Background: Workplace violence against healthcare workers is a global issue that is on the rise, with Chinese healthcare workers facing growing challenges with hospital violence. Attacks on medical staff have increased in recent years with no clear resolution. Prior research focused on policies to improve the doctor-patient relationship and better protect clinicians, but few studies addressed the patient perspective. This paper examines patients' choices when facing a medical dispute and identifies groups who are more likely to respond to conflict with violence or other serious actions.Methods: Patient survey responses were collected in 12 leading public hospitals in five Chinese provinces with 5556 participants. The survey asked sociodemographic information, patients' attitudes (e.g., general optimism, trust in their physicians, perceived healthcare quality), and their primary response to a medical dispute. From least to most severe, the options range from "complaining within the family" to "violence." We used t-tests and Chi-square tests to explore the relationships between reactions and patient characteristics. We also performed multivariable logistic regressions to determine the impact of sociodemographics and provider trust on the seriousness of responses. Results: The primary response of a third of respondents was complaining to hospital or health department officials (32.5%). Seeking legal help (26.3%) and direct negotiation with doctors (19.6%) were other frequent responses. More serious responses included 83 stating violence (1.5%), 9.7% expressing a desire to expose the issue to the news media, and 7.4% resorting to seeking third-party assistance. Patients who were more likely to report "violence" were male (OR = 1.81, p < .05), high-income earners (OR = 3.71, p < .05), or reported lower life satisfaction (OR = 1.40, p < .05). Higher trust scores were associated with a lower likelihood of a serious response, including violence (OR = 0.80, p < .01).

Objective We investigated the level of physician trust in China and how it is influenced by various demographic factors. MethodsWe surveyed 12 public hospitals from which inpatients were randomly selected using hospitalization ID and outpatients were selected using census sampling to participate in the interview. Trust in physicians was measured using the Chinese version of Wake Forest Physician Trust Scale. Mixed-effects and logistic models were employed to study correlates of trust. ResultsThe distribution of scale mean was left skewed, which implied a subpopulation bearing low levels of trust towards physicians. Respondents who were male, young, outpatients, unsatisfied with their life status, had high levels of education and income, and paid less attention to their health were prone to be less satisfied with their physicians. ConclusionsThe level of physician trust in China is lower compared to studies in western countries. We also found demographic factors related with significantly lower physician trust, which may help policymakers identify potential target subpopulations and be more specific with their efforts to improve patient-physician relationships.

Background and purpose. Stress has been recognized as a public health problem. However, little research has been done on gender differences in sources of stress and coping strategies in Hawaii. In this study, we hypothesized that: 1) women will report higher levels of stress than men; 2) women will report being stressed by family and health related stressors while men will report stress related to finances and work-related issues; 3) women will report using adaptive coping strategies more frequently while men will report using maladaptive and avoidance strategies more frequently; 4) there will be no gender differences in the readiness to use stress management strategies. Method. A statewide cross-sectional telephone-survey of 1518 participants was conducted during the spring and summer of 2006. Results. Women reported higher overall perceived stress levels, but there was no difference in the experienced social stressors and health stressors between genders. Men perceived more stress from personal factors. There were no gender differences in the perceived ability to cope with stress. However, women were more likely to use adaptive coping strategies, whereas men were more likely to use maladaptive and avoidance coping strategies. There were no significant gender differences in stages of change for stress management. Conclusion. Based on this study, interventions can be developed to help people better cope with stress. Interventions for women may focus on increasing the use of adaptive strategies such as praying and talking to friends and family, while interventions for men may introduce the use of adaptive coping strategies such as exercise and actively fighting causes of stress. This study shows that gender differences in stress levels and coping in Hawaii are similar to previous studies conducted on the mainland. More research into specific stressors and coping strategies may help tailor interventions that are more effective and comprehensive.

No abstract

BACKGROUND: Genetic research has potential benefits for improving health, such as identifying molecular characteristics of a disease, understanding disease prevalence and treatment, and developing treatments tailored to patients based on individual genetic characteristics of their disease. Indigenous people are often targeted for genetic research because genes are easier to study in communities that practice endogamy. Therefore, populations perceived to be more homogenous, such as Indigenous peoples, are ideal for genetic studies. While Indigenous communities remain the focal point of many genomic studies, some result in harm and unethical practice. Unfortunately, the harms of poorly formulated and unethical research involving Indigenous people have created barriers to participation that prevent critical and lifesaving research. These harms have led a number of Indigenous communities to develop guidelines for engaging with researchers to assist in safely bridging the gap between genetic research and Indigenous peoples. SPECIFIC AIMS: The specific aims of this study were: (1) to conduct an international review and comparison of Indigenous research guidelines that highlight topics regarding genetics and use of biological samples and identify commonalities and differences among ethical principles of concern to Indigenous peoples; and (2) develop policy recommendations for Indigenous populations interested in creating formal policies around the use of genetic information and protection of biological samples using data from specific aim 1. METHODS: A comparative analysis was performed to identify best research practices and recommendations for Indigenous groups from four countries: Canada, New Zealand, Australia, and the United States. The analysis examined commonalities in political relationships, which support self-determination among these Indigenous communities to control their data. Current international Indigenous guidelines were analyzed to review processes of how genetic research is conducted and the use of biological samples is handled with Indigenous peoples. RESULTS: Results suggest the need for genetic and genomic research policies for the world’s Indigenous people. Indigenous groups are most vulnerable to research exploitation and harm; therefore, identifying principles that work for Indigenous people will lead to best practices for all populations. CONCLUSIONS: Development and implementation of best practices informed by research guidelines in Canada, New Zealand, Australia, and the U.S. may be helpful to advise Indigenous leaders, policy makers, and researchers to the proper conduction of genetic research within Indigenous communities. Comparative analyses are a useful tool for identifying areas for further work in developing genetic research policy for Indigenous communities. OUTCOME: The outcomes of this analysis are relevant and useful to Indigenous communities and inform the development of community-based genetic research guidelines. The recommendations can be used in designing appropriate policies for future genomic research with Indigenous peoples.