Zhang Li, Wang Baokai, Fu Chang
School of Health Management, Binzhou Medical University, Yantai, Shandong, China.
Yantai Yuhuangding Hospital, Yantai, Shandong, China.
Front Public Health. 2025 May 14;13:1586123. doi: 10.3389/fpubh.2025.1586123. eCollection 2025.
Low levels of trust in primary health care physicians (PHCPs) significantly decrease primary health care utilization among patients with chronic diseases. In the context of the Chinese government having made considerable efforts to strengthen the development of chronic disease management within Chinese primary health care institutions, it is of great theoretical and practical significance to investigate ways to improve the trust in PHCPs among patients with chronic diseases. This study aimed to explore the impact of patient participation on patient trust in PHCPs, and to examine the mediating role of patient perceived value on this relationship.
This study included 884 patients with chronic diseases from a cross-sectional survey conducted in Shandong Province, China, from July to August 2023, using a multistage stratified sampling method. Structural equation modeling was conducted to investigate the relationships between patient participation, patient perceived value, and patient trust.
Patient participation had a direct effect on patient trust (Bias-corrected 95%CI = 0.10-0.20; Percentile 95%CI = 0.10-0.20). Furthermore, patient perceived value mediated the relationship between patient participation and patient trust (Bias-corrected 95%CI = 0.15-0.32; Percentile 95%CI = 0.15-0.32).
Patient participation cannot only directly and positively predict patient trust in PHCPs, but also indirectly affect patient trust through patient perceived value. These findings highlight the importance of patient participation and perceived value to improve the trust in PHCPs among patients with chronic diseases. Therefore, health managers and policymakers should facilitate patient participation and recognize patient perceived value during the service delivery process.
对基层医疗保健医生(PHCPs)的低信任度显著降低了慢性病患者对基层医疗保健的利用率。在中国政府大力加强基层医疗卫生机构慢性病管理发展的背景下,研究提高慢性病患者对基层医疗保健医生信任度的方法具有重要的理论和实践意义。本研究旨在探讨患者参与对患者对基层医疗保健医生信任度的影响,并检验患者感知价值在这种关系中的中介作用。
本研究纳入了2023年7月至8月在中国山东省进行的一项横断面调查中的884名慢性病患者,采用多阶段分层抽样方法。进行结构方程模型分析以研究患者参与、患者感知价值和患者信任之间的关系。
患者参与对患者信任有直接影响(偏差校正95%CI = 0.10 - 0.20;百分位数95%CI = 0.10 - 0.20)。此外,患者感知价值在患者参与和患者信任之间起中介作用(偏差校正95%CI = 0.15 - 0.32;百分位数95%CI = 0.15 - 0.32)。
患者参与不仅能直接且正向预测患者对基层医疗保健医生的信任度,还能通过患者感知价值间接影响患者信任。这些发现凸显了患者参与和感知价值对提高慢性病患者对基层医疗保健医生信任度的重要性。因此,卫生管理人员和政策制定者应在服务提供过程中促进患者参与并认可患者感知价值。