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Liang H, Reiss MJ, Isaacs T. Factors affecting physicians' attitudes towards patient-centred care: a cross-sectional survey in Beijing. BMJ Open 2023; 13:e073224. [PMID: 37015797 PMCID: PMC10083761 DOI: 10.1136/bmjopen-2023-073224] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVES Patient-centred care has been raised as an important component in providing high-quality healthcare services. This research aims to measure physicians' attitudes towards patient-centred care in Chinese healthcare settings and to identify the sociodemographic predictors of their attitudes using an exploratory research design. DESIGN A cross-sectional survey. SETTING Twelve hospitals in Beijing, China. PARTICIPANTS 1290 physicians from 12 hospitals in Beijing were invited to take part in the survey using snowball sampling methods. There was a response rate of 84% (n=1084), of which 1053 responses (82%) were valid and included in this research. METHODS This research used a survey containing a previously validated 6-point Likert scale called 'Chinese-revised Patient-Practitioner Orientation Scale' (CR-PPOS). Descriptive statistics and multivariable logistic regression analyses were performed to measure participants' attitudes and to identify the sociodemographic predictors of Chinese physicians' attitudes towards patient-centred care. RESULTS Gender, professional title (ie, seniority) and hospital type influence Chinese physicians' attitudes towards patient-centred care. Female physicians, physicians with intermediate titles and those who work in tertiary (ie, top-level) hospitals tend to have higher patient-centred attitudes (OR=1.532, 95% CI 1.160 to 2.022; OR=2.089, 95% CI 1.206 to 3.618; OR=2.198, 95% CI 1.465 to 3.297) than male physicians with other titles, and than those who work in first, secondary or private hospitals. Physicians working in non-surgical departments, those who have received training in doctor-patient communication, and those who are satisfied with their income obtained high patient-centred scores, both on the overall CR-PPOS and its two subscales. CONCLUSIONS This research identified sociodemographic predictors of Chinese physicians' attitudes towards patient-centred care. The findings contribute to knowledge of factors to be considered in reforming medical education and the Chinese healthcare system to improve physician-patient relationships and provide high-quality healthcare to patients. However, these findings are exploratory in nature and require further investigation to establish their validity and generalisability.
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Affiliation(s)
- Haiying Liang
- Institute of Education, University College London, London, UK
| | - Michael J Reiss
- Institute of Education, University College London, London, UK
| | - Talia Isaacs
- Institute of Education, University College London, London, UK
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Song W, Hao Y, Cui Y, Zhao X, Liu W, Tao S, Xue Y, Liu C, Zhang Q, Jiao M, Xu W, Sun H, Li Y, Shan L, Zhao J, Liang L, Wu Q. Attitudes of medical professionals towards patient-centredness: a cross-sectional study in H City, China. BMJ Open 2022; 12:e045542. [PMID: 35063951 PMCID: PMC8785163 DOI: 10.1136/bmjopen-2020-045542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Patient-centred communication improves patient experiences and patient care outcomes. This study aimed to assess the preference of medical professionals in China towards patient-centred communication under the context of the deteriorating doctor-patient relationship. METHODS A cross-sectional survey of medical professionals was conducted in January and February 2018 in H City of Heilongjiang province, the northeast of China. The Chinese-Revised Patient-Practitioner Orientation Scale (CR-PPOS) was adopted to measure the individual preference of respondents towards patient-centredness in clinical communication. Multivariate logistic regression models were established to identify the sociodemographic (gender, age, marital status and educational attainment) and work experience (years of working, seniority, satisfaction with income, daily workload and perceived doctor-patient relationship) predictors of the preference towards patient-centredness. PATIENT AND PUBLIC INVOLVEMENT Not applicable. RESULTS A total of 618 valid questionnaires were returned. The CR-PPOS demonstrated acceptable reliability and validity. Overall, a low level of preference towards patient-centredness in clinical communication was found. Relatively higher scores on 'caring for patients' (20.42±4.42) was found compared with those on 'information/responsibility sharing' (15.26±4.21). Younger age, higher educational attainment, lower daily workload and a perception of harmonious doctor-patient relationship were associated with a higher preference towards patient-centredness in clinical communication. CONCLUSIONS A low level of preference towards patient-centredness in clinical communication was found in medical professionals in the northeast of China, which may further jeopardise the efforts to improve doctor-patient relationship.
