Interpersonal factors contributing to tension in the Chinese doctor–patient–family relationship: a qualitative study in Hunan Province
Siyu Xiao, Lixuan Wang, E. Jennifer Edelman, Kaveh Khoshnood
Abstract
OBJECTIVE: To identify actionable barriers to communication that contribute to tension in the Chinese doctor-patient-family relationship (DPFR) among surgeons, surgical patients and their family members. DESIGN: We employed qualitative research methods using in-depth, semistructured interviews in Mandarin and English and conducted preoperatively and postoperatively. Interviews were audio recorded, transcribed and translated into English. Data were analysed using thematic analysis. SETTING: An urban, tertiary-level teaching hospital in Hunan Province, China. PARTICIPANTS: We recruited a purposive sample of 11 inpatients undergoing the same minor surgery, 9 of their family members and 9 surgeons between June and August 2015. RESULTS: We identified three emergent themes. First, trust degradation occurred before and during the healthcare experience. Second, the healthcare-seeking experience for patients and family members was marked by unmet expectations for achieving a basic understanding of the illness as well as powerlessness over their situation. Third, societal pressures on doctors contributed to a state of learned helplessness. CONCLUSIONS: Our findings suggest that tension in the DPFR is associated with interpersonal and structural challenges, with communication playing an important role. Reforms at all levels are needed to promote a more patient-centred experience while ensuring the well-being and security of providers.