School of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China.
Shenzhen Kanning Hospital, Shenzhen, China.
J Psychiatr Ment Health Nurs. 2021 Jun;28(3):394-408. doi: 10.1111/jpm.12687. Epub 2020 Sep 17.
Low utilization of the family-oriented community rehabilitation services is a threatening challenge facing low- and middle- income countries. Family caregiver's trust in community healthcare providers is the precondition of service utilization and is shaped by their perceived quality of primary healthcare services from previous experience. Most of the studies concerning the relationship between perceived quality and institutional trust were conducted in western countries, resulting in limited attention paid to conditions in non-western countries. Which aspect of quality predicts institutional trust in China has not been studied yet.
In China's context, institutional trust was generally associated with communication, worry relief and risk of privacy leak, but not with technical competence. Significant rural-urban disparity was observed: among rural respondents, institutional trust was associated with technical competence, communication and risk of privacy leak, but not with worry relief; institutional trust was only associated with worry relief in urban respondents.
Mental health nurses training or working with community healthcare workers may improve their technical and communicative competence. Priorities may differ between rural and urban areas. Mental health nurses or community healthcare workers may provide more family-oriented psycho-education to rural families, and more emotional support to urban families. Wider public anti-stigma initiatives are needed to reduce the affiliated stigma of families of persons diagnosed with a severe mental illness.
Introduction Prior studies suggested that caregiver's trust in community healthcare providers is the precondition of the utilization of community-based rehabilitation services and is shaped by their perceived quality of primary healthcare services. Nevertheless, the research conducted in non-western countries is scarce, and which aspect of quality is associated with institutional trust in China has not been studied. Aim To explore the association between perceived quality of primary healthcare services and institutional trust in China's context. Methods This cross-sectional study was conducted with 796 family caregivers from Eastern, Central and Western China between August 2018 and October 2019. Perceived quality of primary healthcare services was measured by technical competence, communication, worry relief and risk of privacy leak. Results Institutional trust was generally associated with communication, worry relief and risk of privacy leak, but not with technical competence. Among rural respondents, institutional trust was associated with technical competence, communication and risk of privacy leak, but not with worry relief. Contrary finding was observed in urban respondents. Discussion and implications for practice With rural-urban disparity considered, strategies such as improving the technical and communicative competence of community healthcare workers, providing family-oriented psycho-education and emotional support, and promoting public anti-stigma initiatives may be worth consideration.
已知信息：低利用率的以家庭为导向的社区康复服务是中低收入国家面临的威胁性挑战。家庭照顾者对社区医疗服务提供者的信任是服务利用的前提，并且受到他们之前对初级保健服务质量的感知的影响。关于感知质量与制度信任之间关系的大多数研究都是在西方国家进行的，因此对非西方国家的情况关注较少。在中国，哪些方面的质量可以预测制度信任尚未得到研究。
本研究的新增内容：在中国的背景下，制度信任通常与沟通、减轻担忧和隐私泄露风险有关，但与技术能力无关。城乡差异显著：在农村受访者中，制度信任与技术能力、沟通和隐私泄露风险有关，但与减轻担忧无关；而在城市受访者中，制度信任仅与减轻担忧有关。
对实践的影响：精神科护士培训或与社区医疗工作者一起工作可以提高他们的技术和沟通能力。农村和城市地区的重点可能不同。精神科护士或社区医疗工作者可以为农村家庭提供更多以家庭为导向的心理教育，为城市家庭提供更多的情感支持。需要开展更广泛的公众反污名活动，以减少被诊断患有严重精神疾病的家庭的关联耻辱感。
摘要：背景：先前的研究表明，照顾者对社区医疗服务提供者的信任是社区康复服务利用的前提条件，并且受到他们对初级保健服务质量的感知的影响。然而，在非西方国家进行的研究很少，中国的哪个方面的质量与制度信任有关尚未得到研究。目的：探讨中国背景下初级保健服务质量感知与制度信任之间的关系。方法：本横断面研究于 2018 年 8 月至 2019 年 10 月期间在中国东部、中部和西部地区对 796 名家庭照顾者进行。初级保健服务质量感知由技术能力、沟通、减轻担忧和隐私泄露风险来衡量。结果：制度信任与沟通、减轻担忧和隐私泄露风险有关，但与技术能力无关。在农村受访者中，制度信任与技术能力、沟通和隐私泄露风险有关，但与减轻担忧无关。在城市受访者中则观察到相反的结果。讨论和对实践的影响：考虑到城乡差异，提高社区医疗工作者的技术和沟通能力、提供以家庭为导向的心理教育和情感支持以及促进公众反污名活动等策略可能值得考虑。
