Impact of organizational and individual factors on patient-provider relationships: A national survey of doctors, nurses and patients in China

Ping, Zhang; Wang, Fang; Cheng, Yao; Zhang, Liu yi; Ye, Bei zhu; Hong, Jiang; Sun, Yi; Zhu, Xi; Liang, Yuan

doi:10.1371/journal.pone.0181396

Cited by 19 publications

(21 citation statements)

References 51 publications

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“…This viewpoint is consistent with abundant previous studies [47,48,[82][83][84]. The important components of effective communication should include patient-centred communication [45,85] and adequate medical information sharing [44,86]. Therefore, this study supports the idea that health workers occupy the dominant position in health worker-patient communication, which suggests that training in communication skills for health workers should be strengthened [87,88].…”

Section: Discussionsupporting

confidence: 91%

“…Moreover, the reimbursement rate and range of medical insurance coverage may also affect the HWPR [78]. Therefore, the establishment of a sound medical insurance system, to a certain extent, would ease patient burdens and improve the HWPR [32,44].…”

Section: Discussionmentioning

confidence: 99%

“…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...…”

Section: Introductionmentioning

confidence: 99%

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

Mao

Wei

Zheng

et al. 2020

Preprint

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BackgroundWith a surge of medical disputes in recent years, the health worker-patient relationship (HWPR) in China is presently in a tense situation. Meanwhile, consequent social problems have begun to emerge, such as the practice of defensive medicine and distrust between health workers and patients. Although many empirical studies about the HWPR have been conducted in China, no related systematic reviews have been found. This study can convey the general findings from China to other areas of the world.MethodsA systematic review and meta-analysis of the HWPR and related determinants were conducted. Six databases were comprehensively searched for articles to include in the review, with no restrictions on language. Articles published between January 1, 2000 and January 1, 2020 were included.ResultsAmong the 3,290 records initially identified, 11 studies met the selection criteria. A total of 96,906 individuals were included in the review. The meta-analysis indicated that health workers who were male (male vs. female, OR: 1.48, 95% CI: 1.42- 1.55), older (≤50 vs. >50, 0.86, 0.80-0.93), less educated (undergraduate or below vs. masters or above, 1.39, 1.21-1.60), working in a non-surgical department (surgery vs. other, 0.92, 0.88-0.96), and had a senior title (intermediate or below vs. senior, 0.77, 0.74-0.81) were more likely to be pessimistic about the HWPR or to encounter medical disputes. Patients who were rural residents (urban vs. rural, 0.92, 0.87-0.97), highly educated (below undergraduate vs. undergraduate or above, 0.75, 0.72-079), and had no medical insurance (medical insurance vs. no medical insurance, 0.77, 0.67-0.89) were more likely to be pessimistic about the HWPR or to encounter medical disputes. Furthermore, mutual trust could improve rapport between health workers and patients. The 25 other related factors were analysed and described using a narrative approach.ConclusionOn average, 55.73% of health workers consider the HWPR to be tense, which is higher than the proportion of patients who hold this view (33.7%). The HWPR was significantly associated with individual factors and socioeconomic factors of both health workers and patients, as well as factors related to the health worker-patient interaction. More targeted strategies should be developed to improve the HWPR.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Mao

Wei

Zheng

et al. 2020

Preprint

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“…In China, Level 3 hospitals are the largest size and high‐technology hospitals; Level 2 hospitals are medium size and lower technology (Zhu et al, ). Although Level 3 hospitals care for larger numbers of higher acuity patients, they have more serious nurse understaffing than Level 2 hospitals (P. Zhang et al, ). The NHFPC's () goals are that the nurse‐to‐bed ratio should reach 0.8:1 in Level 3 hospitals and 0.6:1 in Level 2 hospitals by the end of 2015.…”

Section: Introductionmentioning

confidence: 99%

“…Although Level 3 hospitals care for larger numbers of higher acuity patients, they have more serious nurse understaffing than Level 2 hospitals (P. Zhang et al, 2017). The NHFPC's (2011) goals are that the nurse-to-bed ratio should reach 0.8:1 in Level 3 hospitals and 0.6:1 in Level 2 hospitals by the end of 2015.…”

mentioning

confidence: 99%

The associations of occupational hazards and injuries with work environments and overtime for nurses in China

Zheng

Liu

et al. 2018

Research in Nursing & Health

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Occupational hazards (OHs) and occupational injuries (OIs) may contribute to nurses needing sick time and to a high financial burden for hospitals. There is little published literature about nurse-reported OHs/OIs and their relationships with work environments and working overtime in China. This study was designed to describe Chinese hospital registered nurses' OHs/OIs and to explore the associations between work environments, working overtime, and nurse-reported OHs/OIs. This cross-sectional study was conducted in Guangdong province in China in 2014. The sample included 1,517 nurses from 111 medical/surgical units in 23 hospitals. The Practice Environment Scale of the Nursing Work Index was used to measure work environment. Overtime was calculated by subtracting scheduled work hours from actual work hours. Six items were used to measure nurse-reported OHs/OIs. Descriptive statistics, Chi-square tests, and two-level logistic regression models were used to analyze the data. The percentages of nurses reporting OHs/OIs occurred in the year before the survey ranged from 47% to 80%. Nurses who worked in good (vs. poor) unit work environments were less likely to experience OHs/OIs (Odds ratio [OR] = 0.65-0.68, p < .05). Nurses who worked overtime (OR = 1.19-1.33, p < .05) and in Level 3 (largest) hospitals (OR = 1.45-1.80, p < .05) were more likely to experience OHs/OIs. We found that OHs/OIs were prevalent among hospital nurses in China. Better work environment and less nurse overtime were associated with fewer nurse OHs/OIs.

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A Meta-analytic Systematic Review and Theory of the Effects of Perceived Listening on Work Outcomes

et al. 2023

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The quality of listening in interpersonal contexts was hypothesized to improve a variety of work outcomes. However, research of this general hypothesis is dispersed across multiple disciplines and mostly atheoretical. We propose that perceived listening improves job performance through its effects on affect, cognition, and relationship quality. To test our theory, we conducted a registered systematic review and multiple meta-analyses, using three-level meta-analysis models, based on 664 effect sizes and 400,020 observations. Our results suggest a strong positive correlation between perceived listening and work outcomes, $$\overline{r}$$ r ¯ = .39, 95%CI = [.36, .43], $$\overline{\rho }$$ ρ ¯ = .44, with the effect on relationship quality, $$\overline{r}=$$ r ¯ = .51, being stronger than the effect on performance, $$\overline{r}=$$ r ¯ = .36. These findings partially support our theory, indicating that perceived listening may enhance job performance by improving relationship quality. However, 75% of the literature relied on self-reports raising concerns about discriminant validity. Despite this limitation, removing data solely based on self-reports still produced substantial estimates of the association between listening and work outcomes (e.g., listening and job performance, $$\overline{r}$$ r ¯ = .21, 95%CI = [.13, .29], $$\overline{\rho }$$ ρ ¯ = .23). Our meta-analyses suggest further research into (a) the relationship between listening and job knowledge, (b) measures assessing poor listening behaviors, (c) the incremental validity of listening in predicting listeners’ and speakers’ job performance, and (d) listening as a means to improve relationships at work.

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Impact of organizational and individual factors on patient-provider relationships: A national survey of doctors, nurses and patients in China

Cited by 19 publications

References 51 publications

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

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

The associations of occupational hazards and injuries with work environments and overtime for nurses in China

A Meta-analytic Systematic Review and Theory of the Effects of Perceived Listening on Work Outcomes

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