Relationship between self-care compliance, trust, and satisfaction among hypertensive patients in China

An Exploratory Study of Factors Associated with Medication Adherence in Chinese Rheumatoid Arthritis Patients

Purpose

This study aims to estimate the prevalence of medication adherence in Chinese patients with RA and to identify factors influencing it.

Patients and Methods

A cross - sectional study was conducted, involving 1137 RA patients who were treated at a university hospital in Guizhou, China. Sociodemographic data, medication adherence, patient satisfaction, and quality of life (QoL) were collected through face-to-face interviews, while disease course and comorbidities (including pneumonia and gastrointestinal conditions) were extracted from hospital information systems (HIS). Multifactorial logistic regression analysis was applied to assess the factors influencing patients' adherence. Subsequently, mediation analysis was employed to delve deeper into the interrelationships among the variables.

Results

The proportion of patients with good adherence was 61.57%. Multivariable logistic regression analysis revealed that patient satisfaction (OR=2.079), treatment regimen (OR=0.280), and pulmonary infection (OR=1.695) were independently associated with medication adherence. The QoL scores for the groups demonstrating good adherence and satisfaction were markedly higher compared to those exhibiting non-adherence and dissatisfaction (P<0.001). Medication adherence mediated the positive relationship between patient satisfaction and mental health (MH) in QoL (β= 0.140).

Conclusion

Our study demonstrates a significant positive correlation between patient satisfaction and medication adherence. Improving patients' satisfaction with treatment is feasible approaches to enhancing medication adherence. However, Single-center studies limit the generalizability of results, and potential confounding by unmeasured variables should be considered.

Unintended Consequences of Follow-Up Care: Patient Experiences with Hypertension Management in Chinese Community Nursing

PURPOSE

Community follow-up care is essential for managing hypertension, with Chinese community nurses playing a pivotal role in sustaining long-term management. However, little research has examined how rigid or inappropriate care approaches may inadvertently cause patient discomfort. This study addresses this gap by exploring the unintended consequences of follow-up practices among community nurses caring for hypertensive patients in China.

DESIGN

A qualitative descriptive study.

METHODS

Semi-structured interviews were conducted with 23 hypertensive patients in Shenzhen between June and August 2024. Data were analyzed using iterative thematic analysis.

FINDINGS

Three themes emerged. First, standardized follow-up protocols often clashed with patients' individual needs, leading to frustration with the rigid, one-size-fits-all approach. Second, patients experienced emotional distress, feeling alienated by impersonal, task-oriented nurse communication. Third, health education communication breakdowns were prevalent, with patients finding vague lifestyle recommendations impractical and difficult to apply.

CONCLUSIONS

This study uncovers overlooked complexities in follow-up interactions, critiques the rigidity of current protocols, and challenges the predominantly positive perception of standardized follow-up care.

CLINICAL EVIDENCE

Findings underscore the need for training programs to equip community nurses with patient-centered care skills, emphasizing effective communication and personalized health education to improve patient engagement and clinical outcomes in hypertension management.

The Impact of Medical Risk Perception on Patient Satisfaction: The Moderating Role of Shared Decision-Making

Purpose

The perception of medical risks is ubiquitous, influencing patients' healthcare experiences, yet the "black box" of this influencing process is seldom explored. This study explores the relationship between medical risk perception, trust, and patient satisfaction while taking shared decision-making as a moderator.

Methods

A stratified random sample of 450 inpatients from a tertiary public hospital in Guangzhou was selected for investigation, from June 2023 to September 2023. A moderated mediation model was tested using the PROCESS program, wherein medical risk perception was linked to patient satisfaction through trust, with shared decision-making acting as the moderating variable.

Results

Medical risk perception had a significant negative predictive effect on patient satisfaction (β = -0.383, p < 0.001), and after introducing the mediating variable, the negative predictive effect of medical risk perception on patient satisfaction remained significant (β = -0.237, p < 0.001). Trust partially mediated the relationship between medical risk perception and patient satisfaction, with the mediating effect accounting for 37.86% of the total effect. The interaction term between medical risk perception and shared decision-making (β = 0.211, p < 0.001) significantly predicted trust.

Conclusion

This study confirmed the mediating and moderating effects of trust and shared decision-making on the relationship between medical risk perception and patient satisfaction. The theoretical model constructed based on the theory of information asymmetry provides strategies and methods for healthcare managers to improve the quality of healthcare services and alleviate tensions in doctor-patient relationship.

User perceptions of intelligent offloading diabetic footwear

Aims

Adherence to therapeutic footwear is vital for effective diabetic foot ulcer prevention and treatment. Understanding the key adherence factors and potential barriers is important for footwear design and implementation. Our team is creating intelligent offloading footwear to prevent lower extremity amputations in people living with diabetes (PLwD). This exploratory study assessed the ability of the established Unified Theory of Acceptance and Use of Technology (UTAUT) model to predict behavioral intention to use or recommend this intelligent offloading footwear by PLwD, caregivers of PLwD, or medical professionals treating PLwD.

