Study on the Health Communication Behavior of Chinese Doctors on Network Media——Based on the Empirical Investigation of 119 Chinese Doctors

Introduction In order to reduce the perceived risk of medical decision-making, Chinese patients tend to spend time and energy to understand relevant medical knowledge. After comparing online reviews and news reports of Chinese doctors, they carefully choose doctors. It is precisely because of the patient’s treatment habits that many doctors have spread health information through their own microblogs, WeChat public numbers, websites, videos and other means. Therefore, doctors’ speeches in cyberspace often play a dominant role in the development of health communication and guide the risk communication. This paper studies the influencing factors of Chinese doctors’ healthy communication behavior in online media. This has positive reference value for improving the health literacy of the whole people and the crisis management and guidance of public events. Methods In order to maximize the representativeness of the sample, the universality of the problems reflected in the survey data, and the adaptability of the purpose and method of the research questions, this paper adopts a multi-stage sampling method. In each region, a medical institution is selected according to a simple random sampling method in three types of hospitals: public hospitals, social hospitals, and primary medical institutions. A total of 10-11 medical institutions were selected in each region, and a total of 32 hospitals were selected from the three regions. According to the PPS sampling method, a corresponding number of working doctors are drawn in each hospital. Statistical analysis of the data was performed using SPSS 21.0 statistical software. Analysis The study found that doctors’ transmission of health-related content on online media is still at a lower level of involvement, and the frequency of transmission is significantly lower than the general level. There are also significant differences in the health transmission of doctors from different backgrounds on the Internet. In the context of control hospital background, continue to examine the impact of Media usage and occupational psychology on doctors’ dissemination of health-related content. The results show that the influence of Media usage on the health communication behavior of doctors on the Internet media, to a certain extent, verifies that the rise of online media plays a significant role in putting doctors into health science. This also shows that the media has fostered the doctor’s communication behavior. In addition, the higher the self-efficacy of doctors in the workplace, the more cautious they are about their words and deeds, the more they care about the impact of their speech on interpersonal communication.

This provides a reference for the public to seek medical information.
In general, in order to reduce the perceived risk of medical decision-making, patients tend to work hard to understand relevant medical knowledge, and then carefully select doctors after comparing online reviews and news reports [1][2][3] . As a result, this has also inspired many doctors to publish and widely disseminate health information through their own microblogs, WeChat public account, website, video and other means. The spread of health information by doctors on the Internet has a more complex impact on the development of health knowledge and the formation and evolution of risk paradoxes 4-7 . According to "the 2017 China Health and Wellness Development Statistics improving the health literacy of the whole people, the supervision of public opinion in the government, and the crisis management and guidance of public events [8][9][10][11] . In view of this, this study explores the following questions: 1. What is the current state of health communication among doctors on the Internet? 2. What is the difference between the health communication behavior of doctors at different levels of medical institutions on the online media. 3. What factors will affect the health communication behavior of doctors on the online media.

Methods
All the samples in this survey were from the "Doctor Health Communication Behavior and Attitudes" questionnaire conducted in Wuhan hospitals from February 2018 to July 2018. The surveyed institutions included public hospitals, social private hospitals and grassroots hospitals. The target sample size of this survey was 150.
After a six-month field survey, 119 valid questionnaires were collected, and the recovery rate was 79%. The specific survey methods are as follows:

Survey area
The survey area is divided by the geographical distribution of the three towns of Hankou, Hanyang and Wuchang, each covering 1 to 2 municipal-level regional medical centers. In the areas of Optics Valley, Caidian, Huangpi and other areas, each area covers 1-2 comprehensive or specialist medical service institutions. Due to the wide coverage, the doctor's survey sample of this study can be considered as a representative sample of doctors in central cities in central China.

Hospitals surveyed
The total sample of this survey was derived from the list of medical institutions announced by the Wuhan Municipal Health and Family Planning Commission

Sample extraction
The choice of sampling method for the study depends on the purpose of the study, the theoretical analytical framework used, the sample size of the survey, and the material conditions required for the survey. Based on this, in order to maximize the representativeness of the sample and the universality of the problems reflected in the survey data, and the suitability of the research objectives and methods, this study will adopt a multi-stage sampling method. The composition of the samples at each stage and the sampling degree are assigned as follows: public hospitals, social private hospitals, and grassroots hospitals, a medical institution is selected by simple random sampling. A total of 10-11 medical institutions were selected in each region, and a total of 32 hospitals were selected from the three regions.

