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张玥, 喻荣彬, 王锦帆. 扎根理论视角下中国医患信息沟通影响因子评价[J]. 中国公共卫生, 2022, 38(1): 57-60. DOI: 10.11847/zgggws1124619
引用本文: 张玥, 喻荣彬, 王锦帆. 扎根理论视角下中国医患信息沟通影响因子评价[J]. 中国公共卫生, 2022, 38(1): 57-60. DOI: 10.11847/zgggws1124619
ZHANG Yue, YU Rong-bin, WANG Jin-fan. Evaluation on influencing factors of doctor-patient information communication in China: a grounded theory-based cross-sectional survey[J]. Chinese Journal of Public Health, 2022, 38(1): 57-60. DOI: 10.11847/zgggws1124619
Citation: ZHANG Yue, YU Rong-bin, WANG Jin-fan. Evaluation on influencing factors of doctor-patient information communication in China: a grounded theory-based cross-sectional survey[J]. Chinese Journal of Public Health, 2022, 38(1): 57-60. DOI: 10.11847/zgggws1124619

扎根理论视角下中国医患信息沟通影响因子评价

Evaluation on influencing factors of doctor-patient information communication in China: a grounded theory-based cross-sectional survey

  • 摘要:
      目的  评价中国医患信息沟通的影响因子,为改善当前医患关系效果提供对策性依据。
      方法  基于扎根理论,依据目的性抽样原则选取从事医学人文教育和研究的教授和学者8人及南京地区3所三级甲等医院的高级职称医生20人和患者20例,以半结构访谈和专家打分形式进行影响因子编码,并细化为自编问卷;于2016年3 — 5月采用整群随机抽样方法抽取全国三级甲等医院的医患群体4 508人(医方2 727人,患方1 781人)进行问卷调查,对所得数据进一步进行赋值计算,以综合影响得分和平均影响得分反映各影响因子在医患关系中的权重和排序。
      结果  医方和患方沟通的需求选择为非常希望者比例分别为45.9 % 和44.1 %,对政府作用评价为非常必要的比例分别为75.9 % 和71.4 %,对媒体和网络作用评价为非常必要的比例分别为49.0 % 和53.9 %,对医药协会作用评价为很有代表性的比例分别为21.6 % 和18.0 %,对消费者协会作用评价为很有代表性的比例分别为14.5 % 和26.7 %,医患双方沟通的需求选择及对政府、媒体和网络、医药协会、消费者协会作用的评价差异均有统计学意义(均P < 0.01);经赋值计算,医方的信息沟通影响因子由高到低依次为政府(3.69分)、沟通需求(3.34分)、媒体和网络(3.18分)、医药协会(2.56分)、消费者协会(2.21分),患方的信息沟通影响因子由高到低依次为政府(3.61分)、媒体和网络(3.32分)、沟通需求(3.25分)、消费者协会(2.71分)、医药协会(2.47分)。
      结论  良好的医患间信息沟通来自于医患双方、政府、媒体及网络、相关协会的因子共同作用力,需要通过影响因子的联动打造医患信息沟通的综合平台。

     

    Abstract:
      Objective  To explore influencing factors of doctor-patient information communication (DPIC) and to provide evidences for improving the situation of DPIC in China.
      Methods  To screen influencing factors of DPIC based on grounded theory, we conducted an expert fractal analysis and semi-structured interviews among 8 schoolors engaged in medical humanities education and research, 20 senior doctors and 20 patients in three tertiary hospitals in Nanjing city using purposive sampling. With the coded influencing factors prelimilarily determined, we compiled a questionnaire. Then we conducted an on-site self-administered questionnaire survey among 2 727 medical professionals and 1 781 patients and their relatives recruited using cluster random sampling at tertiary hospitals in 23 municipalities/provinces across China during March – May 2016. We analyzed the data collected for weighting and ranking all influencing factor of DPIC by comprehensive and average impact scores calculated for each of the factors.
      Results  Of the surveyed medical professionals and patients and their relatives, 45.9% and 44.1% reported a strong willingness to conduct DPIC; 75.9% and 71.4% affirmed the necessity of governmental agencies' role in DPIC; 49.0% and 53.9% evaluated the role of media and network in DPIC as very necessary; 21.6% and 18.0% approved representative role of medical associations in the process of DPIC but only 14.5% and 26.7% approved the representative role of consumers associations. There were significant disparities between medical professionals and patients and their relatives in attitudes towards DPIC and its relevant dimensions mentioned above (all P < 0.01). The rank order from high to low for impact scores of DPIC influencing factors was governmental administration (score = 3.69), demand for the communication (3.34), media and network (3.18), medical association (2.56), and consumer association (2.21) among the medical professionals; while among the patients and their relatives, the rank order was government administration (3.61), media and network (3.32), demand for the communication (3.25), consumer association (2.71), and medical association (2.47).
      Conclusion  A good doctor-patient information communication comes from the joint efforts among medical staff, patients, government agencies, media and network, and relevant social organizations. The study result suggests that a comprehensive platform needs to be established to promote the communication.

     

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