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The vicious circle of patient–physician mistrust in China: health professionals’ perspectives, institutional conflict of interest, and building trust through medical professionalism

机译：中国患者医生不信任的恶性循环：卫生专业人员的观点，体制利益冲突，通过医学专业主义建立信任

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Abstract >To investigate the phenomenon of patient–physician mistrust in China, a qualitative study involving 107 physicians, nurses and health officials in Guangdong Province, southern China, was conducted through semi‐structured interviews and focus groups. In this paper we report the key findings of the empirical study and argue for the essential role of medical professionalism in rebuilding patient‐physician trust. Health professionals are trapped in a vicious circle of mistrust. Mistrust (particularly physicians’ distrust of patients and their relatives) leads to increased levels of fear and self‐protection by doctors which exacerbate difficulties in communication; in turn, this increases physician workloads, adding to a strong sense of injustice and victimization. These factors produce poorer healthcare outcomes and increasingly discontented and angry patients, escalate conflicts and disputes, and result in negative media coverage, all these ultimately contributing to even greater levels of mistrust. The vicious circle indicates not only the crisis of patient‐physician relationship but the crisis of medicine as a profession and institution. Underlying the circle is the inherent conflict of interest in the healthcare system by which health professionals and hospitals have become profit‐driven. This institutional conflict of interest seriously compromises the fundamental principle of medical professionalism—the primacy of patient welfare—as well as the traditional Chinese ideal of “medicine as the art of humanity”. Patient trust can be restored through rectifying this institutional conflict of interest and promoting medical professionalism via a series of recommended practical measures. </abstract> </span> <span class="z_kbtn z_kbtnclass hoverxs" style="display: none;">展开▼</span> </div> <div class="translation abstracttxt"> <span class="zhankaihshouqi fivelineshidden" id="abstract"> <span>机译：</span><Abstract XMLNS =“http://www.wiley.com/namespaces/wiley”type =“main”xml：id =“dewb12170-abs-abs-0001”> <标题类型=“main”>抽象</ title> < P>调查中国患者医生信任的现象，通过半结构化访谈和焦点小组进行了涉及107名医生，广东省医生，护士和卫生官员的定性研究。在本文中，我们报告了实证研究的主要结果，并争论医学专业主义在重建患者 - 医生信任方面的基本作用。卫生专业人士被困在一个恶性的不信任圈子中。不信任（特别是医生对患者及其亲属的不信任）导致医生加剧了沟通困难的医生增加了恐惧和自我保护水平;反过来，这增加了医生工作负载，增加了强烈的不公正感和受害。这些因素产生了较差的医疗保健结果，越来越不满，愤怒的患者，升级的冲突和纠纷，并导致负面媒体覆盖，所有这些都促进了更大的不信任程度。恶性循环不仅表明了患者医生关系的危机，而是危机作为专业和机构的医学危机。基础圈子是健康专业人士和医院已成为利润驱动的医疗保健系统的固有的利益冲突。这种机构利益冲突严重损害了医学专业人心的基本原则 - 患者福利 - 以及“作为人类艺术的医学”的传统理想。通过纠正这一制度的利益冲突和通过一系列推荐的实际措施促进医疗专业措施，可以通过纠正病人信任。</ p> </ abstract> </span> <span class="z_kbtn z_kbtnclass hoverxs" style="display: none;">展开▼</span> </div> </div> <div class="record"> <h2 class="all_title" id="enpatent33" >著录项</h2> <ul> <li> <span class="lefttit">来源</span> <div style="width: 86%;vertical-align: text-top;display: inline-block;"> <a href='/journal-foreign-32947/'>《Developing world bioethics》</a> <b style="margin: 0 2px;">|</b><span>2018年第1期</span><b style="margin: 0 2px;">|</b><span>共11页</span> </div> </li> <li> <div class="author"> <span class="lefttit">作者</span> <p id="fAuthorthree" class="threelineshidden zhankaihshouqi"> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Nie Jing‐Bao&option=202" target="_blank" rel="nofollow">Nie Jing‐Bao;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Cheng Yu&option=202" target="_blank" rel="nofollow">Cheng Yu;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Zou Xiang&option=202" target="_blank" rel="nofollow">Zou Xiang;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Gong Ni&option=202" target="_blank" rel="nofollow">Gong Ni;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Tucker Joseph D.