Sampling doctors
According to the pps (probability proportionate to size sampling) sampling method, a

Statistical Analysis
Through the interviews with Chinese doctors, the close concerns of the influencing factors were collected. The interview results were summarized and summarized as the basis for the questionnaire design. This provides practical guidance for the research of the subject. Then, the survey was conducted by means of on-site questionnaires, and the data required for the research of this topic was collected. Finally, SPSS21.0 statistical analysis software is used to process the data. The analysis methods include descriptive statistics, single factor analysis and multiple linear regression analysis, and the statistical results are analyzed and discussed..

The current status of doctors' health communication on online media
The doctor's health communication on the Internet media is measured by asking the doctor the frequency of posting his own science content on the online medium or to forward the frequency of health-related content. The results show that doctors who distribute a lot of their own science or forward health-related content on the network account for 1.7%, more accounted for 7.2%, generally accounted for 32.1%, relatively less accounted for 35.9%, almost never released or shared accounted for 23.1%. As shown in Figure 1, the frequency at which doctors post or share health-related content on the web media from "nearly released" to "frequently released" is assigned a value Media literacy. According to Rubin's analysis, there are three main aspects of media literacy, namely, ability mode, knowledge mode and understanding mode 15 . As far as the ability model is concerned, it refers to the ability of citizens to acquire, analyze, evaluate and transmit various forms of information, focusing on the cognitive process of information; the knowledge model believes that media literacy is about how media contribute to society, with a focus on how information is transmitted. The understanding mode claims that media literacy is to understand that media information is subject to the coercive role of cultural, economic, political, and technological forces in the process of manufacturing, production, and communication, with a focus on the ability to judge and understand information. What is media literacy? It refers to people's ability to choose, understand, question, evaluate, create, and think in response to various media information. The media literacy of this study was measured by asking doctors how they agree with the following options: I know how to publish my own health science or medical insights; I can identify the meaning and value of health information on the web; I know how to spread health knowledge on the web; I know how to use the medium to shape the image of a doctor. All of the above questions were evaluated and assigned using the Likert Level 5 scale from "1=nearly understood" to "5=very well understood". The average score of these four The higher the doctor's satisfaction with the profession, the more enthusiasm he or she will show to the profession, otherwise it will show complaints and indifference 17 .
Therefore, doctors' satisfaction with occupation may affect their initiative and enthusiasm for health communication. In this study, the Likert 5 scale was used to assign doctors' professional satisfaction from "1=very dissatisfied" to "5=very satisfied". The results of the correlation analysis showed that doctors' satisfaction with occupation (r=0.051, P<0.01) was positively correlated with the frequency of healthy communication behavior on the network.
Self-efficacy. According to social cognition theory, self-efficacy has a significant predictive effect on human motivation, behavior, and attitude 18 . The professional efficacy of this study was measured by the doctor's consent to the following statements: I am confident in my professional skills; the operation of the hospital is a complex system that I cannot understand; commenting on the Internet is one of the ways I express my views on hospital development.; I don't think the hospital will take into account my opinions and ideas, from "1=very agree" to "5=very dissatisfied".
The average score of these four questions was used to indicate the doctor's selfefficacy (M = 2.92, SD = 0.791). The higher the score, the higher the doctor's selfefficacy. The results showed that the doctor's self-efficacy was inversely related to the frequency of healthy communication on the network (r=-0.103, P<0.01). It also shows that the higher the self-efficacy of doctors in hospitals, the lower the frequency of dissemination of health-related content on online media.

Regression analysis of the influencing factors of doctors' health communication behavior on online media
The above correlation analysis is only a step-by-step test of factors that may affect the behavior of doctors on the Internet, but whether these factors will affect the health behavior of doctors on the Internet, as well as the intensity and direction of impact, further verification was performed using multiple regression analysis. Therefore, this study specifically explores the effects of doctor background, Media usage, and occupational psychology on doctors' health communication behaviors on online media by establishing a multivariate hierarchical regression model.
In the regression analysis, the first layer inputs gender, title, department, and hospital type; the second layer inputs the media usage status, that is, media contact and media literacy; the third layer inputs professional attitude, that is, occupational satisfaction and self-efficacy. In the table, at the doctor's background level, gender  However, this study also has some shortcomings. When examining social mentality and professional mentality, there is a lack of multiple dimensions. Future research should examine doctors' social mentality and professional mentality from multiple dimensions to better explain the influence of social mentality and professional mentality on their communication behavior. However, this study also has certain theoretical and practical significance: it theoretically proves the influence of doctor background and Media usage on doctors' dissemination of health-related content on online media, and also provides empirical support for the popularization of national health knowledge and the guidance of risk public opinion.