye
- Department of Public Management, School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jing Feng
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qiaosen Chen
- Division of Cardiovascular Medicine, Department of Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Ge Qu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhengyi Wan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zihui Lei
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Adamm Ferrier
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Heng Jiang
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Yanling Zheng
- Department of General Practice, Shouyilu Street Community Health Service Center, Wuhan, Hubei, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Chen L, Zhang J, Zhu Y, Shan J, Zeng L. Exploration and practice of humanistic education for medical students based on volunteerism. MEDICAL EDUCATION ONLINE 2023; 28:2182691. [PMID: 36840966 PMCID: PMC9970200 DOI: 10.1080/10872981.2023.2182691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/29/2022] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
Humanistic education aims to promote educated people's practical and conscious activities to enhance their humanity, cultivate ideal personalities, and realize personal and social values, to develop a humanistic spirit. The advancement of higher education in China has led to the proposal to strengthen scientific and humanistic education integration. Medicine is between science and humanities, shouldering the important task of training senior medical personnel, the quality of medical students will affect the quality of future medical and health work; thus, medical students must explore and practice humanistic education. Promoting and practicing volunteerism is a specific act of constructing spiritual civilization in the whole society, and it is also considered beneficial for improving citizens' sense of responsibility and dedication. Medical students' practice of volunteerism and help in society is a precise manifestation of humanistic care. This review summarizes medical students' exploration and practice of humanistic education in volunteering.
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Affiliation(s)
- Lizhi Chen
- Department of Science and Education, Guangdong Second Provincial General Hospital, Guangzhou, P.R. China
| | - Jiayi Zhang
- School of Medicine, Jinan University, Guangzhou, P.R. China
| | - Yingjun Zhu
- School of Medicine, Jinan University, Guangzhou, P.R. China
| | - Jie Shan
- Department of Science and Education, Guangdong Second Provincial General Hospital, Guangzhou, P.R. China
| | - Luxian Zeng
- Unions of Trade, Guangdong Second Provincial General Hospital, Guangzhou, P.R. China
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Deng J, Xu Y, Li Q, Yang W, Deng H. The relationship between psychological capital, patient's contempt, and professional identity among general practitioners during COVID-19 in Chongqing, China. PLoS One 2023; 18:e0287462. [PMID: 37812597 PMCID: PMC10561861 DOI: 10.1371/journal.pone.0287462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/06/2023] [Indexed: 10/11/2023] Open
Abstract
General practitioners are crucial in the primary healthcare system as well as for epidemic prevention and control. However, few researchers have examined their professional identity. This study investigated the current status of the professional identity of general practitioners in Chongqing, China and explored the effects of psychological capital and patient's contempt on their professional identity. From December 2021 to January 2022, randomized cluster sampling was used to conduct a cross-sectional online self-assessment questionnaire survey among general practitioners in Chongqing. In total, 2,180 general practitioners working for more than one year were selected. General practitioners' sense of professional identity, mental health, and sense of patients' disrespect were measured using the Professional Identity Scale, Psychological Capital Questionnaire, and Patient's Contempt Questionnaire. Sociodemographic characteristics were also collected. A multiple linear regression model was used to analyze the association between professional identity, psychological capital, and patient's contempt. The average score for professional identity among general practitioners was 53.59 (SD = 6.42). The scores for self-efficacy, hope, resilience, and optimism (subscales of psychological capital) were 26.87 (SD = 5.70), 26.47 (SD = 5.74), 26.97 (SD = 5.55), and 26.86 (SD = 5.59), respectively. The score for perceived contempt was 34.19 (SD = 7.59). An average monthly income greater than CNY 8,000 (β = 1.018, p < 0.001), work tenure of more than 15 years (β = 0.440, p = 0.001), hope (β = 0.249, p < 0.001) and a higher optimism score (β = 0.333, p < 0.001) were positively correlated with professional identity. Having a bachelor's degree and above (β = -0.720, p = 0.014), an administrative role (β = -1.456, p < 0.001), self-efficacy (β = -0.122, p < 0.001), and higher patient's contempt (β = -0.103, p < 0.001) were negatively associated with professional identity. General practitioners in Chongqing demonstrated high professional identity and a strong psychological status during the COVID-19 pandemic. Psychological capital and patient's contempt were associated with professional identity. To improve general practitioners' professional identity, stakeholders should promote practitioners' mental health and physician-patient relationships in China.