&option=202" target="_blank" rel="nofollow">Tucker Joseph D.;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Wong Bonnie&option=202" target="_blank" rel="nofollow">Wong Bonnie;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Kleinman Arthur&option=202" target="_blank" rel="nofollow">Kleinman Arthur;</a> </p> <span class="z_kbtnclass z_kbtnclassall hoverxs" id="zkzz" style="display: none;">展开▼</span> </div> </li> <li> <div style="display: flex;"> <span class="lefttit">作者单位</span> <div style="position: relative;margin-left: 3px;max-width: 639px;"> <div class="threelineshidden zhankaihshouqi" id="fOrgthree"> </div> <span class="z_kbtnclass z_kbtnclassall hoverxs" id="zhdw" style="display: none;">展开▼</span> </div> </div> </li> <li > <span class="lefttit">收录信息</span> <span style="width: 86%;vertical-align: text-top;display: inline-block;"></span> </li> <li> <span class="lefttit">原文格式</span> <span>PDF</span> </li> <li> <span class="lefttit">正文语种</span> <span>eng</span> </li> <li> <span class="lefttit">中图分类</span> <span><a href="https://www.zhangqiaokeyan.com/clc/5696.html" title="医学伦理学">医学伦理学;</a></span> </li> <li class="antistop"> <span class="lefttit">关键词</span> <p style="width: 86%;vertical-align: text-top;"> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=China&option=203" rel="nofollow">China;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=health professionals&option=203" rel="nofollow">health professionals;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=medical professionalism&option=203" rel="nofollow">medical professionalism;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=patient–physician relationship&option=203" rel="nofollow">patient–physician relationship;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=professional ethics&option=203" rel="nofollow">professional ethics;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=trust and mistrust&option=203" rel="nofollow">trust and mistrust;</a> </p> <div class="translation"> 机译：中国;卫生专业人员;医学专业人员;患者 - 医师关系;职业道德;信任和不信任; 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Loos&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">Joanne R. Loos,</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext= Elizabeth J. Davidson&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor"> Elizabeth J. Davidson </a> <a href="/conference-foreign-64102/" target="_blank" rel="nofollow" class="tuijian_authcolor">Hawaii International Conference on System Sciences .</a> <span>2016</span> </span> </div> <p class="zwjiyix translation" style="max-width: initial;height: auto;word-break: break-all;white-space: initial;text-overflow: initial;overflow: initial;"> <span>机译：穿戴式健康监护仪和医师与患者的交流：医师的观点</span> </p> </li> <li> <div> <b>5. </b><a class="enjiyixqcontent" href="/academic-degree-foreign_mphd_thesis/02061286542.html">"Christian physicians for China": The professionalism and self-sacrifice of Cheeloo medical graduates, 1917--1980.</a> <b>[D] </b> . <span> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Luesink, David.&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">Luesink, David. </a> <span>2004</span> </span> </div> <p class="zwjiyix translation" style="max-width: initial;height: auto;word-break: break-all;white-space: initial;text-overflow: initial;overflow: initial;"> <span>机译：“中国的基督教医生”：Cheeloo医学毕业生的专业精神和自我牺牲精神，1917年至1980年。