Wang Yidi, Yang Xiaoya, Liu Jiaying
Department of Communication, University of California Santa Barbara, Santa Barbara, CA 93106, USA.
School of Journalism and Communication, Wuhan University, Wuhan 430072, China.
Healthcare (Basel). 2024 Dec 6;12(23):2465. doi: 10.3390/healthcare12232465.
: In China, discussing sexual and reproductive health remains taboo, often preventing patients from seeking care or advice on sensitive topics. Online medical consultations (OMCs) offer a unique platform for patients to discuss these concerns more openly. This study investigates how patient-centered communication (PCC) practices, including conversational themes and the use of politeness markers, influence patient satisfaction in Chinese OMCs, with a focus on sensitive gynecology and andrology topics. : This study used a mixed-methods approach, including theme-oriented discourse analysis (TODA) and content analysis on 328 OMCs (179 in andrology, 149 in gynecology) collected from Dr. Chunyu, a popular Chinese online healthcare platform that provides medical consultations, from 19 to 22 March 2022. Logistic regressions were conducted to assess the influence of politeness markers on patient satisfaction, while TODA examined PCC practices in sensitive conversations. : TODA identified two key themes in PCC that enhanced patient satisfaction: normalizing sensitive health concerns and fostering collaborative decision-making. Politeness markers, specifically the use of polite words and expressions of best wishes, were positively associated with patient satisfaction. However, downtoners, emojis, and sentence-final particles showed no significant effect. There were no significant differences in the impact of politeness markers between gynecology and andrology consultations. : This study highlights the importance of PCC and politeness markers in improving patient satisfaction in OMCs, especially when addressing sensitive sexual health topics.
在中国，讨论性与生殖健康仍然是个禁忌话题，这常常使患者无法就敏感问题寻求治疗或建议。在线医疗咨询为患者提供了一个更公开地讨论这些问题的独特平台。本研究调查了以患者为中心的沟通（PCC）方式，包括对话主题和礼貌标记的使用，如何影响中国在线医疗咨询中患者的满意度，重点关注敏感的妇科和男科话题。
本研究采用了混合方法，包括面向主题的话语分析（TODA）和对328次在线医疗咨询（男科179次，妇科149次）的内容分析，这些咨询是从中国一个提供医疗咨询的热门在线医疗平台春雨医生收集的，时间为2022年3月19日至22日。进行逻辑回归以评估礼貌标记对患者满意度的影响，而TODA则研究了敏感对话中的PCC方式。
TODA确定了PCC中提高患者满意度的两个关键主题：使敏感的健康问题常态化和促进共同决策。礼貌标记，特别是礼貌用语和美好祝愿的表达，与患者满意度呈正相关。然而，缓和语、表情符号和句末语气词没有显著影响。礼貌标记在妇科和男科咨询中的影响没有显著差异。
本研究强调了PCC和礼貌标记在提高在线医疗咨询中患者满意度方面的重要性，尤其是在处理敏感的性健康话题时。
