Research On The Relationship Between Doctors And Patients With Disabilities

Objective:Based on the investigation of the doctor-patient relationship status of a grade 3 rehabilitation hospital in Chengdu, this research can make a comparative analysis of the differences of cognition on the present situation of the doctor-patient relationship between medical personnel and disabled patients and their families, understand and analyze the status of the doctor-disabled patient relationship and influencing factors, find ways to improve the doctor-patient relationship, provide specific measures for strengthening the management on doctor-patient relationship to improve the service quality, enhance patient satisfaction, promote the sustainable development of the hospital, and build blocks for the construction of a harmonious society. At the same time, this research can provide some reference for Chinese rehabilitation hospital management.Methods:In this research, a questionnaire survey was carried out in a grade 3 rehabilitation hospital in Chengdu, and a total of 476 questionnaires were distributed. 247 questionnaires were for medical personnel questionnaires and 229 for disabled patients and their families. Questionnaires consisted 10 aspects of content, doctor-patient relationship in general understanding, cognition of doctor-patient communication, medical ethics situation, cognition of the responsible party for the doctors-patient relationship, cognition of the reasons for tension between doctors and patients, cognition of existing model and ideal harmonious model of relationship between doctors and patients with disabilities, patient satisfaction, medical staff job satisfaction, cognition of the ways to improve doctor-patient relationship, cognition of doctor-patient relationship development trend, which contains some open-end problem.Spss18.0 software was used for statistical analysis of survey data.1.Doctor-patient relationship in general understandingIn the overall understanding of the relationship between doctors and patients, only 44.09% of the respondents believe that the relationship between doctors and patients is harmonious, and there is a significant difference in the overall understanding of the relationship between doctors and patients(Z=-9.673, P<0.001). 29.26% medical personnel consider harmonious relationship between doctors and patients, 60.08% disabled patients and their families consider harmonious relationship between doctors and patients. Medical understanding of doctor-patient relationship is negative, while the understanding from disabled patients and their family is more positive. 85.02% of the respondents are through their own personal feelings to make a judge.2. Situation of doctor-patient communicationThere are significant differences in the degree of satisfaction between doctors and patients(Z=-10.878, P<0.001). 35.36% of the medical staffs are satisfied with the communication, and 72.81% of the disabled patients and their families are satisfied with the communication. Medical personnel’s communication satisfaction is lower, and patients with higher communication satisfaction. Doctors’ and patients’ cognition of the main reason on communication difficulty has significant difference(χ2=149.549, P<0.001), 78.86% of the medical staff consider that "trust between doctors and patients lack”, 54.39% of the disabled patients and their families consider that “medical staff is busy, timeless”. Doctors’ and patients’ cognition of the main reason on the communication barrier has difference(χ2=36.833, P<0.001), 34.15% of the medical staff, 34.15% of the disabled patients and their families consider that is “communication”. Doctors’ and patients’ cognition of “Which aspects can be best improve from strengthening communication” has significant difference(χ2=28.742, P<0.001), 26.42% medical personnel choose “conducive to the elimination of both doctors and patients’ no trust”, 23.68% of the disabled patients and their families choose “to promote harmony”.3. Medical ethics situationDoctors’ and patients’ cognition of the most serious problem on medical ethics has difference(χ2=14.291, P<0.05). 33.33% of the medical staff consider that is “bad service attitude”, 29.82% of the disabled patients and their families consider that is “excessive examination”. Doctors’ and patients’ cognition of the aspect most been needed to improve the medical ethics has significant difference(χ2=18.711, P< 0.05). Results: 34.15% of the medical staff consider that is “to enhance the responsibility of medical personnel”, 31.58% of the disabled patients and their families consider that is “reasonable examination and treatment”.4. Cognition of the responsible party for the doctors-patients relationshipDoctors’ and patients’ cognition of responsible party for doctor-patient relationship has significant difference(χ2=34.300, P<0.001), 61.38% medical staffs and 57.02% patients with disabilities and their families consider that is “institutional factors”.5. Reasons of tension between doctors and patients and the cognition of the responsibility of the parties. In the cognition on tense doctor-patient relationship(multiple choice), the medical staff consider that the top five reasons are followed by “medical and health system is not perfect”, “the unreasonable allocation of health resources”, “high medical costs”, “patients with limited medical knowledge”, “expectation value is too high”, “direction of public opinion is not correct”; the patients and their families consider that the top five reasons are followed by “high medical costs”, “medical and health care system is not perfect”, “the unreasonable allocation of health resources”, “doctor-patient communication lack”, “patients with limited medical knowledge”, “expected value is too high”. Doctors’ and patients’ cognition of doctors’ responsibility has no difference(χ2=4.466, P>0.05), they have the same view that doctors’ main responsibility is “poor service consciousness”. Doctors’ and patients’ cognition of patients’ responsibility has significant difference(χ2=67.799, P<0.001). 