</span> </p> </li> <li> <div> <b>6. </b><a class="enjiyixqcontent" href="/academic-journal-foreign-pmc_detail_thesis/04000467242.html">The physician charter on medical professionalism: a Jewish ethical perspective</a> <b>[O] </b> . <span> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=A Jotkowitz&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">A Jotkowitz,</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=S Glick&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">S Glick </a> <span>2005</span> </span> </div> <p class="zwjiyix translation" style="max-width: initial;height: auto;word-break: break-all;white-space: initial;text-overflow: initial;overflow: initial;"> <span>机译：关于医学专业精神的医师宪章：犹太人的道德观</span> </p> </li> <li> <div> <b>7. </b><a class="enjiyixqcontent" href="/open-access_resources_thesis/01000128638843.html">The vicious circle of patient-physician mistrust in China: health professionals’ perspectives, institutional conflict of interest, and building trust through medical professionalism</a> <b>[O] </b> . <span> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Jing-Bao Nie&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">Jing-Bao Nie,</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Yu Cheng&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">Yu Cheng,</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Xiang Zou&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">Xiang Zou,</a> <span>2017</span> </span> </div> <p class="zwjiyix translation" style="max-width: initial;height: auto;word-break: break-all;white-space: initial;text-overflow: initial;overflow: initial;"> <span>机译：中国患者 - 医师不信任的恶性循环：卫生专业人员的观点，体制利益冲突，通过医学专业主义建立信任</span> </p> </li> </ul> <ul style="display: none;"> <li> <div> <b>1. </b><a class="enjiyixqcontent" href="/academic-journal-cn_journal-southeast-university-philosophy-social-science_thesis/0201269399217.html">中国患医不信任的恶性循环:医务人员的观点、制度性利益冲突以及通过医疗专业精神构建信任</a> <b>[J]</b> <span> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=聂精保&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor"> . 聂精保</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=程瑜&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">,程瑜</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=邹翔&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">,邹翔</a> <span> <a href="/journal-cn-1334/" target="_blank" rel="nofollow" class="tuijian_authcolor"> . 东南大学学报（哲学社会科学版） </a> </span> <span> . 2018</span><span>,第004期</span> </span> </div> </li> <li> <div> <b>2. </b><a class="enjiyixqcontent" href="/academic-journal-cn_chinese-community-doctors_thesis/0201292987115.html">三项措施解决患者对社区医生不信任问题</a> <b>[J]</b> <span> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=高春芳&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor"> . 高春芳</a> <span> <a href="/journal-cn-5610/" target="_blank" rel="nofollow" class="tuijian_authcolor"> . 中国社区医师 </a> </span> <span> . 2011</span><span>,第19期</span> </span> </div> </li> <li> <div> <b>3. </b><a class="enjiyixqcontent" href="/academic-journal-cn_chinese-medical-ethics_thesis/0201254412145.html">增进患者对医生信任的医学伦理学思考</a> <b>[J]</b> <span> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=王德国&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor"> . 王德国</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=王时霞&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">,王时霞</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=孔全新&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">,孔全新</a> <span> <a href="/journal-cn-6705/" target="_blank" rel="nofollow" class="tuijian_authcolor"> . 中国医学伦理学 </a> </span> <span> . 2002</span><span>,第003期</span> </span> </div> </li> <li> <div> <b>4. </b><a class="enjiyixqcontent" href="/academic-journal-cn_health-economics-research_thesis/0201285668187.html">建立适应社会主义市场经济的卫生保健体制(四)──深层卫生改革及其目标模式的研究(中国卫生经济学会重点研究课题)</a> <b>[J]</b> <span> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=戴迪&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor"> . 戴迪</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=陈晓非&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">,陈晓非</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=钱友渔&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">,钱友渔</a> <span> <a href="/journal-cn-5540/" target="_blank" rel="nofollow" class="tuijian_authcolor"> . 