Positive Practice Environments Evaluation Of Doctors And Nurses:A National Sampling Survey In China

Objectives:The aim of this study is to investigate the positive practice environments?PPE?evaluation of doctors and nurses in China and compare this between doctors from Traditional Chinese Medicine hospital?TCMH?and General Hospital?GH?hospital,and nurses from TCMH and GH,and to analysis the effect of hospital factors and individual factors on PPE,then providing recommendation and evidence for PPE improvement.Method:Using stratified cluster sampling method,a national cross-sectional survey was performed in 51 GH and 26 TCMH across 7 provinces/metropolis.3,564eligible doctors and 5374 nurses were included.The research contents included demographic characteristics,PPE?including organization management and provider-patient relationship 2 dimension?,hospital factors?hospital level,ratio of doctors/nurses beds,performance assessment?and individual factors?responsibility,discussion treatment plan and listening to patients?.The analysis methods include descriptive analysis,t test,analysis of variance,and generalized linear regression.Result:The PPE evaluation of doctors?18.02±4.86?was lower than that of nurses?18.51±4.69?.Doctors of GH had lower PPE evaluation?17.86±4.92?than doctors of TCMH?18.41±4.70?,but nurses of GH had higher PPE evaluation?18.68±4.68?than nurses of TCMH?18.08±4.67?,with statistic significantly?P<0.01?.In general,providers had higher evaluation of organization management than provider-patient relationship.Multivariable analysis showed that,compared with providers who had not very much concerns about performance assessment,providers who had very much concerns had lower PPE evaluation(?_doctors=-1.01,95%CI:-1.40^-0.61;?_nurses=-1.21,95%CI:-1.54^-0.87);Compared with providers who had infrequently listening to patients,providers who had frequently listening to patients had higher PPE evaluation(?_doctors=2.23,95%CI:1.85².61;?_nurses=2.53,95%CI:2.17².89);Discussion treatment plan had different influence on doctors and nurses.Compared with providers who had infrequently discussion,doctors who had frequently discussion had lower PPE evaluation??=-1.12,95%CI:-1.87^-0.37?,but nurses who had average discussion had higher PPE evaluation??=0.96,95%CI:0.49¹.43?.Responsibility had positive influence on doctors of GH only.Compared with doctors who had little responsibility,doctors who had average and very much responsibility had higher PPE evaluation??=1.43,95%CI:0.53².34;?=1.75,95%CI:0.88².61?.Ratio of nurses to beds had positive influence on nurses of TCMH only.Compared with nurses from departments with ratio of nurses to beds lower than 0.4,nurses from departments with ratio of nurses to beds between 0.4-0.6 had higher PPE evaluation??=0.59,95%CI:0.11¹.07?.Conclusion:It is serious that the PPE of providers in China,and provider-patient relations were worse than organizational management.Doctors had better PPE than nurses.Doctors from GH perceived worse PPE than ones from TCMH,but nurses from GH perceived better PPE than ones from TCMH.To improve PPE,hospital should implement moderate levels of performance assessment and train more nurses who study Traditional Chinese Medicine.Besides,developing a sense of responsibility during medical education for doctors and training communication skill,may enhance PPE.