Quality of doctor–patient relationship in patients with high somatic symptom severity in China

Wu, Haitao; Zhao, Xudong; Fritzsche, Kurt; Leonhart, Rainer; Schaefert, Rainer; Sun, Xin; Larisch, Astrid

doi:10.1016/j.ctim.2014.12.006

Cited by 21 publications

(60 citation statements)

References 39 publications

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“…The improvement of health workforce competencies, strengthening of law and order and effective management of patient complaints are often proposed as coping strategies for workplace violence [ 38 , 39 ]. But trust, a critical element in building loyalty and good patient-provider relationships has often been overlooked in Chinese studies [ 40 , 41 ].…”

Section: Introductionmentioning

confidence: 99%

Patient Satisfaction with Hospital Inpatient Care: Effects of Trust, Medical Insurance and Perceived Quality of Care

et al. 2016

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ObjectiveDeteriorations in the patient-provider relationship in China have attracted increasing attention in the international community. This study aims to explore the role of trust in patient satisfaction with hospital inpatient care, and how patient-provider trust is shaped from the perspectives of both patients and providers.MethodsWe adopted a mixed methods approach comprising a multivariate logistic regression model using secondary data (1200 people with inpatient experiences over the past year) from the fifth National Health Service Survey (NHSS, 2013) in Heilongjiang Province to determine the associations between patient satisfaction and trust, financial burden and perceived quality of care, followed by in-depth interviews with 62 conveniently selected key informants (27 from health and 35 from non-health sectors). A thematic analysis established a conceptual framework to explain deteriorating patient-provider relationships.FindingsAbout 24% of respondents reported being dissatisfied with hospital inpatient care. The logistic regression model indicated that patient satisfaction was positively associated with higher level of trust (OR = 14.995), lower levels of hospital medical expenditure (OR = 5.736–1.829 as compared with the highest quintile of hospital expenditure), good staff attitude (OR = 3.155) as well as good ward environment (OR = 2.361). But patient satisfaction was negatively associated with medical insurance for urban residents and other insurance status (OR = 0.215–0.357 as compared with medical insurance for urban employees). The qualitative analysis showed that patient trust—the most significant predictor of patient satisfaction—is shaped by perceived high quality of service delivery, empathic and caring interpersonal interactions, and a better designed medical insurance that provides stronger financial protection and enables more equitable access to health care.ConclusionAt the core of high levels of patient dissatisfaction with hospital care is the lack of trust. The current health care system reform in China has yet to address the fundamental problems embedded in the system that caused distrust. A singular focus on doctor-patient inter-personal interactions will not offer a successful solution to the deteriorated patient-provider relationships unless a systems approach to accountability is put into place involving all stakeholders.

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Section: Introductionmentioning

confidence: 99%

Patient Satisfaction with Hospital Inpatient Care: Effects of Trust, Medical Insurance and Perceived Quality of Care

et al. 2016

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“…However, it is important to note that psychological distress might play a more important role in DPR than we previously hypothesized. As a previous study suggested, rather than somatic symptom severity, it is the level of depression that predicted patients’ experiences of the DPR [ 54 ]. Therefore, we assume that multiple somatic symptoms could have an indirect relationship with patients’ experiences of the DPR via psychological problems.…”

Section: Discussionmentioning

confidence: 99%

Psychological and somatic distress in Chinese outpatients at general hospitals: a cross-sectional study

et al. 2017

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BackgroundOur study aimed (1) to describe the proportion of psychological distress among Chinese outpatients at general hospitals, (2) to compare cognitive and behavioral characteristics of patients with different distress patterns, and (3) to investigate the discriminant function of the analyzed variables in indicating the affinity towards the different distress patterns.MethodsThis multicenter cross-sectional study was conducted at ten outpatient departments at Chinese general hospitals. The somatic symptom severity scale (PHQ-15), the nine-item depression scale (PHQ-9), and the seven-item anxiety scale (GAD-7) were employed to classify patients in terms of four distress patterns.ResultsA total of 491 patients were enrolled. Among them, the proportion of patients with high psychological distress was significantly higher within those with high somatic distress (74.5% vs. 25.5%, p < .001). Patients with psychological distress alone and mixed distress were significantly younger and with lower monthly family income, while the proportion of female patients (80.9%) was highest in the somatic distress group. Patients with mixed distress had the most negative cognitive and behavioral characteristics [highest health anxiety (5.0 ± 1.9), lowest sense of coherence (35.5 ± 10.0), the worst doctor–patient relationship from both patients’ (36.0 ± 7.3) and doctors’ perspectives (23.3 ± 7.0)], as well as most impaired quality of life (41.6 ± 7.4 and 31.9 ± 10.3). In addition, compared with patients with somatic distress alone, those with psychological distress alone had lower sense of coherence, worse doctor–patient relationship, and more impaired mental quality of life, but less doctor visits. Discriminant analysis showed that gender, mental quality of life, health anxiety, sense of coherence, and frequent doctor visits were significant indicators in identifying patients with different distress patterns.ConclusionsOur study found that (1) psychological distress was not rare in the Chinese general hospital outpatients, especially in those with high somatic distress; (2) patients with psychological distress alone sought less help from doctors, despite their severe psychosocial impairment; and (3) gender, health anxiety, sense of coherence, mental quality of life, and frequent doctor visits could help to identify different distress patterns.

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“…In this study, diagnosis inconsistency refers to how much the disease type, disease severity and diagnosis process suggested by a physician are different from a patient's expectation based on the patient's collected information. Unmet expectations negatively affect patients’ trust (Wu et al, ). Particularly, diagnosis inconsistency is suggested to decrease trust (Simons, ).…”

Section: Research Model and Hypothesesmentioning

confidence: 99%

“…Conversely, those who lack trust may fail to adhere to the prescribed regimens. Earlier studies suggest that lack of patient trust decreases adherence, whereas a trusting relationship leads to adherence, satisfaction, and improved health outcomes (Liu et al, ; Wu et al, ). Although patients from various countries may vary in adherence, Wong, Jiang, and Griffiths () found similar factors associated with drug adherence in China and western populations.…”

Section: Research Model and Hypothesesmentioning

confidence: 99%

Internet usage and patient's trust in physician during diagnoses: A knowledge power perspective

Wallace

2017

Asso for Info Science & Tech

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Does patients' Internet search of disease information affect their trust in physicians during diagnosis? This study proposes a research model from a knowledge power perspective, that is, Internet search affects patients' perception of their knowledge level. Our empirical study of more than 400 subjects suggests that for patients who searched online for disease information, the inconsistency between their self-diagnosis expectations and their physician's diagnosis reduces their trust in their physician. The effect is stronger for those who spent more time on Internet search. Patients with chronic conditions are less affected by the inconsistency, as are patients of physicians with a higher professional status. This study also found that physicians' interaction quality in the diagnosis process-how well they communicate with their patient-still plays a dominant role in gaining patient's trust. This finding suggests that even in the high-tech age, high-touch remains an important factor to physician-patient trust.

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Quality of doctor–patient relationship in patients with high somatic symptom severity in China

Cited by 21 publications

References 39 publications

Patient Satisfaction with Hospital Inpatient Care: Effects of Trust, Medical Insurance and Perceived Quality of Care

Patient Satisfaction with Hospital Inpatient Care: Effects of Trust, Medical Insurance and Perceived Quality of Care

Psychological and somatic distress in Chinese outpatients at general hospitals: a cross-sectional study

Internet usage and patient's trust in physician during diagnoses: A knowledge power perspective

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