A Multidimensional Deconstructed Study Of The Impact Of Patient Experience On Physician Trust

Objectives and Significance:Trust is a concept that is extremely important to human society.In the social sciences,"trust" has many connotations.Generally speaking,trust refers to a specific situation with the following characteristics:One party(the trustor)is willing to depend his own interests on the behavior of the other party(the trustee).Furthermore,the trustor has given up control of the trustee’s behavior,unable to determine the final result,and can only have some expectations.This uncertainty about the results means that when the trustee does not act as expected,the trustor will suffer certain losses and injuries.When specific to the medical industry,"physician trust" is a complex and multi-dimensional concept.Different scholars have described it from their respective professional fields.Some scholars believe that physician trust refers to "patients believe that doctors will follow a specific way to take action",while other scholars emphasize the emotional nature of trust,thinking that it means" the patient is emotionally reassured by the doctor’s behavior and intentions and feels that he can rely on the doctor".Studies have shown that physician trust has a significant effect on establishing a positive doctor-patient relationship.Lack of trust between doctors and patients is an important driving factor that triggers and accelerates the tension between doctors and patients.With the gradual prominence of the problem of doctor-patient relationship in China,in the era of doctor-patient conflicts that need to be alleviated and improved,the trust of physicians has shown the potential to alleviate the conflict between doctors and patients,ameliorate the relationship between doctors and patients,and improve the quality of medical services.However,existing researches on the trust of doctors mostly focus on the single dimension of doctor-patient communication,medical information,and quality of the work of medical staff.There has not been a multi-dimensional deconstruction study of "trust of doctors"from the overall perspective of "patient experience".This study chooses to start from the overall perspectives of "patient experience",to explore the impact of various links on the "physician’s trust" in the entire medical process in a more comprehensive manner,and to provide guidance to medical service providers with doctor-patient communication,nurse-patient communication,and medical staffs response,pain management,drug communication,environmental cleanliness,and other aspects of optimizing "physician trust",to help medical service providers with more diversified solutions and a more holistic perspective,and to comprehensively improve the quality of medical services around the"patient-centric" medical concept.Methods:Literature related to physician trust and patient experience were searched within"China Knowledge Network" and "ProQuest" database,taking "Doctor Trust","Physician Trust","Doctor-Patient Trust","Patients’ trust" and "Patients’ Experience”as keywords,102 Chinese literature and 99 English literature selected respectively.Through literature research.and summary,the concept,influencing factors and measurement tools of doctors’ trust,and the concept,research status and measurement tools of patient experience were clarified.The effect of patient experience on trust in physicians were initially verified through exploratory research.An exploratory research questionnaire was formed through extracting questions from the existing questionnaires in the field of patients’ experience and physicians’ trust.Using convenient sampling,selecting 150 out-patients and in-patients each,a questionnaire survey was conducted to verify the effect of patients’ experience on trust in physicians through regression analysis.After that,a formal survey was conducted and a theoretical model was built in which patient experience affects doctors’ trust,and then to screen and determine the patient experience and doctors’ trust measurement tools used in this research.8 Beijing secondary and above hospitals were taken as the research sites,formulating research processes and standards,selecting and training investigators and issuing questionnaires.A total of 450 out-patient questionnaires were issued and 437 valid questionnaires were retrieved.The effective recovery rate was 97.11%.Then quality was screened and Excel software was used for data entry.The collected data was used to test the reliability of the measurement tool to modify and adjust the question and dimension.SPSS software was used for regression analysis to verify the hypothesis.Research findings were discussed and summarized according to the regression results.Results:In the exploratory study,the impact of patients’ experience on physicians’ trust and the dimension of benevolence trust and ability trust have been verified in the out-patient group.In the in-patient group,the impact of patients’ experience on physicians’ trust and the dimension of benevolence trust have been verified,but the impact of ability trust is not significant(P>0.05).In the out-patient data,the standardized regression coefficient of patient experience and physician trust is 0.61,Adjusted R2=0.38.The standardized regression coefficient of patient experience and benevolence trust is 0.58,Adjusted R2=0.32.And the standardized regression coefficient of patient experience and ability trust is 0.51,Adjusted R2=0.25.In the in-patient data,the standardized regression coefficient of patient experience and physician trust is 0.41,Adjusted R2=0.23.The standardized regression coefficient of patient experience and benevolence trust is 0.65,Adjusted R2=0.49.In the formal study,the standardized regression coefficient of patient experience and physician trust is 0.66,Adjusted R2=0.47.The standardized regression coefficient of patient experience and benevolence trust is 0.84,Adjusted R2=0.71.And the standardized regression coefficient of patient experience and ability trust is 0.51,Adjusted R2=0.28.Adjusted R2 of the regression model of patients’different dimensions of experience and benevolence trust is 0.71.The dimensions that have a significant correlation with benevolence trust include:information and education(β=0.20,P<0.01),pain management(β=0.27,P<0.01),emotional support(β=0.08,P<0.05),respect for patients(β=-0.06,P<0.05),participation of relatives and friends(β=0.16,P<0.01)and continuous and excessive treatment(β=0.31,P<0.01).Adjusted R2 of regression model of patients’ different dimensions of experience and ability trust is 0.39.The dimensions that have a significant correlation with ability trust include:treatment coordination(β=0.34,P<0.01)and respect for patients(β=0.41,P<0.01).Conclusion:Research found that patients’ experience significantly affects patients’ trust in doctors,including ability trust dimension and benevolent trust dimension.The relevant hypotheses of patients’ different dimensions of experience and benevolence trust and ability trust have partially obtained positive results.It is found that information and education,pain management,emotional support,respect for the patient,involvement of relatives and friends,the continuity and excess of the treatment all have a significant positive correlation with the patients’ benevolence trust in the doctor.Coordination of treatment and respect for the patient have a significant positive correlation with the patients’ ability trust in the doctor.