OBJECTIVE: To explore and understand the conflict in decision-making of hematopoietic stem cell transplantation in patients with hematological neoplasms.
METHODS: A descriptive qualitative study of 16 patients with hematologic neoplasms in the hematology department was conducted between February 2022 and May 2022. Purposive sampling was used to select participants. Face-to-face in-depth personal interviews were performed. Interviews were recorded, transcribed, and coded. This descriptive qualitative study adhered to the COREQ checklist.
RESULTS: All patients indicated difficulties in making decisions regarding hematopoietic stem cell transplantation. Five themes were identified: (1) weighing the pros and cons of HSCT, (2) financial burden versus desire for rebirth, (3) treatment urgency versus being unprepared, (4) saving oneself versus damaging loved ones, and (5) family companionship versus emotional isolation. These themes reflect the contradictions, entanglements, and realistic conflicts in decision-making regarding hematopoietic stem cell transplantation for patients with hematological neoplasms.
CONCLUSIONS: This study identified multiple conflicts of decision-making in patients with hematologic neoplasms regarding decisions on hematopoietic stem cell transplantations. Healthcare workers should provide patients with disease knowledge, doctor-patient and intra-family communication, and access to financial support in order to resolve their conflicts and ultimately help them make the decision that is most optimum for them.

UNASSIGNED: To investigate the influence mechanism of doctor-patient communication on patients\' trust, especially the mediating role of patient-physician consistency and the moderating role of perceived threat of disease.
UNASSIGNED: A total of 699 patients in Guangzhou, China was investigated by questionnaire. The main effect, mediating effect, and moderating effect of the model was verified by SPSS23.0 and LISREL8.71 statistical software.
UNASSIGNED: It was revealed that doctor-patient communication has a significant positive effect on patients\' trust. The consistency between patient and physician partially mediates the relationship between doctor-patient communication and patients\' trust. Additionally, the perceived threat of the disease moderates the psychological process through which doctor-patient communication affects patients\' trust.
UNASSIGNED: Both doctor-patient communication and patient-physician consistency have predictive effects on patients\' trust. Doctor-patient communication is not only a direct influence on patient trust but also an indirect influence mediated by patient-physician consistency. Perceived threat of disease moderates the psychological process through which doctor-patient communication affects patients\' trust. Specifically, compared to a high level of perceived threat of disease, a low level of perceived threat of disease can enhance the effect of doctor-patient communication on patients\' trust. The results of this study underscore the importance of doctor-patient communication and the value of patient-physician consistency for building patients\' trust. To foster a harmonious doctor-patient relationship, medical colleges should place great emphasis on cultivating medical students\' communication skills. Hospitals should enhance on-the-job training and provide institutional support for doctors, encourage agreements between doctors and patients regarding disease diagnosis and decision-making, and be attentive to patients\' perceived threat of disease, particularly for those with high level of perceived threat of disease.

BACKGROUND: Different kinds of mobile apps are used to promote communications between patients and doctors. Studies have investigated patients\' mobile app adoption behavior; however, they offer limited insights into doctors\' personal preferences among a variety of choices of mobile apps.
OBJECTIVE: This study aimed to investigate the nuanced adoption behaviors among doctors in China, which has a robust adoption of mobile apps in health care, and to explore the constraints influencing their selection of specific mobile apps. This paper addressed 3 research questions: (1) Which doctors opt to adopt mobile apps to communicate with patients? (2) What types of mobile apps do they choose? (3) To what degree do they exercise personal choice in adopting specific mobile apps?
METHODS: We used thematic content analysis of qualitative data gathered from semistructured interviews with 11 doctors in Hangzhou, which has been recognized for its advanced adoption of mobile technology in social services, including health care services. The selection of participants was purposive, encompassing diverse departments and hospitals.
RESULTS: In total, 5 themes emerged from the data analysis. First, the interviewees had a variety of options for communicating with patients via mobile apps, with the predominant ones being social networking apps (eg, WeChat) and medical platforms (eg, Haodf). Second, all interviewees used WeChat to facilitate communication with patients, although their willingness to share personal accounts varied (they are more likely to share with trusty intermediaries). Third, fewer than half of the doctors adopted medical platforms, and they were all from tertiary hospitals. Fourth, the preferences for in-person, WeChat, or medical platform communication reflected the interviewees\' perceptions of different patient cohorts. Lastly, the selection of a particular kind of mobile app was significantly influenced by the doctors\' affiliation with hospitals, driven by their professional obligations to fulfill multiple tasks assigned by the hospitals or the necessity of maintaining social connections with their colleagues.
CONCLUSIONS: Our findings contribute to a nuanced understanding of doctors\' adoption behavior regarding specific types of mobile apps for patient communication, instead of addressing such adoption behavior of a wide range of mobile apps as equal. Their choices of a particular kind of app were positioned within a social context where health care policies (eg, limited funding for public hospitals, dominance of public health care institutions, and absence of robust referral systems) and traditional culture (eg, trust based on social connections) largely shape their behavioral patterns.

