PLoS ONE
Volume 10, Issue 5, 2015

African migrant patients' trust in Chinese physicians: A social ecological approach to understanding patient-physician trust (Article) (Open Access)

McLaughlin M.M. , Simonson L. , Zou X. , Ling L. , Tucker J.D.
  • a UNC Project-China, Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University School of Public Health, Guangzhou, Guangdong Province, China
  • b Department of Geography and Planning, Sun Yat-sen University, Guangzhou, Guangdong Province, China
  • c Sun Yat-sen Center for Migrant Health Policy, Faculty of Medical Statistics and Epidemiology, Sun Yat-sen University School of Public Health, Yuexiu District, Guangzhou, Guangdong Province, China
  • d Sun Yat-sen Center for Migrant Health Policy, Faculty of Medical Statistics and Epidemiology, Sun Yat-sen University School of Public Health, Yuexiu District, Guangzhou, Guangdong Province, China
  • e UNC Project-China, Guangzhou, Guangdong Province, China

Abstract

Background: Patient trust in physicians is a critical determinant of health seeking behaviors, medication adherence, and health outcomes. A crisis of interpersonal trust exists in China, extending throughout multiple social spheres, including the healthcare system. At the same time, with increased migration from Africa to China in the last two decades, Chinese physicians must establish mutual trust with an increasingly diverse patient population. We undertook a qualitative study to identify factors affecting African migrants' trust in Chinese physicians and to identify potential mechanisms for promoting trust. Methods / Principal Findings: We conducted semi-structured, in-depth interviews with 40 African migrants in Guangzhou, China. A modified version of the social ecological model was used as a theoretical framework. At the patient-physician level, interpersonal treatment, technical competence, perceived commitment and motive, and language concordance were associated with enhanced trust. At the health system level, two primary factors influenced African migrants' trust in their physicians: the fee-for-service payment system and lack of continuity with any one physician. Patients' social networks and the broader socio-cultural context of interactions between African migrants and Chinese locals also influenced patients' trust of their physicians. Conclusions: These findings demonstrate the importance of factors beyond the immediate patient-physician interaction and suggest opportunities to promote trust through health system interventions. © 2015 McLaughlin et al.

Author Keywords

[No Keywords available]

Index Keywords

personal experience doctor patient relation patient care China Physician-Patient Relations Chinese interpersonal communication health insurance human medical fee controlled study social network African language qualitative research Professional Competence health care cost Humans migrant psychology ethnic conflict Trust Black person male African Continental Ancestry Group female Socioeconomic Factors socioeconomics cultural factor Article adult migration Transients and Migrants social discrimination
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84930619279&doi=10.1371%2fjournal.pone.0123255&partnerID=40&md5=a48ed84d34c979dbf0d4fae3925c04d0
DOI: 10.1371/journal.pone.0123255
ISSN: 19326203
Cited by: 3
Original Language: English