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Antecedents of the client’s trust in low- versus high-consequence decisions

Mellina da Silva Terres (Escola Superior de Propaganda e Marketing – ESPM and UniRitter – Laureate International Universities, Porto Alegre, Brazil)
Cristiane Pizzutti dos Santos (Universidade Federal do Rio Grande do Sul, Porte Alegre, Brazil)
Kenny Basso (Faculdade Meridional-IMED/Escola de Administração, Passo Fundo, Brazil)

Journal of Services Marketing

ISSN: 0887-6045

Article publication date: 9 February 2015




The purpose of this study is to address the role of high- and low-consequence exchanges in the relationship between trust and its antecedents (i.e., affective and cognitive elements) and consequences (i.e., positive WOM and search for second opinion intentions) in the context of the provision of medical services.


We performed a survey with 681 patients from a large hospital. The data were analyzed through a multigroup structural equation approach.


Findings show that during service encounters affective aspects have greater impact on consumer trust in situations of high-consequence than in low-consequence exchanges, while cognitive aspects have greater impact when consequences are low than when they are high. In addition, the authors found that the more severe the consequences, the greater the impact of trust on positive WOM and search for second opinion intentions.


This study is the first to consider the exchange consequences as an important moderator of the relationship between trust and affection and cognition elements involved in client-service provider encounters. Overall, the findings show higher importance of affective aspects (compared to cognitive aspects) for the formation of trust, in situations in which the individual perceives the consequences of their exchanges as severe.



Thanks for the Centro de Altos Estudos de Marketing (CAEPM) of the Escola Superior de Propaganda e Marketing for sponsoring this research. The authors also gratefully acknowledge Barbara B. Boller for her assistance in the qualitative research and for the Hospital Mãe de Deus and its patients for supporting this research.


Terres, M.d.S., dos Santos, C.P. and Basso, K. (2015), "Antecedents of the client’s trust in low- versus high-consequence decisions", Journal of Services Marketing, Vol. 29 No. 1, pp. 26-37.



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