Factors Influencing Trust towards Physicians among Patients from 12 Hospitals in China

Wang, Wenxin; Zhang, Hao; Washburn, David J.; Shi, Hongmei; Chen, Yinghua; Lee, Shinduk; Du, Yuxian; Maddock, Jay E.

doi:10.5993/ajhb.42.6.3

Cited by 18 publications

(38 citation statements)

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“…Few studies have discussed whether it could be a moderator. In China, in the context of unbalanced medical resource distribution and distrust between doctors and patients, this construct could play a more complicated role [66,68,80]. Our finding confirmed that this construct is a moderator, as trust had a significant moderation effect (beta=–.095; P =.049) on the path from PU to IU.…”

Section: Discussionsupporting

confidence: 74%

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Psychosocial Factors Affecting Artificial Intelligence Adoption in Health Care in China: Cross-Sectional Study

Ye¹,

Xue²,

He³

et al. 2019

J Med Internet Res

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BackgroundPoor quality primary health care is a major issue in China, particularly in blindness prevention. Artificial intelligence (AI) could provide early screening and accurate auxiliary diagnosis to improve primary care services and reduce unnecessary referrals, but the application of AI in medical settings is still an emerging field.ObjectiveThis study aimed to investigate the general public’s acceptance of ophthalmic AI devices, with reference to those already used in China, and the interrelated influencing factors that shape people’s intention to use these devices.MethodsWe proposed a model of ophthalmic AI acceptance based on technology acceptance theories and variables from other health care–related studies. The model was verified via a 32-item questionnaire with 7-point Likert scales completed by 474 respondents (nationally random sampled). Structural equation modeling was used to evaluate item and construct reliability and validity via a confirmatory factor analysis, and the model’s path effects, significance, goodness of fit, and mediation and moderation effects were analyzed.ResultsStandardized factor loadings of items were between 0.583 and 0.876. Composite reliability of 9 constructs ranged from 0.673 to 0.841. The discriminant validity of all constructs met the Fornell and Larcker criteria. Model fit indicators such as standardized root mean square residual (0.057), comparative fit index (0.915), and root mean squared error of approximation (0.049) demonstrated good fit. Intention to use (R2=0.515) is significantly affected by subjective norms (beta=.408; P<.001), perceived usefulness (beta=.336; P=.03), and resistance bias (beta=–.237; P=.02). Subjective norms and perceived behavior control had an indirect impact on intention to use through perceived usefulness and perceived ease of use. Eye health consciousness had an indirect positive effect on intention to use through perceived usefulness. Trust had a significant moderation effect (beta=–.095; P=.049) on the effect path of perceived usefulness to intention to use.ConclusionsThe item, construct, and model indicators indicate reliable interpretation power and help explain the levels of public acceptance of ophthalmic AI devices in China. The influence of subjective norms can be linked to Confucian culture, collectivism, authoritarianism, and conformity mentality in China. Overall, the use of AI in diagnostics and clinical laboratory analysis is underdeveloped, and the Chinese public are generally mistrustful of medical staff and the Chinese medical system. Stakeholders such as doctors and AI suppliers should therefore avoid making misleading or over-exaggerated claims in the promotion of AI health care products.

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Section: Discussionsupporting

confidence: 74%

“…In China, patients’ trust of physicians is lower than in Western countries [66] and has become a serious social problem [67,68]. Trust in applied AI is an evolving phenomenon, and cognitive compatibility, trialability, and usability are the main factors related to trust in a technology [63].…”

Section: Introductionmentioning

confidence: 99%

Psychosocial Factors Affecting Artificial Intelligence Adoption in Health Care in China: Cross-Sectional Study

Ye¹,

Xue²,

He³

et al. 2019

J Med Internet Res

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“…The independent variables were patients' opinions on healthcare quality, patient-provider interpersonal trust, and general life attitudes. This survey used the existing composite measures adapted from the Interpersonal Trust Scale (ITS) [23], Wake Forest Physician Trust Scale (WFPTS) [24] and SERVQUAL (Service Quality Scale) [25], to evaluate the quality of care [26] and patient-physician trust [27,28]. We also developed specific questions on participants' attitudes towards their life and health.…”

Section: Study Variablesmentioning

confidence: 99%

Violence against healthcare workers and other serious responses to medical disputes in China: surveys of patients at 12 public hospitals

Wang

Washburn

et al. 2020

BMC Health Serv Res

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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).

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“…A survey indicated that in 2010 alone, there were over 17,000 cases of violence against doctors in China [ 60 ]. Patients tend to think that doctors put making money before patients’ health [ 61 ]. The negative consequence of distrust in doctors is that patients’ refusal to follow physicians’ clinical treatment comes at the cost of health deterioration.…”

Section: Discussionmentioning

confidence: 99%

Barriers to Low-Dose CT Lung Cancer Screening among Middle-Aged Chinese

Jia

Chen

et al. 2020

IJERPH

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Purpose: The current study aims to explore the barriers for middle-aged Chinese to learn about and uptake low-dose computed tomography (LDCT) lung cancer screening. Methods: Data were collected via an online survey in December 2019. Final valid sample included 640 respondents, aged 40–60 years old, from 21 provinces of China. We performed multiple linear regressions to test the potential barriers to LDCT scan. Findings: Cost concerns, distrust in doctors, fears of disease, lack of knowledge, and optimistic bias are negatively associated with the intention to learn about and uptake LDCT scan. Implications: Our study contributes to understanding the negative predictors of middle-aged Chinese to get LDCT lung cancer scans. Future campaign programs should help audiences to build comprehensive understandings about lung cancer and LDCT scan. To better promote LDCT scan in China, the government should fund more trial programs continuously and public efforts should be made to rebuild the patient–doctor trust.

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Factors Influencing Trust towards Physicians among Patients from 12 Hospitals in China

Cited by 18 publications

References 0 publications

Psychosocial Factors Affecting Artificial Intelligence Adoption in Health Care in China: Cross-Sectional Study

Psychosocial Factors Affecting Artificial Intelligence Adoption in Health Care in China: Cross-Sectional Study

Violence against healthcare workers and other serious responses to medical disputes in China: surveys of patients at 12 public hospitals

Barriers to Low-Dose CT Lung Cancer Screening among Middle-Aged Chinese

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