Abstract
ObjectivesAssessing medical students’ attitudes toward patient-centred care is essential to bettering medical education. Based on doctor-patient relationships and the medical system in China, it is important to explore the impact of gender differences and other background factors on patient-centred attitudes and to provide references for medical education reform.MethodsA cross-sectional study was conducted on fourth-year medical undergraduate students from November 2017 to March 2018 in Heilongjiang Province, Northeast China. The Chinese-revised Patient-Practitioner Orientation Scale (CR-PPOS), which has been validated in previous research, was used to measure the medical students’ attitudes. The medical students’ demographic data was collected, including their gender, age, information on whether they have siblings, family residence location, doctor(s) for parents, year in which the student first experienced clinical practice, and student category.ResultsA total of 513 students (91.12%) completed the survey. The Chinese medical students scored considerably higher for ‘Caring’ (including patients’ preferences into the decision-making process) than for ‘Sharing’ (sharing information/responsibility with patients). These students tended to have patient-centred attitudes, as measured by an average overall CR-PPOS score of 3.63 (scores higher than 3.5 indicate patient-centred attitudes), which is higher than Malian (3.38) and Pakistani (3.40) medical students but lower than American (4.57) and Brazilian (4.66) students. Female students (P < 0.05) were significantly associated with more patient-centred attitudes and with higher ‘Sharing’ and ‘Caring’ subscale scores. Student category (P < 0.05) was associated with ‘Sharing’ and ‘Caring’ scores. Clinical hospital students (P < 0.05) were associated with more patient-centred attitudes and with higher ‘Sharing’ and ‘Caring’ subscale scores, Students without siblings (p < 0.07) were associated with the higher ‘Sharing’ subscale scores.ConclusionsIn China, gender has a significant impact on medical students’ patient-centred attitudes, which is similar to findings from other countries. If medical schools want to raise patient-centred attitudes across the board and bridge the gap between male and female patient-centred attitudes, gender, student category, and other factors should be incorporated into medical education.
Highlights
Traditional biomedicine practices are based on Western science, focusing on the specific disease rather than the patient as a whole and tending to grant doctors the decision-making power (Engel, 1980)
If medical schools want to raise patient-centred attitudes across the board and bridge the gap between male and female patient-centred attitudes, gender, student category, and other factors should be incorporated into medical education
Patient-centred care, which was proposed by Balint et al and is an overall approach to medical practice compared with the biomedical medical practice, treats patients as unique human beings and establishes a more egalitarian relationship between doctor and patient (Balint, 1969; Ishikawa, Hashimoto & Kiuchi, 2013)
Summary
Traditional biomedicine practices are based on Western science, focusing on the specific disease rather than the patient as a whole and tending to grant doctors the decision-making power (Engel, 1980). Patient-centred care refers to the establishment of relationships among doctors, patients, and their families in order to care for patients’ needs and preferences and to provide the necessary information and support so that patients can actively participate in clinical decision-making and in their own care (America, 2001; Health & Delivery, 2001) With this approach, doctors use their communication skills to understand the patient’s ideas, expectations, emotions, preferences, and concerns about the illness in order to seek an integrated understanding of the patient’s world (Stewart, 2001; Epstein et al, 2005a; Epstein et al, 2005b; Stewart et al, 2000). Patient-centred care has been associated with positive patient outcomes in many fields by increasing satisfaction, promoting effective communication, reducing medical complaints, decreasing consultation time, improving perceptions on service delivery quality (Pereira et al, 2013; Stone, 2008; Hudon et al, 2011)
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