The Impact Of Perceived Information Asymmetry On Patient-physician Trust:The Revision Of Scale And Its Application Research

Background and objective of the studyThe relationship between the patient and the doctor will affect the patient’s compliance with the doctor’s treatment plan,and only when the patient closely follows the doctor’s treatment plan,the cure rate of the disease will increase,thereby effectively reducing the medical cost.A large number of studies abroad have shown that the medical information obtained by patients,the consistency of patients and doctors in medical decision-making will affect the relationship between patients and doctors,and will also affect patient compliance.The relevant research in China is still in its infancy,and there are no relevant measurement tools such as perceived information asymmetry,patient physician concordance,patient compliance,the relationship between various factors and how these factors affect the relationship between doctors and patients and medical standards.It remains to be further clarified.Therefore,this study takes the patient as the research object,and the Chinese version of the perceived information asymmetry,patient physician concordance,patient compliance scale compiled by Canadian scholar Laugesen is revised to provide methodological guidance for domestic related research.Use the questionnaire method to explore the relationship between the three mentioned above and the trust of doctors and patients,which not only deepens the research field of domestic doctor-patient relationship.Moreover,it provides empirical evidence for improving the relationship between doctors and patients,improving the cure rate of diseases,and reducing waste of medical resources.Study one:Chinese version revision of perceived information asymmetry,patient physician concordance,and patient compliance scale1.Revision process of the scale(1)Review the literature and screen the scale.(2)Obtain the consent of the author of the original scale(3)Translation scale(4)Expert consultation,research group discussion,revision of terms and content,forming a scale of perceived information asymmetry,patient physician concordance,and patient compliance.(5)Pre-survey of 30 patients,based on feedback,form a formal test version of perceived information asymmetry,patient physician concordance,patient compliance scale.(6)Select the patients in the hospital for testing,and verify the reliability and validity of the scale after the test.2.Subjects and Methods(1)Sampling methods and subjectsIn September 2018,a questionnaire was conducted by using convenient sampliing method from a medical university affiliated hospital.A total of 150 questionnaires were distributed and 132 valid questionnaires were returmed.The effective recovery rate was 88%.Among them,67 were male(50.8%)and 65 were female(49.2%).(2)Assessment toolsIncluding:self-edited basic information questionnaire,perceived information asymmetry scale,patient physician concordance scale,patient compliance scale.(3)Data processingEpiData3.1 was used for data entry,and SPSS21.0 was used to organize and analyze the data.The statistical methods used were descriptive analysis,Person correlation analysis.3.Results(1)Each scale item was significantly correlated with the total score.The difference between the upper and lower 27%high and low group t test showed statistical significance.The Perceived Information Asymmetry Scale consists of four entries,the Patient Physician Concordance Scale consists of five entries,and the Patient Compliance Scale consists of five entries.(2)Reliability Index:The Cronbach’s a coefficients of the Perceived Information Asymmetry Scale,the Patient Physician Concordance Scale,and the Patient Compliance Scale were 0.953,0.926,and 0.929,respectively;the split-half coefficients were 0.929,0.929,and 0.890,respectively;the construct reliability were 0.935,0.916,and 0.909,respectively.(3)Validity index:The Perceived Information Asymmetry Scale,the Patient Physician Concordance Scale,and the Patient Compliance Scale have good convergent validity and discriminant validity.In terms of calibration validity,the Patient Physician Concordance Scale is highly correlated with the patient satisfaction scale for medical decision-making participation(r=0.737),and the patient compliance scale is associated with the Morisky medication adherence scale(r=0.280).Study two:Study on the relationship between patient physician consistency and sensory information asymmetry,doctor-patient trust,and patient compliance1.Objects and methodsIn November 2018,four hospitals in Guangzhou and Foshan were purposely selected to conduct questionnaire surveys.The questionnaire was filled out on site,350 questionnaires were distributed,and 268 valid questionnaires were collected.The questionnaire included self-edited basic information questionnaire,Perceived information asymmetry scale,Information asymmetry scale,patient-physician concordance scale,patient compliance scale,and Wake Forest physician trust scale.EpiData3.1 was used for data entry,and data was collated and analyzed using SPSS21.0 and AMOS23.0.The statistical methods used were descriptive statistical analysis,two independent samples t-test,one factor analysis of variance,Person correlation analysis and Structural equation model.2.Results(1)Analysis of Perceived information asymmetry and its demographic factorsa.The Perceived information asymmetry average scores of investigated patients was 22.56±4.07,of which the male score was 22.28±3.97 and the female score was 22.85±4.16.b.Perceived information asymmetry scores have statistically significant differences in different marital status or different satisfaction levels(P<0.05).(2)Analysis of patient-physician concordance and its demographic factorsa.The average score of patient-physician concordance was 26.77±5.35,of which the male score was 26.26±5.24 and the female score was 27.29±5.43.b.The patient-physician concordance scores of different patients with satisfactory medical treatment was statistically significant(P<0.05).