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Affiliation(s)
- Weijian Song
- Department of Social Medicine,School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Humanity and Social Sciences, Harbin Medical University, Daqing, Heilongjiang, China
| | - Yanhua Hao
- Department of Social Medicine,School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yu Cui
- Department of Social Medicine,School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xiaowen Zhao
- Department of Social Medicine,School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Wei Liu
- Department of Social Medicine,School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Siyi Tao
- Department of Social Medicine,School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
- Academic Affair Office, Dean's Office of Clinical Medical College, Anhui Medical University, Hefei, Anhui, China
| | - Yuxin Xue
- Office of discipline supervision & investigation, Chengyang People's Hospital, Qingdao, Shandong, China
| | - Chaojie Liu
- Department of Public Health,School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Qiao Zhang
- Department of Social Medicine,School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Mingli Jiao
- Department of Social Medicine,School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Weilan Xu
- College of International Education, Qiqihaer Medical University, Qiqihaer, Heilongjiang, China
| | - Hong Sun
- Department of Social Medicine,School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ye Li
- Department of Social Medicine,School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Linghan Shan
- Department of Social Medicine,School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Juan Zhao
- Department of Social Medicine,School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Libo Liang
- Department of Social Medicine,School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qunhong Wu
- Department of Social Medicine,School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
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Yune SJ, Kang SH, Park K. Medical Students' Perceptions of Patient-Doctor Relationship in South Korea: Concept Mapping Analysis. Front Public Health 2021; 9:658220. [PMID: 34869134 PMCID: PMC8634939 DOI: 10.3389/fpubh.2021.658220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The patient-doctor relationship has evolved from early paternalism to a consumerism and partnership model that emphasizes cooperation. Patient-doctor relationships might vary with the socio-cultural environment, because the medical environment affects such relationships. Method: We investigated the patient-doctor relationship among medical students through concept mapping analysis. Twenty-six fourth-grade Korean medical students wrote a reflection journal and participated in the concept classification and the importance evaluation of the derived concept. ALSCAL multidimensional scaling and Ward hierarchical cluster analysis were performed. Also, the 5-point Likert scale was used to evaluate the importance of the concept. Results: Sixty-six statements about the patient-doctor relationship were extracted and grouped into six clusters. The x-axis is the dimension of “Information-Respect,” and the y-axis is “Changeability-Persistence.” Six patient-doctor concepts were derived and students evaluated “Patient-centered” as the most important. Conclusions: Medical students express various concepts of the patient-doctor relationship. Considering that they may encounter various medical conditions and patients, it is necessary that they understand deeply the complex patient-doctor relationship.
