Dong Enhong, Yan Yue, Ji Sheng, Li Jiabin, Wang Tingting, Shi Jiahua, Xu Ting, Gao Weimin, Liu Yuping, Zhang Shixiang
School of Nursing and Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, China.
Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China.
Front Public Health. 2025 Apr 23;13:1506520. doi: 10.3389/fpubh.2025.1506520. eCollection 2025.
This study aimed to clarify patterns of Berry's acculturation strategy and further identify the factors influencing physician trust among internal migrants.
This study used a sample of 1,200 respondents of Shanghai's migrant population through an online survey (Wenjuanxing platform) from January 2021 to December 2021. K-means cluster analysis and multivariate logistic regression models were used to identify acculturation strategy patterns of internal migrants and the factors influencing their physician trust in China.
Among the 1,117 valid respondents, 85.5% were aged 18-39 years, 51.8% (579) were male, 74.8% (836) were married, and 62.9% (703) had completed university or junior college education, 62.1% (690) were covered by urban employee medical insurance, and 46.3% (517) had an annual income of 110,000-250,000 yuan. Through K-means clustering analysis, four clusters of acculturation strategy patterns were obtained: integration, assimilation, separation, and marginalization. When controlling for all significant socioeconomic and other covariates, compared to physician trust of the respondents adopting the separation acculturation strategy groups, the OR values of physician trust of the respondents adopting the integration and assimilation acculturation strategy groups were 1.979 ( < 0.01) and 1.585 ( < 0.01), respectively.
Berry's framework delineates four acculturation strategy patterns applicable to internal migrants in Chinese megacities, and the effects of these distinct patterns on trust in physicians have been demonstrated. This research provides valuable insights into the dynamics of doctor-patient relationships among internal migrants in China's megacities. Therefore, it is advisable for the Chinese government to launch a combined effort from multiple stakeholders to adopt targeted interventions designed for specific demographic groups to foster greater trust in physicians among internal migrants.
本研究旨在阐明贝里文化适应策略的模式，并进一步确定影响国内移民对医生信任的因素。
本研究通过2021年1月至2021年12月在上海外来人口中选取1200名受访者作为样本进行在线调查（问卷星平台）。采用K均值聚类分析和多变量逻辑回归模型来确定国内移民的文化适应策略模式以及影响他们在中国对医生信任的因素。
在1117名有效受访者中，85.5%的年龄在18 - 39岁之间，51.8%（579人）为男性，74.8%（836人）已婚，62.9%（703人）完成了大学或大专教育，62.1%（690人）参加了城镇职工医疗保险，46.3%（517人）的年收入在11万至25万元之间。通过K均值聚类分析，获得了四种文化适应策略模式集群：整合、同化、分离和边缘化。在控制所有显著的社会经济和其他协变量后，与采用分离文化适应策略组的受访者对医生的信任相比，采用整合和同化文化适应策略组的受访者对医生信任的OR值分别为1.979（<0.01）和1.585（<0.01）。
贝里框架描绘了适用于中国特大城市国内移民的四种文化适应策略模式，并证明了这些不同模式对医生信任的影响。本研究为中国特大城市国内移民医患关系的动态变化提供了有价值的见解。因此，建议中国政府联合多个利益相关者共同努力，针对特定人口群体采取有针对性的干预措施，以增强国内移民对医生的信任。
