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Article: Primary care physicians’ views on the factors for enhancing patients’ trust in rural areas of Zhejiang province, China: a cross-sectional study

TitlePrimary care physicians’ views on the factors for enhancing patients’ trust in rural areas of Zhejiang province, China: a cross-sectional study
Authors
Keywordshealth policy
primary care
public health
Issue Date2021
PublisherBMJ Publishing Group: BMJ Open. The Journal's web site is located at http://bmjopen.bmj.com
Citation
BMJ Open, 2021, v. 11, p. article no. e049114 How to Cite?
AbstractObjectives: To examine primary care physicians’ (PCPs) perception of patients’ trust and associated factors for enhancing perceived trust in rural China. Design: A cross-sectional questionnaire study. Setting: All township health centres (primary care facilities in rural areas of China) in both developed and less developed counties of Zhejiang province, China, were chosen as the study sites. Participants: A total of 849 questionnaires were distributed from December 2019 to January 2020, and 673 PCPs working in township health centres completed the questionnaires. The response rate was 79.3%. Outcome measures PCPs’ perceived patients’ trust in them, PCPs’ practices to meet patients’ expectations and PCPs’ perceived conflicting patient and employer interests were measured by a self-designed and verified questionnaire. Confirmatory factor analysis was applied to verify the measurement model of PCPs’ practices. Multivariable logistic regression analyses were performed to explore the association between clinical practice characteristics, discordant patient and employer interests and perceived patient trust after controlling for social–demographic characteristics. Results Among all participants, 572 (85.0%) PCPs often/always perceived patients’ trust in their clinical competence, and over two-thirds of PCPs reported ever perceived patient worries about overprescriptions. After adjustment for social-demographic characteristics, regression model results indicated that, among PCPs’ clinical practices characteristics, emotional support (OR=1.23, 95% CI=1.06 to 1.42) and accurate diagnosis and treatment (OR=1.35, 95% CI=1.17 to 1.55) were positively associated with PCPs’ perceived patients’ trust in their clinical competence. A strong association was found between accurate diagnosis and treatment (OR=1.20, 95% CI=1.08 to 1.34, p<0.001; OR=1.22, 95% CI=1.10 to 1.35, p<0.001), conflicting patient and employer interests (OR=1.35, 95% CI=1.12 to 1.63, p<0.01; OR=1.29, 95% CI=1.07 to 1.54, p<0.01) and PCPs’ perceived patient worries about unnecessary medicine or tests, respectively. Conclusions PCPs’ emotional support to patients as well as their abilities to make accurate diagnosis and provide appropriate treatment is positively associated with PCPs’ self-reported patients’ trust. It is recommended that reforms to realign patient and employer’s interests be investigated.
Persistent Identifierhttp://hdl.handle.net/10722/303973
ISSN
2023 Impact Factor: 2.4
2023 SCImago Journal Rankings: 0.971
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorCai, J-
dc.contributor.authorWu, D-
dc.contributor.authorSun, KS-
dc.contributor.authorYang, S-
dc.contributor.authorLam, KF-
dc.contributor.authorLi, LU-
dc.contributor.authorLam, TP-
dc.contributor.authorZhou, X-
dc.date.accessioned2021-09-23T08:53:25Z-
dc.date.available2021-09-23T08:53:25Z-
dc.date.issued2021-
dc.identifier.citationBMJ Open, 2021, v. 11, p. article no. e049114-
dc.identifier.issn2044-6055-
dc.identifier.urihttp://hdl.handle.net/10722/303973-
dc.description.abstractObjectives: To examine primary care physicians’ (PCPs) perception of patients’ trust and associated factors for enhancing perceived trust in rural China. Design: A cross-sectional questionnaire study. Setting: All township health centres (primary care facilities in rural areas of China) in both developed and less developed counties of Zhejiang province, China, were chosen as the study sites. Participants: A total of 849 questionnaires were distributed from December 2019 to January 2020, and 673 PCPs working in township health centres completed the questionnaires. The response rate was 79.3%. Outcome measures PCPs’ perceived patients’ trust in them, PCPs’ practices to meet patients’ expectations and PCPs’ perceived conflicting patient and employer interests were measured by a self-designed and verified questionnaire. Confirmatory factor analysis was applied to verify the measurement model of PCPs’ practices. Multivariable logistic regression analyses were performed to explore the association between clinical practice characteristics, discordant patient and employer interests and perceived patient trust after controlling for social–demographic characteristics. Results Among all participants, 572 (85.0%) PCPs often/always perceived patients’ trust in their clinical competence, and over two-thirds of PCPs reported ever perceived patient worries about overprescriptions. After adjustment for social-demographic characteristics, regression model results indicated that, among PCPs’ clinical practices characteristics, emotional support (OR=1.23, 95% CI=1.06 to 1.42) and accurate diagnosis and treatment (OR=1.35, 95% CI=1.17 to 1.55) were positively associated with PCPs’ perceived patients’ trust in their clinical competence. A strong association was found between accurate diagnosis and treatment (OR=1.20, 95% CI=1.08 to 1.34, p<0.001; OR=1.22, 95% CI=1.10 to 1.35, p<0.001), conflicting patient and employer interests (OR=1.35, 95% CI=1.12 to 1.63, p<0.01; OR=1.29, 95% CI=1.07 to 1.54, p<0.01) and PCPs’ perceived patient worries about unnecessary medicine or tests, respectively. Conclusions PCPs’ emotional support to patients as well as their abilities to make accurate diagnosis and provide appropriate treatment is positively associated with PCPs’ self-reported patients’ trust. It is recommended that reforms to realign patient and employer’s interests be investigated.-
dc.languageeng-
dc.publisherBMJ Publishing Group: BMJ Open. The Journal's web site is located at http://bmjopen.bmj.com-
dc.relation.ispartofBMJ Open-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjecthealth policy-
dc.subjectprimary care-
dc.subjectpublic health-
dc.titlePrimary care physicians’ views on the factors for enhancing patients’ trust in rural areas of Zhejiang province, China: a cross-sectional study-
dc.typeArticle-
dc.identifier.emailLam, KF: hrntlkf@hkucc.hku.hk-
dc.identifier.emailLam, TP: tplam@hku.hk-
dc.identifier.authorityLam, KF=rp00718-
dc.identifier.authorityLam, TP=rp00386-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1136/bmjopen-2021-049114-
dc.identifier.pmid34315796-
dc.identifier.pmcidPMC8317079-
dc.identifier.scopuseid_2-s2.0-85111808395-
dc.identifier.hkuros325548-
dc.identifier.volume11-
dc.identifier.spagearticle no. e049114-
dc.identifier.epagearticle no. e049114-
dc.identifier.isiWOS:000691829800006-
dc.publisher.placeUnited Kingdom-

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