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Affiliation(s)
- So Jung Yune
- Department of Medical Education, School of Medicine, Pusan National University, Busan, South Korea
| | - Seung Hee Kang
- Department of Lifelong Education and Counseling, Pukyong National University, Busan, South Korea
| | - Kwihwa Park
- Department of Medical Education, Gachon University College of Medicine, Incheon, South Korea
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Liu W, Hao Y, Zhao X, Peng T, Song W, Xue Y, Tao S, Kang Z, Ning N, Gao L, Cui Y, Liang L, Wu Q. Gender differences on medical students' attitudes toward patient-centred care: a cross-sectional survey conducted in Heilongjiang, China. PeerJ 2019; 7:e7896. [PMID: 31660273 PMCID: PMC6815647 DOI: 10.7717/peerj.7896] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 09/16/2019] [Indexed: 12/30/2022] Open
Abstract
Objectives Assessing medical students' attitudes toward patient-centred care is essential to bettering medical education. Based on doctor-patient relationships and the medical system in China, it is important to explore the impact of gender differences and other background factors on patient-centred attitudes and to provide references for medical education reform. Methods A cross-sectional study was conducted on fourth-year medical undergraduate students from November 2017 to March 2018 in Heilongjiang Province, Northeast China. The Chinese-revised Patient-Practitioner Orientation Scale (CR-PPOS), which has been validated in previous research, was used to measure the medical students' attitudes. The medical students' demographic data was collected, including their gender, age, information on whether they have siblings, family residence location, doctor(s) for parents, year in which the student first experienced clinical practice, and student category. Results A total of 513 students (91.12%) completed the survey. The Chinese medical students scored considerably higher for 'Caring' (including patients' preferences into the decision-making process) than for 'Sharing' (sharing information/responsibility with patients). These students tended to have patient-centred attitudes, as measured by an average overall CR-PPOS score of 3.63 (scores higher than 3.5 indicate patient-centred attitudes), which is higher than Malian (3.38) and Pakistani (3.40) medical students but lower than American (4.57) and Brazilian (4.66) students. Female students (P < 0.05) were significantly associated with more patient-centred attitudes and with higher 'Sharing' and 'Caring' subscale scores. Student category (P < 0.05) was associated with 'Sharing' and 'Caring' scores. Clinical hospital students (P < 0.05) were associated with more patient-centred attitudes and with higher 'Sharing' and 'Caring' subscale scores, Students without siblings (p < 0.07) were associated with the higher 'Sharing' subscale scores. Conclusions In China, gender has a significant impact on medical students' patient-centred attitudes, which is similar to findings from other countries. If medical schools want to raise patient-centred attitudes across the board and bridge the gap between male and female patient-centred attitudes, gender, student category, and other factors should be incorporated into medical education.
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Affiliation(s)
- Wei Liu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Yanhua Hao
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Xiaowen Zhao
- Department of Health Economics, School of Health Management, Harbin Medical University, Harbin, China
| | - Tao Peng
- Department of Sexual Health Education, School of Health Management, Harbin Medical University, Harbin, China
| | - Weijian Song
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China.,Department of Humanities and Social Sciences, Harbin Medical University, Daqing, China
| | - Yuxin Xue
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China.,Chengyang People's Hospital, Qingdao, China
| | - Siyi Tao
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Zheng Kang
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Ning Ning
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Lijun Gao
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Yu Cui
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Libo Liang
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Qunhong Wu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
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Attitudes Toward Patient-Centered Care in the Mental Care Services in Isfahan, Iran. Community Ment Health J 2019; 55:548-552. [PMID: 30535891 DOI: 10.1007/s10597-018-0357-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 12/04/2018] [Indexed: 10/27/2022]
Abstract
Understanding patient-physician relationships in mental care services is an indispensable element to improve the quality of mental care, yet little is known about it in Iran. This study measured the attitudes of the patients' family and personal caregivers (FPCs) and psychiatrists toward patient-centered care. A sample of 88 FPCs of mental patients and 29 psychiatrists in four teaching hospitals of Isfahan city, Iran, providing mental care, were asked to complete the patient-practitioner orientation scale (PPOS). Results showed mean scores of PPOS, sharing and caring for the psychiatrists were 3.4, 3.8, and 3.1, compared to 3.9, 4.2, and 3.7 for the mental patients' FPCs. There was a significant difference between the PPOS mean scores of the FPC and psychiatrist groups (p < 0.05) indicating that psychiatrists' attitudes were less patient-centered. Developing medical training interventions, establishing communication skills workshops, and increasing patients' awareness are some approaches to address the low level of patient-centered care.