BACKGROUND: Psychological stress and anxiety have seriously affected the ability of new clinicians to adapt and coordinate their clinical work. Traditional pre-job training is often not very good at assisting new recruits to regulate their emotional problems.
METHODS: This study is a randomized controlled study. A total of 435 newly recruited clinicians participated in the study. 428 clinicians were randomized into a control group (n = 214) and an intervention group (n = 214). The control group conducted regular pre-job training. Doctors of the intervention group attend a themed course every two weeks on the basis of regular induction training. Their physiological status was evaluated by Perceived Stress Scale (PPS-10), Generalized Anxiety Scale (GAD-7) and Psychological Resilience Scale (CD-RISC-10) 3 months later. Participants in the intervention group received a training satisfaction questionnaire.
RESULTS: After entering the clinic for 3 months, the PSS-10 and GAD-7 scores of the intervention group were significantly lower than that of the control group. Consistently, the CD-RISC-10 score of new clinicians who received proof-of-concept pre-job training was significantly higher than that of new doctors in the control group.
CONCLUSIONS: New doctors received the proof-of-concept group experienced alleviation in stress and anxiety.

BACKGROUND: To explore the feasibility and effectiveness of applying CBL teaching method and SEGUE Framework in the doctor-patient communication skills of resident physicians in the department of otolaryngology.
METHODS: This is an observational study to compare the score changes in doctor-patient communication skills of 120 resident physicians, before and after using CBL combined SEGUE Framework teaching method. The effects of gender, age, grade, educational background and marital status on SEGUE score were analyzed.
RESULTS: Through the combined application of CBL teaching method and SEGUE Framework, the SEGUE score of 120 resident physicians was significantly improved. There was no significant difference in SEGUE score among different sex and marital status of resident physicians. SEGUE score is positively correlated with age; Different grades and educational backgrounds have significant effects on SEGUE score.
CONCLUSIONS: The combination of CBL teaching method and SEGUE Framework is feasible and effective in the education program of doctor-patient communication skills for resident physicians in the department of otolaryngology, and worthy of popularization and application in other medical specialties.

Mobile apps have become commonplace in doctor-patient communication over the last 20 years. Doctors mainly use two kinds of app, social networking apps (i.e., WeChat) and medical platform apps (i.e., Haodf). The purpose of this study was to investigate whether the attributes of social interaction in local society impact doctors\' choice of mobile apps to communicate with patients. This article addresses two research questions: (a) To what degree do doctors\' adoption patterns in different societies differ? (b) Why do doctors choose certain mobile apps to communicate with patients?
This study employed a mixed methods research design to analyze doctor\'s adoption behavior patterns in two cities, Hangzhou (HZ) and Yancheng (YC), which represent two stages in transforming society. Various patterns, measured as the percentage of doctors who utilize the medical platform app of Haodf among all doctors and the average service counts per doctor, were compared in three groups of tertiary hospitals: the top ones in HZ, the average ones in HZ, and the average ones in YC. We also conducted thematic content analysis of qualitative data from semi-structured interviews with 20 purposely selected doctors in the two cities.
The percentages of doctors who have adopted the app of Haodf from the three groups of tertiary hospitals were 49.97%, 41.00%, and 32.03%, with an average service counts per doctor of 261, 182 and 39, respectively. According to the interviewees, doctors from YC are more likely to use social networking apps to communicate with patients than their HZ counterparts to maintain social connections with their relatives, friends, colleagues, and others.
This study demonstrates that doctors\' choices of mobile apps are dependent upon social context. In traditional society, where people have close ties, the logic of using social networking apps lies in doctors\' need to maximize the utility of their knowledge by maintaining social connections with others. In modern society, where the close ties between people have gradually weakened, the logic of using medical platform apps lies in doctors\' needs for reputation marketing, either for themselves or for institutions, their affiliated departments or hospitals.

