Jiang, Shaohai (2017-05). Promoting Online Patient-Provider Communication in China: An Internet-based Intervention. Doctoral Dissertation. Thesis uri icon

abstract

  • The Chinese health care system has suffered from severe tension between patients and doctors during the past decade. Violence towards health care providers has become a familiar occurrence in China. Faced with the increasing number of deaths and injuries of health care providers from angry health care consumers, Chinese scholars have made great efforts to explore possible ways to improve doctor-patient relationships. Study 1 of the dissertation conducted a cross-sectional survey among 758 Chinese patients to examine pathways through which patient-centered communication (e.g., degree to which doctors are perceived as informative, supportive, and helpful making medical decisions) could influence patient satisfaction and patient trust, variables that could then contribute to better patient-reported health outcomes. The findings showed that patient-centered communication significantly increased patient satisfaction and patient trust. Patient satisfaction in turn significantly improved three types of health outcomes (general, emotional, and physical), and patient trust significantly enhanced emotional health. Bootstrap analyses provided support for the mediation effects of satisfaction and trust. While improving patient satisfaction and patient trust holds enormous potential to mitigate the conflicting doctor-patient relationship in China, another important contributing factor to the crises in the health care system is the difficulties many Chinese patients are facing in receiving affordable health care. Online patient-provider communication may bring a new option for the delivery of affordable health services in a timely way. However, online patient-provider communication is still a relatively new concept to Chinese patients. Thus, to promote this new but important practice, study 2 of the dissertation conducted a four-week blog-based intervention among Chinese patients aged 40 or above. With the randomized control trial design and a general basis of the Social Cognitive Theory, this intervention was effective in promoting online patient-provider communication. Specifically, the findings indicated that this intervention resulted in improvements in the frequency of participants' online patient-provider communication and related psychosocial constructs from Social Cognitive Theory (e.g., self-efficacy, outcome expectations, and awareness).
  • The Chinese health care system has suffered from severe tension between patients and doctors during the past decade. Violence towards health care providers has become a familiar occurrence in China. Faced with the increasing number of deaths and injuries of health care providers from angry health care consumers, Chinese scholars have made great efforts to explore possible ways to improve doctor-patient relationships. Study 1 of the dissertation conducted a cross-sectional survey among 758 Chinese patients to examine pathways through which patient-centered communication (e.g., degree to which doctors are perceived as informative, supportive, and helpful making medical decisions) could influence patient satisfaction and patient trust, variables that could then contribute to better patient-reported health outcomes. The findings showed that patient-centered communication significantly increased patient satisfaction and patient trust. Patient satisfaction in turn significantly improved three types of health outcomes (general, emotional, and physical), and patient trust significantly enhanced emotional health. Bootstrap analyses provided support for the mediation effects of satisfaction and trust.

    While improving patient satisfaction and patient trust holds enormous potential to mitigate the conflicting doctor-patient relationship in China, another important contributing factor to the crises in the health care system is the difficulties many Chinese patients are facing in receiving affordable health care. Online patient-provider communication may bring a new option for the delivery of affordable health services in a timely way. However, online patient-provider communication is still a relatively new concept to Chinese patients. Thus, to promote this new but important practice, study 2 of the dissertation conducted a four-week blog-based intervention among Chinese patients aged 40 or above. With the randomized control trial design and a general basis of the Social Cognitive Theory, this intervention was effective in promoting online patient-provider communication. Specifically, the findings indicated that this intervention resulted in improvements in the frequency of participants' online patient-provider communication and related psychosocial constructs from Social Cognitive Theory (e.g., self-efficacy, outcome expectations, and awareness).

publication date

  • May 2017