卫生经济研究 </a> </span> <span> . 1994</span><span>,第001期</span> </span> </div> </li> <li> <div> <b>5. </b><a class="enjiyixqcontent" href="/academic-journal-cn_social-policy-research_thesis/0201280372695.html">从医患关系看医疗卫生体制改革——评《在利益与道德之间:当代中国城市医生职业自主性的社会学研究》</a> <b>[J]</b> <span> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=涂真&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor"> . 涂真</a> <span> <a href="/journal-cn-12898/" target="_blank" rel="nofollow" class="tuijian_authcolor"> . 社会政策研究 </a> </span> <span> . 2020</span><span>,第002期</span> </span> </div> </li> <li> <div> <b>6. </b><a class="enjiyixqcontent" href="/academic-conference-cn_meeting-66417_thesis/020222976154.html">患者不信任医生的原因探析</a> <b>[C]</b> <span> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=王德国&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor"> . 王德国</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=王敏&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">,王敏</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=王时霞&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">,王时霞</a> <span> <a href="/conference-cn-66417/" target="_blank" rel="nofollow" class="tuijian_authcolor"> . 山东省医学伦理学学会第三届学术年会 </a> <span> <span> . 2002</span> </span> </div> </li> </ul> <ul style="display: none;"> <li> <div> <b>1. </b><a class="enjiyixqcontent" href="/patent-detail/06130408980858.html">HealthScout will be an app that uses location based services to connect a client with an allied health professional. They will be able to search key words that professionals list as their specialty focus and consenting patients and health practitioners will be able to share medical records between them. The app will also assist in improving the efficiency of the initial consultation through electronic delivery of consent waivers and any evaluation or assessment tools. Only a prototype of screens currently exists and there is no programmed data input or output as of yet.</a> <b>[P]</b> . <span> 外国专利：  AU2017101060A4 </span> <span> . 2017-09-07</span> </div> <p class="zwjiyix translation" style="max-width: initial;height: auto;word-break: break-all;white-space: initial;text-overflow: initial;overflow: initial;"> <span>机译：HealthScout将是一个使用基于位置的服务将客户与专职医疗专业人员联系起来的应用程序。他们将能够搜索专业人员列出的关键词作为他们的专业重点，并且同意的患者和卫生从业人员将能够在他们之间共享病历。该应用程序还将通过电子方式提供同意豁免和任何评估或评估工具来帮助提高初步咨询的效率。当前仅存在屏幕原型，并且到目前为止还没有编程的数据输入或输出。 </span> </p> </li> <li> <div> <b>2. </b><a class="enjiyixqcontent" href="/patent-detail/06130409072609.html">METHOD FOR AN INTERACTIVE, PATIENT CONTROLLED MEDICAL INFORMATION SYSTEM IN A DIGITAL, REAL TIME MANNER WHICH FEATURES A SINGLE POINT OF ENTRY FOR PATIENTS, PHYSICIANS, ALL OTHER HEALTH CARE PROVIDERS, HEALTH CARE PAYERS, RESEARCHERS AND PHARMACEUTICAL COMPANIES</a> <b>[P]</b> . <span> 外国专利：  WO2016196023A1 </span> <span> . 2016-12-08</span> </div> <p class="zwjiyix translation" style="max-width: initial;height: auto;word-break: break-all;white-space: initial;text-overflow: initial;overflow: initial;"> <span>机译：数字，实时方式的交互式，患者控制的医疗信息系统，其特征是患者，医生，所有其他健康护理人员，健康护理人员，研究人员和制药公司的单点输入 </span> </p> </li> <li> <div> <b>3. </b><a class="enjiyixqcontent" href="/patent-detail/06130412525999.html">Method for an Interactive, Patient Controlled Medical Information System in a Digital, Real Time Manner which Features a Single Point of Entry for Patients, Physicians, all other Health Care Providers, Health Care Payers, Researchers and Pharmaceutical Companies</a> <b>[P]</b> . <span> 外国专利：  US2015356250A1 </span> <span> . 2015-12-10</span> </div> <p class="zwjiyix translation" style="max-width: initial;height: auto;word-break: break-all;white-space: initial;text-overflow: initial;overflow: initial;"> <span>机译：数字实时方式的交互式，患者控制的医疗信息系统的方法，其特征是为患者，医师，所有其他医疗保健提供者，医疗保健付款人，研究人员和制药公司提供单一入口点 </span> </p> </li> </ul> </div> </div> </div> <div class="theme 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