Qiao Tingting, Fan Yancun, Geater Alan F, Chongsuvivatwong Virasakdi, McNeil Edward B
School of Health Management, Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia, People's Republic of China.
Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand.
Patient Prefer Adherence. 2019 Jul 16;13:1125-1143. doi: 10.2147/PPA.S189345. eCollection 2019.
The doctor-patient relationship (DPR) in People's Republic of China is very tense. This study aimed to provide some explanation by exploring factors influencing the DPR from doctors' and patients' perspectives.
A cross-sectional study was conducted in one provincial and one city-level general public hospital in Inner Mongolia Autonomous Region of People's Republic of China. The Difficult Doctor-Patient Relationship Questionnaire (DDPRQ-10) and the Patient-Doctor Relationship Questionnaire (PDRQ-9) were used to assess the quality of the DPR from 226 doctors, and 713 patients' perspectives, respectively. Multivariate linear regression was used to identify factors significantly associated with the doctors' and patients' perceptions of the DPR by assessing coefficients of total effect and their 95% confidence interval.
The result revealed that provincial-level doctors had a higher DDPRQ-10 score than city-level doctors. Worse DDPRQ-10 scores were seen for doctors who worked in the Internal Medicine departments were aged between 31 and 40 years, held a master's degree, were dissatisfied with their income, worked more than 40 hrs per week, felt pressure at work, considered the hospital environment to be bad, often felt affected by negative media reports and had defensive behaviors. Patients visiting the provincial hospital had a lower PDRQ-9 score than those from the city-level hospital. Lower PDRQ-9 scores were also seen for patients who were of Mongolian ethnicity, were dissatisfied with their income, waited longer to see the doctor, had a shorter doctor consultation time, had lower expectations of their treatment result, had a low level of trust in the doctor, regarded the hospital environment as bad and those who were frequently influenced by negative media reports.
This study may provide a useful model to raise the quality of the DPR and to supply evidence for health policy makers and administrators to formulate strategies for reducing the problem of tense DPR in Chinese hospitals.
中华人民共和国的医患关系非常紧张。本研究旨在从医生和患者的角度探索影响医患关系的因素，以提供一些解释。
在中国内蒙古自治区的一家省级和一家市级综合公立医院进行了一项横断面研究。分别使用《医患关系困难问卷（DDPRQ - 10）》和《医患关系问卷（PDRQ - 9）》从226名医生和713名患者的角度评估医患关系的质量。通过评估总效应系数及其95%置信区间，采用多元线性回归来确定与医生和患者对医患关系认知显著相关的因素。
结果显示，省级医院的医生DDPRQ - 10得分高于市级医院的医生。在内科工作、年龄在31至40岁之间、拥有硕士学位、对收入不满意、每周工作超过40小时、感到工作压力大、认为医院环境差、经常受到负面媒体报道影响且有防御行为的医生，其DDPRQ - 10得分更差。在省级医院就诊的患者PDRQ - 9得分低于市级医院的患者。蒙古族患者、对收入不满意、候诊时间长、医生问诊时间短、对治疗结果期望低、对医生信任度低、认为医院环境差以及经常受到负面媒体报道影响的患者，其PDRQ - 9得分也较低。
本研究可能提供一个有用的模型，以提高医患关系的质量，并为卫生政策制定者和管理人员制定减少中国医院紧张医患关系问题的策略提供证据。
