Data from: Understanding the role of physician attire on patient perceptions: a systematic review of the literature

Objectives: Despite a growing body of literature, uncertainty regarding the influence of physician dress on patients’ perceptions exists. Therefore, we performed a systematic review to examine the influence of physician attire on patient perceptions including trust, satisfaction and confidence. Setting, participants, interventions and outcomes: We searched MEDLINE, Embase, Biosis Previews and Conference Papers Index. Studies that: (1) involved participants ≥18 years of age; (2) evaluated physician attire; and (3) reported patient perceptions related to attire were included. Two authors determined study eligibility. Studies were categorised by country of origin, clinical discipline (eg, internal medicine, surgery), context (inpatient vs outpatient) and occurrence of a clinical encounter when soliciting opinions regarding attire. Studies were assessed using the Downs and Black Scale risk of bias scale. Owing to clinical and methodological heterogeneity, meta-analyses were not attempted. Results: Of 1040 citations, 30 studies involving 11 533 patients met eligibility criteria. Included studies featured patients from 14 countries. General medicine, procedural (eg, general surgery and obstetrics), clinic, emergency departments and hospital settings were represented. Preferences or positive influence of physician attire on patient perceptions were reported in 21 of the 30 studies (70%). Formal attire and white coats with other attire not specified was preferred in 18 of 30 studies (60%). Preference for formal attire and white coats was more prevalent among older patients and studies conducted in Europe and Asia. Four of seven studies involving procedural specialties reported either no preference for attire or a preference for scrubs; four of five studies in intensive care and emergency settings also found no attire preference. Only 3 of 12 studies that surveyed patients after a clinical encounter concluded that attire influenced patient perceptions. Conclusions: Although patients often prefer formal physician attire, perceptions of attire are influenced by age, locale, setting and context of care. Policy-based interventions that target such factors appear necessary.研究目的：尽管已有大量相关文献发表，但医师着装对患者认知的影响仍存在诸多不确定性。为此，本研究开展系统综述（systematic review），旨在探讨医师着装对患者认知的影响，包括信任、满意度与信心水平。 研究设计、对象、干预措施与结局指标：本研究检索了MEDLINE、Embase、Biosis Previews及Conference Papers Index数据库。纳入符合以下条件的研究：（1）研究对象为年满18周岁及以上的受试者；（2）对医师着装进行评估；（3）报告了与医师着装相关的患者认知结局。由两名研究者独立完成研究纳入资格筛查。研究按以下维度进行分类：原产国、临床学科（如内科、外科）、诊疗场景（住院 vs 门诊）以及针对着装意见征求时是否伴随临床诊疗接触。采用唐斯-布莱克偏倚风险量表（Downs and Black Scale risk of bias scale）对研究进行质量评价。由于临床与方法学异质性显著，未进行Meta分析（meta-analysis）。 研究结果：初检共检索到1040条引文，最终30项涉及11533名患者的研究符合纳入标准。纳入研究的患者来自14个国家，覆盖普通医学、操作类临床专科（如普通外科、产科）、门诊、急诊科及住院病房等诊疗场景。30项研究中有21项（70%）报告了医师着装对患者认知存在正向影响，或患者对特定着装存在偏好。30项研究中有18项（60%）显示患者更偏好正式着装及未明确搭配其他服饰的白大褂。在老年受试者以及在欧洲、亚洲开展的研究中，对正式着装与白大褂的偏好更为普遍。7项针对操作类临床专科的研究中，有4项未发现患者对特定着装存在偏好，或偏好刷手服（scrubs）；5项重症监护与急诊科场景的研究中，亦有4项未发现显著的着装偏好差异。仅在12项临床诊疗结束后开展的患者问卷调查研究中，有3项得出医师着装会影响患者认知的结论。 研究结论：尽管患者通常更偏好医师的正式着装，但患者对医师着装的认知会受年龄、地域、诊疗场景及诊疗情境的影响。针对上述影响因素制定相应的政策干预措施具备必要性。