Construction And Analysis Of Structural Equation Modeling Of Doctor-nurse-patient Relationship For Prevention Of Type ? Violence In Hospitals

ObjectiveThe aim of this study was to conduct surveys among doctors,nurses,and inpatients in order to explore the influence of doctor-patient trust and nurse-patient verbal and social interactions on the satisfaction of hospitalized patients,and thus to construct a structural equation modeling of doctor-nurse-patient relationship which could provide strategies for preventing type ? violence in hospitals.MethodsThis study was designed as a quantitative research by using a convenient sampling in People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine from March 2017 to August 2018.Wake Forest Physician Trust Scale,Physician Trust in the Patient Scale,Verbal and Social Interactions for Nurses,Verbal and Social Interactions for Patients,Satisfaction Scale for Patients were used to survey among physicians,nurses and inpatients.Firstly,descriptive statistics,score statistics,variance expansion factor analysis,and multiple regression analysis were used to analyze the data from the surveys of Wake Forest Physician Trust Scale,Physician Trust in the Patient Scale,Verbal and Social Interactions for Nurses and Verbal and Social Interactions for Patients.Secondly,the independent sample t-test and one-way ANOVA were utilized to analyze the data from the surveys of Satisfaction Scale for Patients.“Patient satisfaction” was used as an indicator to measure the harmony of doctor-nurse-patient relationship.All data were processed by z-score standardization method,and then were performed correlation analysis and assigned values.After the assignment,hierarchical regression analysis was performed.The latent variables with statistically significant in the results of the hierarchical regression analysis were performed confirmatory factor analysis,correlation analysis,and normality test.Finally,the data through the tests was constructed a structural equation modeling for the prevention of type ? violence in hospitals by using the total scores of each dimension in scales and questionnaires.Results1.In the data from Wake Forest Physician Trust Scale,“Technical competence”and “Benevolence” had influence on patients' trust in doctors(P<0.05),and their impact coefficients were respectively 0.4976 and 0.4886.In the Physician Trust in the Patient Scale,“Role of patients” had a big effect on doctors' trust in patients(P<0.05),and its impact coefficient was 0.5563.The doctor's marital status and highest academic degree had influence on doctors' trust in patients(P<0.05),and the impact coefficients were respectively-0.0030 and-0.0006.2.In the data from Verbal and Social Interactions for Nurses,the dimensions of“Caring towards health and well-being”,“Encouraging social aspects in daily life”,“Inviting to talk about feelings and thoughts”,and “Building a caring relationship”had significantly statistics difference(P<0.01).Their impact coefficients were respectively 0.2890,0.2431,0.1691,and 0.2930.The nurses who had longer career life provided more caring care for the patients(P<0.05),and the impact coefficients was 0.0023.In the data from Verbal and Social Interactions for Patients,the dimensions of “Perceived nurse care their health and well-being”,“Perceived nurse encourage social aspects in their daily life”,“Perceived nurse invite to talk about their feelings and thoughts”,and “Perceived nurse builde a caring relationship with them” had significantly statistics difference(P<0.01).Their impact coefficients were respectively 0.3196,0.2062,0.1498,and 0.3381.The age and personality type of patients negatively influenced patient's perception of caring from nurses(P<0.01),and the influence coefficients were respectively-0.0020 and-0.0040.3.In Satisfaction Scale for Patients,patients who were 18-29 years old,were with urban residents medical insurance,and had not experienced type ?violence in hospitals,were more satisfied(P<0.05).4.The total scores of the five dimensions of satisfaction scale for patients were taken as the dependent variables.The latent variables could effectively explain the73.9% variability of patients' satisfaction.Among the latent variables,“Benevolence”and “Technical competence” could effectively explain the 52.4% variability of patients' satisfaction;“Role of patients” and “Respect for interpersonal relationships”could effectively explain the 11.3% variability of patients' satisfaction;“Caring towards health and well-being”,“Encouraging social aspects in daily life”,“Inviting to talk about feelings and thoughts”,and “Building a caring relationship” could effectively explain the 10.2% variability of patients' satisfaction.5.In Structural Equation Modeling,Patients' satisfaction was affected by patients' trust in physicians(P<0.01,path coefficient=0.727),where the most influencing factor was “Benevolence”(P<0.001,path coefficient=0.990),and then“Technical competence” was the followed influencing factor(P < 0.001,path coefficient=0.381);patients' satisfaction was affected by Verbal and social interactions ability of nurses(P<0.05,path coefficient=0.239),where the influencing order was “Building a caring relationship”(P < 0.001,path coefficient=0.901),“Caring towards health and well-being”(P < 0.001,path coefficient=0.874),“Encouraging social aspects in daily life”(P<0.001,path coefficient=0.725),and“Inviting to talk about feelings and thoughts”(P < 0.05,path coefficient=0.145).Physicians' trust in patients had no significantly effect on patients' satisfaction(P>0.05,path coefficient=0.059).Conclusion1.In the relationship between physicians and patients,the contribution of patients' satisfaction is Benevolence > Technical competence,i.e.doctor patiently explaining disease to patients contributes more than doctor' technical competence for patients' satisfaction.2.In the relationship between nurses and patients,the contribution of patients' satisfaction is “Building a caring relationship” >“Caring towards health and well-being” >“Encouraging social aspects in daily life” >“Inviting to talk about feelings and thoughts”.3.“Patients' trust in physicians” and “verbal and social interactions ability of nurses” are the key influence factors of preventing type ? violence in hospitals.The influence of “patients' trust in physicians” is bigger than that of “verbal and social interactions ability of nurses”.Physicians' trust in patients has no significantly effect on preventing type ? violence in hospitals.