OBJECTIVE: To comprehensively analyze and further enhance the established E4 communication model for online medical counseling in Chinese settings, by proposing the novel E5 model. Additionally, it aims to evaluate the performance of Chinese doctors in fulfilling the E5 model.
METHODS: Through thematic analysis and grounded theory of 500 online medical consultations in China, we developed the extended E5 model from the E4 model. We identified four dimensions of patient attitudes and behaviors using Stanford Topic Modeling Toolbox, then employed Chi-square analysis to investigate their influence on doctors\' performance of E5 model.
RESULTS: Our study illustrates that the extended E5 model, with its operable strategies, accurately mirrors the nuanced dynamics of online medical counseling in China, significantly varying in doctors\' execution in response to the four identified dimensions of patient attitudes and behaviors.
CONCLUSIONS: The extended E5 model, coupled with insights into patient attitudes and behaviors, provides a comprehensive framework for understanding and enhancing communication in China\'s online healthcare context.
CONCLUSIONS: The findings highlight the necessity for doctor training in the E5 model for effective online communication. Furthermore, fostering conducive relationship between patients and doctors could potentially boost doctors\' E5 performance.

The poor relationship between doctors and patients is a long-standing, global problem. However, current interventions tend to focus on the training of physicians, while patient-targeted interventions still need to be improved. Considering that patients play a significant role in outpatient consultations, we developed a protocol to assess the effectiveness of the Patient Oriented Four Habits Model (POFHM) in improving doctor-patient relationships.
A cross-sectional incomplete stepped-wedge cluster randomized trial design will be conducted in 8 primary healthcare institutions (PHCs). Following phase I of \"usual care\" as control measures for each PHC, either a patient- or doctor-only intervention will be implemented in phase II. In phase III, both patients and doctors will be involved in the intervention. This study will be conducted simultaneously in Nanling County and West Lake District. The primary outcomes will be evaluated after patients complete their visit: (1) patient literacy, (2) sense of control and (3) quality of doctor-patient communication. Finally, a mixed-effects model and subgroup analysis will be used to evaluate the effectiveness of the interventions.
Fostering good consultation habits for the patient is a potentially effective strategy to improve the quality of doctor-patient communication. This study evaluates the implementation process and develops a rigorous quality control manual using a theoretical domain framework under the collective culture of China. The results of this trial will provide substantial evidence of the effectiveness of patient-oriented interventions. The POFHM can benefit the PHCs and provide a reference for countries and regions where medical resources are scarce and collectivist cultures dominate.
AsPredicted #107,282 on Sep 18, 2022; https://aspredicted.org/QST_MHW.

In order to understand the research status of the relationship between health communication and doctor-patient relationship, and to explore a new path of the impact of health communication on doctor-patient relationship, this paper adopted qualitative methods to quantize the literature over the past 10 years in the Web of Science database and carried out Co-Authorship Analysis, Co-Citation Analysis and Co-Occurrence Analysis based on CiteSpace. In addition, according to the results of bibliometric research, self-designed questionnaires were used to verify the result. A convenience sampling survey was conducted through the online \"Questionnaire Star\" platform (https://www.wjx.cn) on May 8, 2022, and a total of 254 questionnaires were collected. Interviewees were asked to use social software to acquire health knowledge. Participants come from 21 provinces, 4 municipalities, and 4 autonomous regions across the country, which is geographically representative. The results show that uncertainty of social media information and the particularity of the epidemic make the research on health communication and doctor-patient relationship in social media become a new hot spot. Social media health information quality (source credibility and content trust perception), information asymmetry perception, doctor-patient communication, doctor-patient consistency, doctor-patient trust, doctor-patient relationship may be the key variables for constructing theoretical models.

In recent years, news of medical malignant injury events has become common in China. However, it is unclear how exposure to this news affects medical staff.
The present study collected data from a sample of 311 medical staff in China. It explored the effect of exposure to such news on medical staff\'s communication and willingness to let their children be doctors, which was an attitude that reflects their professional identity well. In addition, this study also examined the mediating roles of outgroup attribution and anxiety, and the moderating role of social support.
The results showed that exposure to news of medical injury could positively and directly predict the quality of doctor-patient communication, but negatively and indirectly predict medical staff\'s willingness to let their children become doctors. These effects existed through the mediating role of anxiety and the chain mediating role of both outgroup attribution and anxiety. In addition, social support could mitigate the negative correlation between news exposure and outgroup attribution.
These results suggest that news of medical malignant injury events may incentivize medical staff to improve the quality of communication in the short term, but it is not conducive to medical staff\'s long-term mental health. That is, exposure to news of medical injury is likely to lead to a negative influence on their professional identity, although social support can alleviate this negative influence.