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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-0001”><title type=“main”“>摘要>为了调查中国患者与医生之间的不信任现象，通过半结构式访谈和焦点小组，对中国南方广东省107名医生、护士和卫生官员进行了定性研究。在本文中，我们报告了实证研究的主要发现，并论证了医学专家的重要作用重建医患信任中的人格主义。卫生专业人员陷入了不信任的恶性循环。不信任（尤其是医生对患者及其亲属的不信任）导致医生的恐惧和自我保护程度增加，从而加剧沟通困难；反过来，这又增加了医生的工作量，增加了强烈的不公正感和受害感。这些因素导致医疗结果更差，患者的不满和愤怒日益加剧，冲突和争端升级，并导致负面媒体报道，所有这些最终导致更大程度的不信任。这种恶性循环不仅表明医患关系的危机，还表明医学作为一种职业和机构的危机。这个循环的基础是医疗体系中固有的利益冲突，通过这种冲突，医疗专业人员和医院变得以利润为导向。这种制度性的利益冲突严重损害了医学专业化的基本原则——病人福利至上，以及中国传统的“医学是人类的艺术”的理想。通过纠正这种制度性的利益冲突，并通过一系列建议的实际措施促进医疗专业化，可以恢复患者的信任 </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; </div> </li> </ul> </div> </div> <div class="literature cardcommon"> <div class="similarity "> <h3 class="all_title" id="enpatent66">相似文献</h3> <div class="similaritytab clearfix"> <ul> <li class="active" >外文文献</li> <li >中文文献</li> <li >专利</li> </ul> </div> <div class="similarity_details"> <ul > <li> <div> <b>1. </b><a class="enjiyixqcontent" href="/academic-journal-cn_international-nursing-science-english_thesis/0201280308446.html">Internet access, 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McLaughlin,</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Louis Simonson&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">Louis Simonson,</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Xia Zou&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">Xia Zou,</a> <span>-1</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：非洲移徙患者对中国医师的信任：一种理解患者-医师信任的社会生态学方法</span> </p> </li> <li> <div> <b>10. </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_chinese-higher-education-academic-abstracts-medical_thesis/0201253509387.html">Effectively cultivate the next generation of competent Chinese physicians: a perspective from a physician trained in both Chinese and US medical institutions</a> <b>[J]</b> <span> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Zongyu John CHEN&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor"> . Zongyu John CHEN</a> <span> <a href="/journal-cn-6694/" target="_blank" rel="nofollow" class="tuijian_authcolor"> . 中国高等学校学术文摘·医学 </a> </span> <span> . 2010</span><span>,第004期</span> </span> </div> </li> <li> <div> <b>2. </b><a class="enjiyixqcontent" href="/academic-journal-cn_detail_thesis/0201295395756.html">Effect of job satisfaction on burnout among physicians: A survey study in urban public medical institutions in Hubei province, China</a> <b>[J]</b> <span> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Yimin Zhang&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor"> . Yimin Zhang</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Li Shen&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">,Li Shen</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Jiquan Lou&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">,Jiquan Lou</a> <span> <a href="/journal-cn-56166/" target="_blank" rel="nofollow" class="tuijian_authcolor"> . 健康（英文） </a> </span> <span> . 2012</span><span>,第10期</span> </span> </div> </li> </ul> <ul style="display: none;"> <li> <div> <b>1. </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>2. </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> <li> <div> <b>3. </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> </ul> </div> </div> </div> <div class="theme cardcommon" style="overflow: auto;display:none"> <h3 class="all_title" id="enpatent55">相关主题</h3> <ul id="subject"> </ul> </div> </div> </div> </div> <div class="right rightcon"> <div class="details_img cardcommon clearfix" style="margin-bottom: 10px;display:none;" > </div> </div> </div> <div id="thesis_get_original1" class="downloadBth" style="bottom: 19px;z-index: 999;" 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