(3)Analysis of patient compliance and its demographic factorsa.The total score of patient compliance was 29.35±4.11,of which the male score was 28.92±4.45 and the female score was 29.78±3.71.b.The scores of patient compliance in different treatment satisfaction were statistically signirficant(P<0.05).(4)Analysis of Wake Forest physician trust and its demographic factorsa.The scores of patients’Wake Forest doctor’s trust scale total score,benevolence and technical ability were(36.78 ± 6.04),(18.60 ± 3.12)and(18.18 ± 3.49)respectively.The Wake Forest doctor’s trust scalereflects the patient’s trust in the doctor’s benevolence.b.Wake Forest physician trust scores were statistically significant in different medical treatment methods,gender and satisfaction of treatment(P<0.05).(5)Analysis of information asymmetry between doctors and patients and its demographic factorsa.The information asymmetry score between doctors and patients was(12.63 ±2.80).,including(12.73±2,83)for men and(12.53±2.77)for women.b.The information asymmetry score between doctors and patients were statistically significant in different age and satisfaction of treatment(P<0.05).(6)The relationship of Perceived information asymmetry,Information asymmetry between doctors and patients,patient-physician concordance,patient compliance and Wake Forest physician trusta.Perceived information asymmetry was positively correlated with patient-physician concordance,patient compliance,Wake Forest physician trust(r =0.647,0.508,0.591;P<0.01);The asymmetry of doctor-patient information was negatively correlated with the Wake Forest physician trust scale(r=-0.208,P<0.01);Patient-physician concordance was positively correlated with patient compliance,Wake Forest physician trust(r = 0.526,0.594;P<0.01);Patient compliance was positively correlated with Wake Forest physician trust(r = 0.424;P<0.01).b.Patient-physician concordance was significant in the mediating effect between Perceived information asymmetry and Wake Forest physician trust(mediation effect was 52.3%),Patient-physician concordance was significant in mediating effects between perceived information asymmetry and patient compliance(mediation effect was 37.2%).(7)Path analysis of perceived information asymmetry and information asymmetry between patients and patients on patient trustPath analysis showed that there was a low negative correlation between perceivedinformation asymmetry and information asymmetry between doctors and patients(r=-0.23,P<0.01).It,s also shows that Perceived information asymmetry and information asymmetry between doctors and patients can jointly explain the variation of patient-physician concordance by 42%,Perceived information asymmetry,information asymmetry between doctors and patients,and patient-physician concordance can jointly explain the 55%variation in patient trust.Conclusions1.Chinese version of perceived information asymmetry,patient-physician concordance,and patient compliance scale have good reliability and validity,and have a good promotion value for evaluating patient’s perceived information asymmetry,concordance with physicians and compliance.2.Patients generally believe that doctors have a greater number or quality of medical information than their own.Patient-physician concordance and patient compliance are at a high level.Marriage status can affect the patient’s perceived information asymmetry level.The satisfaction of the treatment can affect the patient’s perceived information asymmetry,patient-physician concordance and patient compliance.3.The patient’s physician trust is at a high level,mainly in the trust of the doctor’s benevolence.The different medical treatment methods of the outpatient,inpatient and emergency departments,as well as gender and treatment satisfaction will affect the patient’s physician trust level.4.The patient’s level of perceived information asymmetry can directly affect the patient’s physician trust level and patient compliance,and can also indirectly affect the patient’s physician trust level and patient compliance by the degree of consistency with the doctor’s treatment plan.5.Perceived information asymmetry and information asymmetry between doctors and patients affect patients’ trust,the former is positive influence and the latter is negative influence.Innovations of the study1.The expansion of research tools.Revised the Chinese version of perceived information asymmetry scale and patient-physician concordance scale,which were not yet available in China,and revised patient compliance scale to measure medication compliance in normal patients.This provides a research tool for quantitative research on perceived information asymmetry,patient-physician concordance,and patient’s compliance.2.Deepening the research content.In the past,the research on information asymmetry mostly stayed at the theoretical level,expanding the research field of information asymmetry.This paper explores the influence of perceived information asymmetry and information asymmetry between patients and doctors on patient trust,and discusses the relationship between perceived information asymmetry、patient-physician concordance and compliance.The limitations of the study and predication of future studies1.This study explores the relationship between perceived information asymmetry,patient-physician concordance,patient’s trust,and patient’s compliance.However,this study only explores the relationship of various factors in a cross-section,and the conclusion needs further verification.2.The research object of this study is only from Guangzhou City and Foshan City.Therefore,it is also possible to expand the sample promotion to other regions to discuss the relationship between the four.3.Influential factors of doctor-patient trust are actually not only information asymmetry and patient physician consistency.Therefore,further research can explore the influencing factors of other patient’s trust and provide more comprehensive suggestions for improving doctor-patient relationship.4.The research method of this research is only the questionnaire survey method,and further research is needed in combination with qualitative research and experimental research.