Effect of hospital culture on professional attitudes and behaviours of Chinese clinical physicians: a cross-sectional investigation. (December 2017)

• Record Type: Journal Article
• Authors: Chen, Jing; Yang, Qiuxia; Zhang, Rui; Tan, Yan
• Is Part Of: Lancet. Volume 390(2017)Supplement 4
• Page Start: S82
• Publication Date: 2017-12
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Medicine; Electronic journals; Periodicals; 610.5
• DOI: 10.1016/S0140-6736(17)33220-8
• Languages: English
• ISSNs: 0140-6736

Abstract

Abstract: Background: An increasing number of studies on physicians' professionalism have been done since the 2002 publication of Medical Professionalism in the New Millennium: A Physician Charter . However, most were done in developed countries, and few have been done in China. Additionally, few studies have examined the effect of hospital culture on physicians' professionalism. Our study investigated professional attitudes and behaviours of doctors in China, and assessed the effect of hospital culture on such attitudes and behaviours. Methods: Self-administered questionnaires including 22 items on patient-centred hospital culture, 20 items on attitude, and ten items on behaviour were given to clinical physicians in five public hospitals in Beijing, Hubei, and Jiangxi Provinces, China, from Feb 24 to March 14, 2017. Verbal informed consent was obtained from the participants. Factor analysis was used to explore principal components for patient-centred hospital culture. Linear regression was used to explore the predictors of professional attitudes and behaviours of doctors. Findings: 232 valid questionnaires were collected. 208 (90%) respondents agreed with 15 of 20 specific statements on medical professionalism. 54 (23%) respondents disagreed with reporting of incompetent colleagues and 49 (21%) disagreed with recertification. More than 185 (83%) respondents reported that they sometimes, usually, or always showed the four positive behaviours on the questionnaire, and 173 (77%) reported that they never showed the six negative behaviours. Factor analysis indicated that the hospital culture scale (21 items) consisted of three dimensions: spiritual and institutional culture, behaviour and material culture, and negative evaluation of hospital culture. Regression analyses indicated that spiritual and institutional culture (β 0·344, 95% CI 0·148–0·343), behaviour and material culture (0·180, 0·028–0·188) and hospital culture (0·171, 0·045–0·232) significantly influenced attitudes (adjusted r 2 25·9%). The predictors of the total score of behaviour were professional attitudes (β 0·295, 95% CI 0·154–0·397) and negative evaluation of hospital culture (0·155, 0·012–0·133; adjusted r 2 12·2% of the variation). Interpretation: Physicians showed relatively positive professional attitudes and behaviours. Hospital culture affected physicians' attitudes and behaviours, suggesting that improvement of hospital culture is crucial to enhance professionalism. Funding: National Natural Science Foundation of China (71203069, 71573094), the Fundamental Research Funds for the Central Universities, HUST (2013WZ024, 2015AC027).