Evidence map›Paper›PMID 41272646›Full record

ArticleBMC health services research2025

Patient participation and its determinants based on the Social Ecological Model: a cross-sectional study in North China.

Xingyu Chen, Liping Cui, Lihua Wu, Dinuo Xin, Qian Zhang, Jing Ma, Ningning Li, Xiaohong Zhang, Wanling Li

Abstract read
In one paragraph

Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Treatment experience of patients with failedFrontiers in public health · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Xingyu Chen *Department of Lymphoma, Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.
Liping Cui *Department of Nursing, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, 030032, China.
Lihua WuDepartment of Lymphoma, Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.
Dinuo XinDepartment of Nursing, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, 030032, China.
Qian ZhangDepartment of Nursing, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, 030032, China.
Jing MaDepartment of Lymphoma, Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.
Ningning LiDepartment of Lymphoma, Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.
Xiaohong Zhang *Department of Nursing, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, 030032, China. zhangxiaohong@sxbqeh.com.cn.
Wanling Li *Department of Nursing, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, 030032, China. 18404998524@163.com.

Funding

Health Commission of Shanxi Province,China 2022139
6 · The paper itself

Abstract

backgroundGrounded in the Social Ecological Model, this study aimed to assess the current status of patient participation in healthcare, identify its associated factors, and quantify the relative contribution of each factor to inform targeted interventions.

methodsA cross-sectional survey was conducted from May to October 2024 using convenience sampling at five tertiary hospitals in North China. A total of 573 patients were recruited. Data were collected through structured questionnaires, including the General Information Questionnaire, the Patient Participation Scale, the Patient Participation Competence Scale, the Patient Participation Attitude Scale, the Facilitation of Patient Involvement Scale, the Family APGAR Index, and the MacArthur Scale of Subjective Social Status.

resultsThe mean patient participation score was 3.56 ± 0.57, indicating a moderate overall level. Multilevel factors across the microsystem, mesosystem, and macrosystem influenced participation, with the microsystem exerting the strongest impact. Participation competence and attitude were the most influential determinants, followed by educational level, facilitation of participation, and family support. Additional factors included patients’ disease knowledge, socioeconomic status, residence, self-rated health, financial burden, age, and communication with healthcare providers.

conclusionsPatient participation in healthcare remains moderate, shaped predominantly by competence and attitudes. These findings highlight the need for healthcare policies and practices that empower patients with the skills, confidence, and supportive environments required for active engagement. Strengthening competence and attitudes, while addressing disparities related to education, socioeconomic status, and health literacy, may foster more equitable and participatory models of care.

Indexed as

Patient ParticipationAdultAgedChinaCross-Sectional StudiesFemaleHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedSocioeconomic FactorsSurveys and QuestionnairesDeterminantsHierarchical regressionPatient participationShapley value decompositionSocial Ecological Model

Identifiers

PMID41272646
PMCPMC12659090

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.