患者信任对健康成果影响的实证研究

Empirical study of the impact of patients＇ trust on health outcomes

目的了解患者信任与健康成果的关系，验证患者行为倾向在患者信任影响健康成果的中介作用。方法采用自编的24个项目的基于医疗质量改进的患者信任度评价量表，调查上海某2家三级医院和20家社区医院共727名住院患者的信任度。通过患者行为倾向测量表、生活质量测量表、患者临床疗效总评量表，了解患者的行为倾向对健康的影响。结果患者信任不仅对患者健康成果有影响作用，而且还通过患者行为倾向中介这种影响，对患者信任影响患者生活质量发挥部分中介作用，对患者信任影响临床疗效发挥完全中介作用。结论可以通过改善患者行为提高健康成果。对医生来说，通过提高与患者之间的信任来影响患者行为倾向，进而促进医息之间的交流，促进治疗方案的实施，改进健康成果。

Objective To identify the relationship between patients＇ trust and their health outcomes and verify the mediator role played by patients＇ behavioral intention in affecting the health outcomes. Methods The 24-item patients＇ trust evaluation scale customized based on QOC improvement was called into play to measure the extent of trust of 727 inpatients at two tertiary hospitals and 20 community hospitals in Shanghai. The patients＇ behavioral intention scale, life quality scale and patients＇ clinical effect general scale helped reveal the patients＇ behavior tendency on their health. Results It is found that patients＇ trust affects their health outcomes. Furthermore, such trust plays partial mediator role on patients＇ life quality, and a complete mediator role in affecting the clinical effect. Conclusion Improvement of patients＇ behavior can result in better health outcomes. For doctors, better trust from the patients can affect patients＇ behavioral intention, encourage doctor-patient communication and therapy plans for better health outcomes in the end.