<p>Factors associated with the doctor–patient relationship: doctor and patient perspectives in hospital outpatient clinics of Inner Mongolia Autonomous Region, China</p>

Abstract

Purpose The doctor–patient relationship (DPR) in People’s Republic of China is very tense. This study aimed to provide some explanation by exploring factors influencing the DPR from doctors’ and patients’ perspectives. Methods A cross-sectional study was conducted in one provincial and one city-level general public hospital in Inner Mongolia Autonomous Region of People’s Republic of China. The Difficult Doctor–Patient Relationship Questionnaire (DDPRQ-10) and the Patient–Doctor Relationship Questionnaire (PDRQ-9) were used to assess the quality of the DPR from 226 doctors, and 713 patients’ perspectives, respectively. Multivariate linear regression was used to identify factors significantly associated with the doctors’ and patients’ perceptions of the DPR by assessing coefficients of total effect and their 95% confidence interval. Results The result revealed that provincial-level doctors had a higher DDPRQ-10 score than city-level doctors. Worse DDPRQ-10 scores were seen for doctors who worked in the Internal Medicine departments were aged between 31 and 40 years, held a master’s degree, were dissatisfied with their income, worked more than 40 hrs per week, felt pressure at work, considered the hospital environment to be bad, often felt affected by negative media reports and had defensive behaviors. Patients visiting the provincial hospital had a lower PDRQ-9 score than those from the city-level hospital. Lower PDRQ-9 scores were also seen for patients who were of Mongolian ethnicity, were dissatisfied with their income, waited longer to see the doctor, had a shorter doctor consultation time, had lower expectations of their treatment result, had a low level of trust in the doctor, regarded the hospital environment as bad and those who were frequently influenced by negative media reports. Conclusion This study may provide a useful model to raise the quality of the DPR and to supply evidence for health policy makers and administrators to formulate strategies for reducing the problem of tense DPR in Chinese hospitals.

A Systematic Review of the Health Worker-Patient Relationship in China

“…Although these senior doctors had rich experience in communication with patients, their workload and work pressure affected the doctor-patient relationship. In addition to the above factors, substantial previous studies have suggested that doctors with high income satisfaction could maintain a harmonious relationship with patients [30,37,38,54]. In Germany, America, and Italy, a better health workers-patient relationship was correlated with higher job satisfaction [68][69][70], which was con rmed by many previous studies [14,[71][72][73][74][75].…”

“…Previous studies have explored the effects of various factors on the HWPR, such as health worker-related factors (i.e., age [13][14][15][16][17][18][19], gender [19][20][21][22][23][24][25], years of experience [26,27], education level [28][29][30], ethnicity [30], marital status [29], professional title [31,32], department [13,33,34], income [30,35,36], income satisfaction [30,37,38], etc. ), patient-related factors (i.e., age [29,30,36], gender [29,30,36], residence [39][40][41], ethnicity [30], education level [42,43], medical insurance [32,44], medical expense [44], household income [30], waiting time...…”

The Therapeutic Relationship in China: A Systematic Review and Meta-Analysis

“…Although these senior doctors had rich experience in communication with patients, their workload and work pressure affected the doctor-patient relationship. In addition to the above factors, substantial previous studies have suggested that doctors with high income-satisfaction could maintain a harmonious relationship with patients [ 45 , 52 , 53 , 73 ]. In Germany, America, and Italy, a better healthcare workers-patient relationship was correlated with higher job satisfaction [ 100 , 101 , 102 ], which was confirmed by many previous studies [ 29 , 103 , 104 , 105 , 106 , 107 ].…”

“…Therefore, it is important to analyze the determinants of the TR and to establish effective strategies to improve such relationships. Previous studies have explored the effects of various factors on the TR, such as healthcare worker-related factors (i.e., age [ 28 , 29 , 30 , 31 , 32 , 33 , 34 ], gender [ 34 , 35 , 36 , 37 , 38 , 39 , 40 ], years of experience [ 41 , 42 ], education level [ 43 , 44 , 45 ], ethnicity [ 45 ], marital status [ 44 ], professional title [ 46 , 47 ], department [ 28 , 48 , 49 ], income [ 45 , 50 , 51 ], income satisfaction [ 45 , 52 , 53 ], etc.,), patient-related factors (i.e., age [ 44 , 45 , 51 ], gender [ 44 , 45 , 51 ], residence [ 54 , 55 , 56 ], ethnicity [ 45 ], education level [ 57 , 58 ], medical insurance [ 47 , 59 ], medical expense [ 59 ], household income [ 45 ], waiting time [ 45 ], etc.,), and other factors (i.e., doctor-patient trust [ 60 …”

High-risk factors for ipsilateral lateral neck lymph node metastasis in clinically node-negative patients with papillary thyroid microcarcinoma (cT1aN0)

“…However, some patients with the cN0 lateral neck might need secondary operations due to positive nodes in lateral compartments during surveillance. Because of the current harsh medical environment in China [19] , suspicious metastatic LNLNs are found via color Doppler US examinations during the follow-up period after the first operation (subsequent years). On the one hand, a second surgery may be needed.…”