Methods

Online and paper questionnaires were implemented to assess the impact of the UTAUT model factors (performance expectancy, effort expectancy, social influence, facilitating conditions) and psychosocial factors (attitude, anxiety, self-efficacy) on the overall behavioral intention to use the footwear. Furthermore, factors influencing potential acceptance and rejection of the footwear were explored.

Results

Patients (4.0/5) and medical professionals (4.1/5) showed a behavioral intention to "agree" to use or recommend the footwear when it becomes available. Structural equation modeling showed that the UTAUT constructed model may not be the best indicator for behavioral intention here based on a lack of statistical significance. However, the logistic regression modeling showed that the social influence for PLwD (p=0.004) and the attitude toward the footwear for medical professionals (p=0.001) may be the most important when designing and implementing the footwear, though several other factors (performance expectancy, effort expectancy, facilitating conditions, and self-efficacy) were also important for one or both of these populations. Additionally, cost and clinician support were shown to be important factors influencing potential acceptance of the footwear.

Conclusions

The study found promising intention to use the intelligent footwear in the future. This highlights the need to continue future development and implementation of the footwear to incorporate these results, thus improving the likelihood of high adherence of the footwear.

Effective analysis of job satisfaction among medical staff in Chinese public hospitals: a random forest model

Objective

This study explored the factors and influence degree of job satisfaction among medical staff in Chinese public hospitals by constructing the optimal discriminant model.

Methods

The participant sample is based on the service volume of 12,405 officially appointed medical staff from different departments of 16 public hospitals for three consecutive years from 2017 to 2019. All medical staff (doctors, nurses, administrative personnel) invited to participate in the survey for the current year will no longer repeat their participation. The importance of all associated factors and the optimal evaluation model has been calculated.

Results

The overall job satisfaction of medical staff is 25.62%. The most important factors affecting medical staff satisfaction are: Value staff opinions (Q10), Get recognition for your work (Q11), Democracy (Q9), and Performance Evaluation Satisfaction (Q5). The random forest model is the best evaluation model for medical staff satisfaction, and its prediction accuracy is higher than other similar models.

Conclusion

The improvement of medical staff job satisfaction is significantly related to the improvement of democracy, recognition of work, and increased employee performance. It has shown that improving these five key variables can maximize the job satisfaction and motivation of medical staff. The random forest model can maximize the accuracy and effectiveness of similar research.

Patient satisfaction and follow-up adherence to glaucoma case management clinic in China

AIM

To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.

METHODS

In this cross-sectional study, a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire. Clinical data was obtained from the case management system. Follow-up adherence was defined as completing each follow-up within ±30d of the scheduled time set by ophthalmologists during the study period.

RESULTS

Average satisfaction scored 78.65±7, with an average of 4.39±0.58 across the seven dimensions. Age negatively correlated with satisfaction (P=0.008), whilst patients with follow-up duration of 2 or more years reported higher satisfaction (P=0.045). Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence (OR=0.97, 95%CI, 0.95-1.00, P=0.044). Additionally, patients with suspected glaucoma (OR=2.72, 95%CI, 1.03-7.20, P=0.044) and those with an annual income over 100 000 Chinese yuan demonstrated higher adherence (OR=5.57, 95%CI, 1.00-30.89, P=0.049).

CONCLUSION

The case management model proves effective for glaucoma patients, with positive adherence rates. The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.

Factors Influencing Medication Adherence in Elderly Patients with Hypertension: A Single Center Study in Western China

Purpose

To develop and empirically test a conceptual model that explains the factors influencing antihypertensive medication adherence behavior in elderly patients in a city in western China.

Patients and Methods

The conceptual model was based on the Theory of Planned Behavior and the Health Belief Model and was empirically tested using cross-sectional survey data from Nanchong City, a city in western China, collected between October and December 2020. Data were analyzed using structural equation modeling.

Results

Behavioral intentions were the main predictor of medication adherence behavior (path coefficient of 0.353). Perceived benefits and perceived barriers directly (path coefficient = 0.201 and -0.150, respectively), and indirectly (path coefficient = 0.118 and -0.060) through behavioral intentions, influenced medication adherence behavior. Perceived susceptibility (path coefficient = 0.390) and perceived severity (path coefficient = 0.408) influenced behavioral attitudes, which influenced behavioral intentions (path coefficient = 0.298).

Conclusion

The conceptual model demonstrates a robust ability to predict and explain medication adherence behavior among elderly patients with hypertension, facilitating the adoption and maintenance of changes in adherence behavior and the potential for preventing disease progression and improving quality of life.