The conflict between doctors and patients has become an important social problem in China, and is detrimental to the physical and mental well-being of both parties, affecting normal operation of medical service. The negative emotion brought by the experience or the event as a source of provocation will affect the perception of the experiencers as well as their attitude towards the relationship between doctors and patients. Medical students will become health professionals, taking on the responsibility of social health improvement and medical services. Therefore their growth and development are closely related to the health of the general public. This research focuses on how doctor-patient conflict exercises psychological stress among in-school medical students who are not directly exposed to this source of provocation. Based on the empirical research of data from 31 universities across the country, this article explores the mechanism of the impact of doctor-patient conflict on the psychological stress of medical students. A multi-stage stratified cluster sampling method was used to get a sampling data of 11,592 medical students from 31 universities across the country. The measurement of doctor-patient conflict was based on the cognitive-social impact theory, and the psychological stress was measured using the Chinese version of the Perceived Stress Scale (CPSS). Multivariate logistic regression and structural equation models were used to analyze the relationships and paths between variables. Among the subjects, 38.0% were found to have high stress and 15.6% had extremely high stress. More than half of the respondents reported that their family members, relatives, friends or classmates had experienced doctor-patient conflicts when seeking and receiving medical services. The reference norm is positively related to psychological stress. The risk of psychological stress of medical students whose family had experienced doctor-patient conflicts was 1.33 times higher than those without such experience, and the risk of medical students with friends or classmates who experienced doctor-patient conflict was 1.28 times higher than those without. Compared with those who did not perceive doctor-patient conflict or those with low perceived stress, the students with moderate or higher perceived stress had higher psychological stress, with OR values of 1.59 (1.32-1.91), 2.36 (2.01-2.77) and 2.80 (2.20-3.50) respectively. It is showed from the results of structural equation fitting that: χ2=139.991, df=13, p<0.01; GIF=0.997, AGIF=0.992, REM=0.006, indicating goodness of fit. The current situation of doctor-patient relationship (r=0.064, p<0.01; r=-0.096, p<0.001), the reference to the norm and pressure perception of doctor-patient conflict were all significantly positively correlated to the psychological stress but negatively correlated to the professional interest(r=0.06, p<0.01). The study has found the relationship between doctor-patient conflict and the psychological stress among medical students in school. The article discusses the importance of properly managing the current tight doctor-patient relationship for the development and growth of medical students. It is necessary to further the reform of the medical service system and deal with the sources of doctor-patient conflicts. Deliberate attention should be equally paid to humanities education as a part of medical education and to improve the students’ social skills such as doctor-patient communication.
章伟芳 王慧慧 彭嗣惠 杨廷忠. 医患冲突对医学生心理压力的影响：基于全国31所大学的实证研究[J]. 浙江大学学报(人文社会科学版), 2020, 6(2): 50-.
Zhang Weifang Wang Huihui Peng Sihui Yang Tingzhong. The Influence of Doctor-Patient Conflict on the Psychological Pressure of Medical Students： An Empirical Analysis of 31 Universities in China. JOURNAL OF ZHEJIANG UNIVERSITY, 2020, 6(2): 50-.