39.84% of the medical staff choose “do not trust doctors and biased”, 34.21% of the disabled patients and their families choose “the lack of relevant knowledge, examination and treatment compliance is poor”. Doctors’ and patients’ cognition of government’s responsibility has significant difference(χ2=11.456, P<0.05), 47.97% medical staff, 45.61% of the disabled patients and their family members choose “the medical system is not perfect, management is not in place, leading to confusion in the medical market”. Significant difference exists in the doctors’ and patients’ cognition on the function of media coverage and public opinion in the doctor-patient relationship,(χ2=95.161, P<0.001). 74.39% medical staff considers false reports, and 63.60% of the patients and their families consider truthfully reports.6. Cognition of existing model and ideal harmonious model of relationship between doctors and patients with disabilitiesDoctors’ and patients’ cognition on the existing mode of relationship between doctors and patients has significant difference(χ2=71.667, P<0.001). 50.00% of the medical staff think that is “contractual relationship between supply and demand”, 31.14% of the disabled patients and their families think that is “mutual trust, understanding and help relationship”. Doctors’ and patients’ cognition on the ideal harmonious doctor-patient relation has no difference(χ2=5.004, P>0.05). Both the vast majority of staff are of the view that the ideal harmonious doctor-patient relationship is mutual trust, understanding and help type relationship.7. Cognition of the ways to improve doctor-patient relationship In doctors’ and patients’ cognition on the main way to improve the doctor-patient relationship(multiple choice), the two sides both select “to improve medical system, increase government investment”, “to improve the medical personnel salary level”, “to improve the management and service level of the hospital”, “to strengthen medical science knowledge propaganda”, “to intensify the investigation on medical industry of law violations”, “to propagate ethics advanced individual stories in hospital” and etcetera.8. Cognition of doctor-patient relationship development trendThe two sides’ cognition on the development trend of the existing doctor-patient relationship has a significant difference(Z=-5.515, P<0.001). 31.71% of the medical staff consider that the relationship between doctors and patients will improve, 60.97% of the disabled patients and their families believe that the doctor-patient relationship will improve. Medical personnel’s attitude on the development trend of doctor- patient relationship is not optimistic, while patients and their families have more positive attitude on the development of the relationship between doctors and patients.9. The satisfaction degree of patients with disabilities in this medical treatment52.19% of the patients with disabilities completely trust, 75.88% of the patients and their families express satisfaction on the medical staff service attitude, 73.69% of patients and their families are satisfactory to the medical staff of the diagnosis and treatment level and treatment effect, but only 39.91% patients and their families express satisfaction on the medical costs.10. Occupational satisfaction of medical personnel52.85% of the medical staff think that they are respected in the doctor-patient relationship. Own occupational recognition of most medical staff is not high in this rehabilitation hospital, only 19.11% of the medical staff will choose the current occupation if they have an opportunity to choose a job again. Only 28.05% of the medical staff are satisfactory on the current job.Conclusions:1. The relationship between doctors and patients with disabilities is not harmonious in general. The doctors’ cognition of the doctor-patient relationship is negative, while the patients’ understanding of the relationship is positive. System factor is the main factor that affects the relationship between doctors and patients, the second is the public opinion factor.2. There is still lack of communication and trust between doctors and patients. Communication time is not enough for doctors’ busy work.The ways of communication are not appropriate. Medical personnel are on the lower level of communication satisfaction, and disabled patients and their families are on the higher communication satisfaction.The main reasons for communication barriers is the way of communication, the degree of culture, the status of doctors and patients, etc.3. The most serious problems on medical ethics are over check and poor service attitude, which need reasonable check and treatment and enhance the sense of responsibility of medical personnel.4. The cognition of medical personnel is more negative to the existing relationship between doctors and patients.Mutual trust, understanding and help relationship is both recognized the ideal harmonious relationship between doctors and patients by two sides.5. On the development trend of the doctor-patient relationship Doctors’ attitude is more negative, while patients and their families have a positive attitude.6. The disabled patients and their families give fairly high trust, satisfaction to the grade 3 rehabilitation hospital, and their treatment level and the effect of treatment are more satisfied, but the satisfaction degree of the medical cost is not high. The current job recognition degree and satisfaction degree of the medical personnel in the grade 3 rehabilitation hospital is both low.7. Unharmonious status of the relationship between doctor and people with disabilities causes by the doctors, the patients, and social multiple-dimension factors. In view of the influence factors, the thesis provide specific countermeasures and suggestions, from strengthening doctor-patient communication, strengthening the construction of medical ethics, improving medical service treatment, unblocking the channels for patient complaints, strengthening propaganda of popular science, deepening the reform of the medical and health care system, establishing a sound independent basic medical insurance system for the disabled, making the laws and regulations of the doctor-patient relationship, reasonably supervising the news media and ect. One particular concern is the establishment of a sound system for the protection of the basic medical insurance for people with disabilities, a clear health care institution for the disabled, so that the people enjoy a truly fair and equitable medical care.