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Affiliation(s)
- Jingzhi Deng
- Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yang Xu
- Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Qiaoya Li
- Department of General Practice, Yan’an Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Wen Yang
- Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Huisheng Deng
- Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
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Wang P, Cheng L, Li Y, Zhang Y, Huang W, Li S, Wang Z, Shan L, Jiao M, Wu Q. Factors and key problems influencing insured's poor perceptions of convenience of basic medical insurance: a mixed methods research of a northern city in China. BMC Public Health 2023; 23:1066. [PMID: 37277834 DOI: 10.1186/s12889-023-15993-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 05/26/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND This study aimed to explore the factors that affect insured's perceptions of convenience of the basic medical insurance (PCBMI) in Harbin, China and to diagnose the key problems to further propose corresponding measures. The findings provide evidence-based support for the reform of convenience of the basic medical insurance system (BMIS) and the cultivation of public literacy. METHODS We adopted a mixed methods design composing a multivariate regression model using the data from a cross-sectional questionnaire survey (n = 1045) of residents who were enrolled for BMIS in Harbin to identify the factors influencing the PCBMI. A quota sampling method was further adopted. Semi-structured interviews were then conducted with 30 important information providers selected by convenience sampling. Interpretative phenomenological analysis was employed to summarize and analyze the key problems. RESULTS Overall, approximately 51% of respondents reported poor PCBMI. The logistic regression model showed that insured without outpatient experience within two weeks (OR = 2.522, 95% CI = 1.267-5.024), had poorer levels of understanding of basic medical insurance information (OR = 2.336, 95% CI = 1.612-3.386), lived in rural areas (OR = 1.819, 95% CI = 1.036-3.195), had low levels of annual out-of-pocket medical expenses (OR = 1.488, 95% CI = 1.129-1.961), and were more likely to give the PCBMI a worse evaluation than their counterparts. The results of the qualitative analysis showed that the key problem areas of the PCBMI were the design of the BMIS, the cognitive biases of the insured, publicity information about the BMIS, and the health system environment. CONCLUSIONS This study found that in addition to the design of BMIS, the cognition of the insured, the BMIS information publicity and the health system environment are also the key problems hindering PCBMI. While optimizing system design and implementation, Chinese policymakers need to focus on the insured with low PCBMI characteristics. Moreover, it is necessary to focus on exploring effective BMIS information publicity methods, supporting public policy literacy and improving the health system environment.
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Affiliation(s)
- Peng Wang
- Department of Social Medicine, School of Health Management, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150081, China
- School of Public Health, Harbin Medical University, Harbin, 150081, China
| | - Lixia Cheng
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, 150081, China
| | - Ye Li
- School of Public Health, Harbin Medical University, Harbin, 150081, China
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150081, China
| | - Yuchao Zhang
- Department of Social Medicine, School of Health Management, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150081, China
- School of Public Health, Harbin Medical University, Harbin, 150081, China
| | - Weiqi Huang
- Department of Social Medicine, School of Health Management, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150081, China
- School of Public Health, Harbin Medical University, Harbin, 150081, China
| | - Shuyi Li
- Department of Social Medicine, School of Health Management, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150081, China
- School of Public Health, Harbin Medical University, Harbin, 150081, China
| | - Zhizhen Wang
- Department of Social Medicine, School of Health Management, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150081, China
- School of Public Health, Harbin Medical University, Harbin, 150081, China
| | - Linghan Shan
- Department of Social Medicine, School of Health Management, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150081, China.
- School of Public Health, Harbin Medical University, Harbin, 150081, China.
| | - Mingli Jiao
- School of Public Health, Harbin Medical University, Harbin, 150081, China.
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150081, China.
| | - Qunhong Wu
- Department of Social Medicine, School of Health Management, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150081, China.
- School of Public Health, Harbin Medical University, Harbin, 150081, China.
