Investigation On The Rights And Obligations Relationship Among Patients And Doctors And Nurses In Internal Medicine Department

Research purposesInvestigate the rights claims and rights implement of patients,doctors and nurses in various medical activities,and simultaneously explore the impact of rights factors on hospitalization satisfaction of patients and occupational satisfaction of medical staff.This study found out the understanding status of the rights of patients and medical staff,and analyzed the causes of disputes between doctors and patients in different medical links.It aims to provide reference materials for China's health legislation,hospital management,and coordination of doctor-patient relations.Research methodCollect demographic basic information of doctors,patients,and nurses,and awareness of rights and obligations,degree of rights implementation,hospitalization or occupational satisfaction in seven medical links.Using the convenient sampling method,the inpatient wards of 6 sample hospitals in Hainan Province and Henan Province were selected.According to the voluntary principle,all the doctors and nurses in the sample hospitals who were in the investigation department were included in the survey.One or two patients were selected from each ward for investigation to avoid mutual influence of the same ward.Interviews were used for patients with no writing ability.Patients with writing ability and all medical staff used the questionnaire self-answer method.The patient questionnaire was collected on-site and 245 valid questionnaires were returned.The questionnaires of medical staff were collected every other day,149 valid questionnaires were collected,and 213 valid questionnaires were collected from nurses.Epidata3.0 was used to establish a database,double entry proofreading,and SPSS20.0 was usedto do statistical analysis.The content is divided into two categories: qualitative research and quantitative research.Qualitative research mainly compares the cognitive differences and rights implementation of patients,doctors and nurses on the same issue in each link.After the answers are classified and encoded,they are sorted according to the frequency,the weighted frequency,and the unimplemented rate of rights.The quantitative research mainly focuses on the influence of demographic factors and rights factors on the satisfaction of the research subjects.The key rights and demographic variables are coded into two-category and multi-class variables for one-way ANOVA.Then the meaningful variables are coded into dummy variables and introduced into the multiple regression model to obtain the influencing factors of satisfaction.Based on the research results and conclusions,the corresponding policy recommendations are proposed.Research result1.Qualitative research results(1)The first consultation session: the difference in claims of rights between doctors and patients is significant,and the patients focus on the rights of humanized service.Cognitive differences affect the patient's assessment of medical quality.(2)Medical examination link: the contradiction between prescription right and right to reasonable medical examination,and the cognitive difference of right to know is the focus of disputes of patients and doctors.(3)Link of establishment of diagnosis and treatment plan: patients and doctors attach great importance to the right to know and the dominance of doctors.But the failure to guarantee patient's right to know has led to a failure to form a good relationship.(4)Link of prescribing a doctor's advice:doctors and patients have a greater gap inunderstanding of patients' rights.Patients have low awareness of their obligations and a relatively one-sided understanding of autonomy.(5)The link of disease change: the patient fails to respect,understand,and cooperate with the doctor.Doctors are more conservative and passive in their work at this stage.(6)Discharge link: The follow-up inspection and return visit rate of patients and doctors are low.The patient is poorly obedient to the doctor.(7)Nursing link: the shortage of nurses' manpower and the quality of the intern nurses affect the patient's right to health.The right to the dignity of the nurse and the right to personal security have not been protected.2.Quantitative research results(1)Impact factors of patient satisfaction: medical payment methods,departmental categories,over-medical(medical examination links),and claims for rational drug use(link of prescribing a doctor's advice).(2)Impact factors of patient's family satisfaction: department category,age and claim for reasonable medical examination.(3)Impact factors of doctor satisfaction: income level,realization of prescription rights(medical examination links),and claims of patients' right to know(link of establishment of diagnosis and treatment plan).(4)Impact factors of nurse satisfaction: age,education,position,stress level,realization of personality dignity and claiming the right to patient health.Conclusion1.The concept of the rights and duties of patients is generally weak.It is necessary to strengthenthe legal education of patients and update doctors' awareness of rights and obligations.2.Both doctors and patients have claims on the moral and legal levels.The realization of rights and right claims affect the relationship between doctors and patients,and there is a big difference in the perception of patients' rights in multiple medical links.3.The right to know affects the degree of cooperation between doctors and patients in medical activities.The patient's request for the right to know is enriched with the changes in the medical link.The multi-level positioning and notification content should become an important task of the health legal system.4.The realization of the doctor's prescription right in the medical examination is in a difficult position,and the conflicts between the doctors and the patients in the link of medical examination and prescribing a doctor's advice are more obvious.5.The absence of nurses' rights protection affects the realization of the rights of both doctors and patients.A nurses' rights relief platform should be established to protect nurses' practicing rights.Innovation1.Guided by the unity of rights and obligations,the rights and obligations of patients and health care workers are studied.Integrating patients with doctors and nurses into the same research scope balances the interests of both parties.2.The hospitalization process is divided into links and processes.For the first time,the hospitalization process of medical patients is systematically divided into the first diagnosis,medical examination,diagnosis and treatment plan,medical treatment,disease change,discharge,and nursing.3.Combining qualitative and quantitative analysis methods,based on the qualitative results,the rights factor was further incorporated into the multiple regression model,and the degree of influence of the right factors on the relationship between doctors and patients was found.Insufficient in this study1.The sample size of this study is relatively insufficient.Many respondents did not answer questions on the implementation of rights,which has a certain impact on the regression analysis model in quantitative research.The follow-up can increase the sample size and carry out relevant research in the country.2.The research method of this paper is relatively simple,but it is suitable for the first time to explore rights and obligations in every medical links between doctors and patients.Subsequent research can further broaden the thinking and apply more sophisticated research methods.