Development And Preliminary Application Of The Patient's Presupposed Distrust Scale

Research significance and purposeNowadays,doctor-patient relationship is tense,Doctor-patient Conflict is increasing,which affects the normal order of hospital diagnosis and treatment,and has a significant negative impact on society.One of the reasons for Doctor-patient Conflict is the mistrust between doctors and patients.Some distrust belongs to the patient's presupposition distrust.That is to say,doctors and patients have not effectively communicated and interacted with each other.It is not credible to presume the doctor's medical ethics and technical ability before seeking medical treatment.They should take precautions against doctors and use various defensive measures in the process of seeking medical treatment.Under the medical system with Chinese characteristics,the doctor-patient relationship is complex and changeable.If the patient does not believe in the doctor presupposedly,it will make the complicated and changeable doctor-patient relationship more tense,and may even lead to the collapse of the doctor-patient relationship,which is not conducive to the construction of a harmonious medical environment.Therefore,the study of patients,presupposed distrust plays an important role in improving medical quality.At present,there is no research tool to measure patients,presupposed distrust in China.Therefore,this topic will focus on the preparation of patients'presupposed distrust scale to provide a scientific tool for the latter to study patients'presupposed distrust.Objects and methods of research1.Constructing the Item Pool of the Scale(1)Construct the situation database of scale.Through literature review,news report review of doctor-patient relationship,team members'Personal experience and brainstorming,we collect relevant information about doctor-patient conflict,doctor-patient trust and doctor-patient relationship.Based on the editor's clinical practice and experience,we discuss and analyze the influencing factors of patients,presupposition distrust,and establish the situation database of patients,presupposition distrust scale.(2)Expert group discussion.Teachers with psychiatric working background,PhD and Master of Psychology were invited to discuss with each other.The situation database of the scale was modified one by one,and the item pool of the patient's presupposed distrust scale was established.2.Establishment and evaluation of scale(1)Pre-survey sampling method and object of study:60 questionnaires were sent out to patients in two hospitals in Shenzhen by convenient sampling method.60 questionnaires were recovered,8 invalid questionnaires were excluded and 52 valid questionnaires were valid.The effective rate was 86.7%,including 24 males(46.2%)and 28 females(53.8%).The age ranged from 21 to 72 years,with an average age of 33.77(+9.39)years.(2)Sampling method and research object of formal investigation:Using convenient sampling method,500 questionnaires were distributed to patients in Guangzhou and Shenzhen hospitals.116 invalid questionnaires and 384 valid questionnaires were rejected.The effective rate was 76.8%,including 151 males(39.3%)and 233 females(60.7%)with an average age of 34.95±13.01.(3)Statistical analysis:EpiData 3.1 software was used to input data,SPSS 19.0 software was used for statistical analysis,descriptive analysis,independent sample t test,K Independent samples Test,correlation analysis and exploratory factor analysis were used.Results of the research1.The expert group discussed the revision of the scale situation database and determined 27 item pools,including hospital environment and investment scale,doctor's title and medical ethics,patient's personal factors and patient's judgment,communication between doctors and patients,information exchange,reform of medical system,social investment in medical treatment,media coverage of medical events.2.The correlation analysis of the scale:the items were correlated with the total score(P<0.05),and the coefficients were between 0.197 and 0.514.The items were correlated with the corresponding common factors(P<0.05),and the coefficients were between 0.429 and 0.852.3.Measurement index analysis of the scale:the scale has good content validity and structural validity;the internal consistency coefficient of the scale is 0.707,and the split-half reliability coefficient is 0.729 according to odd and even items;the scale is negatively correlated with the Vickers Forest Doctor Trust Scale,with a coefficient of-0.275(P<0.01).4.Preliminary application of the scale:The average score of the presupposed distrust physicians was(2.91±0.39)and the scores of each factor were(2.58±0.65)-(3.19±0.77).Conclusion of the study1.The reliability and validity of the patient's presupposed distrust scale meet the statistical requirements.2.Patient's presupposed mistrust of doctors is at a moderate level.Studies show that patients pay more attention to doctors'professional and technical abilities.They can enhance patients,trust in doctors by improving their personal professional literacy,increasing the input of basic drugs,and increasing positive news reports.Research conclusion1.The patient's presupposed distrust scale has good reliability and validity,and has good popularization value.2.Patient's presupposed distrust of doctors is at a moderate level.Studies show that patients value doctors,professional and technical abilities.They can enhance patients,trust in doctors by improving doctors,personal professional accomplishment,increasing the input of basic drugs,and increasing positive news reports.Innovation1.Development of research tools.It is the first circumstance scale for presupposed distrust of patients n our country that contains social situation when patients seek medical treatment.Scenario scale 1s not a direct survey of patients'distrust of doctors,but an indirect reflection of patients,implicit thoughts by letting patients judge the third person in a specific medical situation.Therefore,situation questionnaire can more truly reflect patients,presupposed distrust,measure the extent of patients,presupposed distrust,and presuppose distrust for future patients.Quantitative research provides methodological guidance.2.Expansion of research topics.The theme of this study 1s to study patients,presupposition distrust.At present,the research on Doctor-patient Conflict at home and abroad is mostly confined to the trust research after doctor-patient interaction.Some doctor-patient conflicts occur before the interaction between patients and doctors.Therefore,the research on patients,presupposition distrust is conducive to building a harmonious medical environment,improving medical technology and advancing medical technology.Harmonious development of society.Some aspects of this study need to be improved and deepened1.The patient's presupposed distrust scale developed in this study needs to be further studied,and the factor structure extracted from exploratory factor analysis of the scale needs confirmatory factor analysis.2.The reliability of the scale is not satisfactory,and the samples in this study are only from Guangdong Province.We should increase the sample size and expand the research area to further revise the items of the scale,and constantly verify the reliability and validity of the scale.3.We can further explore the influencing factors of patients'presupposition distrust from different perspectives,such as the impact of disease perception on patients'presupposition distrust.