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Russo E, Giombi F, Paoletti G, Heffler E, Canonica GW, Pirola F, Mercante G, Spriano G, Malvezzi L, Keber E, SGCP, Giua C. Use, Abuse, and Misuse of Nasal Medications: Real-Life Survey on Community Pharmacist’s Perceptions. J Pers Med 2023; 13:jpm13040579. [PMID: 37108966 PMCID: PMC10142332 DOI: 10.3390/jpm13040579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/18/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Background: Medication overuse is an increasing global problem, especially for those rhinology diseases whose management requires over-the-counter drugs. This observational community pharmacy-based study aimed to investigate the actual use of the best-selling topical nasal medications and to characterize the clinical issues underlying their query through the pharmacist’s perception. Methods: In the pilot phase, a preliminary survey was developed by a team of researchers and tested on a small sample of practitioners to assess usability and intelligibility. Eventual amendments were made according to the feedback obtained, and the final version was submitted to practitioners working in 376 pharmacies evenly distributed over the Italian territory. Results: Two groups of customers (18–30 years old and 60–75 years old) were the ones who most frequently purchased topical decongestants. The dosage applied for sympathomimetic amines was higher than recommended in up to 44.4% and the duration of use longer than 5 days in up to 31.9% of the cases. Patients’ queries of alpha agonists and topical corticosteroids resulted in significantly higher numbers than practitioners’ prescriptions. Allergic rhinitis was the most common disease affecting patients seeking sympathomimetic amines. Conclusions: The prolonged use of sympathomimetic amines in patients suffering from rhinology diseases is a significant problem that requires greater attention in terms of social education and surveillance.
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Jiang MM, Wu ZY, Tu AX. Research on the Cooperative Governance Path of Multiple Stakeholders in Doctor-Patient Disputes under the Environment of Information Asymmetry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1597. [PMID: 36674353 PMCID: PMC9863217 DOI: 10.3390/ijerph20021597] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/11/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
The number of doctor-patient conflicts and disputes in China has been increasing recently. In order to solve the current social problems of the tense doctor-patient relationship and frequent medical disputes, this article, based on grounded theory, uses qualitative analysis software to conduct grounded coding on 622 cases of doctor-patient disputes randomly selected by stratification. After successively adopting open, axial, and selective coding, the relationship structure between the causes and development of medical disputes is summarized. Furthermore, this relationship structure can be used to analyze further and discuss the causes of doctor-patient disputes from the perspective of multiple co-governance and the governance framework of doctor-patient disputes. Finally, it reminds us of the need to standardize government's regulatory responsibilities, promote the equal distribution of medical resources, strengthen the communication awareness between doctors and patients, reduce the information asymmetry between doctors and patients, and build a preventive mechanism-oriented multi-subject collaborative governance path to promote the relationship between doctors and patients in China. We provide relevant countermeasures and suggestions for harmonious development and the smooth resolution of doctor-patient conflicts.
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Affiliation(s)
- Mao-Min Jiang
- School of Public Affairs, Xiamen University, Xiamen 361005, China
| | - Zheng-Yu Wu
- School of Public Affairs, Xiamen University, Xiamen 361005, China
| | - Ai-Xian Tu
- School of Management, Hainan Medical University, Haikou 571199, China
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Gu W, Liu Y, Lu Z, Wang J, Che X, Xu Y, Zhang X, Wang J, Du J, Zhang X, Chen J. Associated factors of burnout among Chinese vaccination staff during COVID-19 epidemic: A cross-sectional study. Front Public Health 2023; 11:1086889. [PMID: 36969614 PMCID: PMC10030716 DOI: 10.3389/fpubh.2023.1086889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/20/2023] [Indexed: 03/29/2023] Open
Abstract
Objective During the COVID-19 epidemic, vaccination staff had three main aspects of work: routine vaccination for children and adults, COVID-19 vaccination and COVID-19 prevention and control. All these works significantly increased the workload of vaccination staff. This study aimed to investigate the prevalence and influencing factors of burnout among vaccination staff in Hangzhou, China. Methods A total of 501 vaccination staff from 201 community/township healthcare centers in Hangzhou were recruited using a cross-sectional survey through WeChat social platform. The Maslach Burnout Inventory-General Scale (MBI-GS) was used to assess the level of burnout. Descriptive statistics were made on the characteristics of participants. Univariate analysis using the chi-square test and multivariable analysis using binary logistic regression were conducted to determine the relative predictors of burnout. Univariate analysis and multiple linear regression were used to determine the relative predictors of exhaustive emotion, cynicism, and personal accomplishment. Results During the COVID-19 pandemic, 20.8% of the vaccination staff experienced burnout. Educational level above undergraduate education level, medium professional title, and more working time in COVID-19 vaccination work reported a higher degree of job burnout. The vaccination staff was experiencing a high degree of exhaustive emotion, cynicism, and low personal accomplishment. Professional title, working place, and working time for COVID-19 vaccination were associated with exhaustive emotion and cynicism. Professional title and participation time for COVID-19 prevention and control were associated with personal accomplishment. Conclusions Our findings suggest that the prevalence rate of burnout is high among vaccination staff during the COVID-19 pandemic, especially with a low level of personal accomplishment. Psychological intervention for vaccination staff is urgently needed.
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