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Wang J, Zou R, Fu H, Qian H, Yan Y, Wang F. Measuring the preference towards patient-centred communication with the Chinese-revised Patient-Practitioner Orientation Scale: a cross-sectional study among physicians and patients in clinical settings in Shanghai, China. BMJ Open 2017; 7:e016902. [PMID: 28928188 PMCID: PMC5623567 DOI: 10.1136/bmjopen-2017-016902] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 06/30/2017] [Accepted: 07/14/2017] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To adapt the Patient-Practitioner Orientation Scale (PPOS), to a Chinese context, and explore the preference towards patient-centred communication among physicians and patients with the Chinese-revised Patient-Practitioner Orientation Scale (CR-PPOS). DESIGN A cross-sectional questionnaire-based study. SETTING Clinical settings from eight medical units, including four community hospitals and four general hospitals, in Shanghai, China. PARTICIPANTS 1018 participants, including 187 physicians and 831 patients, completed this study in two successive stages. OUTCOME MEASUREMENTS Psychometric properties of the CR-PPOS and participants' score on the CR-PPOS. RESULTS Compared with the original PPOS, the 11-item CR-PPOS obtained better psychometric indices. Physicians and patients scored differently on both the total CR-PPOS and its two subscales. Compared with physicians, the scores of patients were more influenced by their personal characteristics, such as age and education. CONCLUSIONS The CR-PPOS is a better instrument in a Chinese context than the original translated version. The divergence in the extent to which patient-centred communication is preferred among Chinese physicians and patients should be noted. Adapting physicians' communication strategy to patients' preferences based on their personal characteristics can be a viable approach towards improving clinical efficiency.
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Affiliation(s)
- Jie Wang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Runyu Zou
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hua Fu
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Haihong Qian
- School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Yueren Yan
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
- School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Fan Wang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
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Hur Y, Cho AR, Choi CJ. Medical students' and patients' perceptions of patient-centred attitude. KOREAN JOURNAL OF MEDICAL EDUCATION 2017; 29:33-39. [PMID: 28264552 PMCID: PMC5339447 DOI: 10.3946/kjme.2017.51] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 11/17/2016] [Accepted: 11/22/2016] [Indexed: 05/29/2023]
Abstract
PURPOSE Patient-centred care can increase patient satisfaction and lead to better clinical outcomes for them, such as improved physical status and higher health-related quality of life. However, doctors' and patients' views on patient-centred attitude might differ and could be affected by culture and the community environment. To clarify the differences in primary care patients' and senior medical students' perceptions of medical students' patient-centred attitude. METHODS A total of 1,025 subjects-827 patients from primary care institutions and 198 fourth-year medical students from a medical college in South Korea-completed the Patient Practitioner Orientation Scale (PPOS). The students completed the self-reported questionnaire at the end of their clinical clerkship. Descriptive statistics, t-tests, and one-way analysis of variances were conducted in SPSS version 21.0. RESULTS Firstly, sharing subscale scores were higher among patients than among medical students (students, 3.61 vs. patients, 3.76; p<0.001), but secondly, caring subscale scores were higher among medical students (students, 4.18 vs. patients, 3.82; p<0.001). Thirdly, PPOS total scores were higher among medical students (students, 3.90 vs. patients, 3.79; p=0.001). Finally, male students had the lowest sharing scores (F=6.811, p<0.001) and female students showed the highest PPOS total scores (F=5.805, p=0.001). CONCLUSION Significant differences between medical students' and patients' perceptions of medical students' patient-centred attitudes suggest the necessity of educational efforts to overcome the gap between the groups.
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Affiliation(s)
- Yera Hur
- Department of Medical Education, Konyang University College of Medicine, Daejeon, Korea
| | - A Ra Cho
- Department of Medical Education, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang Jin Choi
- Department of Family Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Huh S. [How to increase the clinical performance of medical students]. KOREAN JOURNAL OF MEDICAL EDUCATION 2013; 25:73-75. [PMID: 25804686 PMCID: PMC8813499 DOI: 10.3946/kjme.2013.25.2.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 05/09/2013] [Accepted: 05/11/2013] [Indexed: 06/04/2023]
Affiliation(s)
- Sun Huh
- Corresponding Author: Sun Huh Department of Parasitology and Institute of Medical Education, College of Medicine, Hallym University, 1 Hallimdaehak-gil, Chuncheon 200-702, Korea Tel: +82.33.248.2652 Fax: +82.33.241.1672
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