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Article
Publication date: 14 February 2020

Po-Chien Chang, Ting Wu and Juan Du

The purpose of this study is to examine the dual effects of the violation of psychological contract on patient’s antisocial behaviour via the mediator of patient trust and…

Abstract

Purpose

The purpose of this study is to examine the dual effects of the violation of psychological contract on patient’s antisocial behaviour via the mediator of patient trust and the role of doctor-patient communication as a critical contingent variable in the psychological contract violation of patient’s antisocial behaviour relationship.

Design/methodology/approach

The data were collected from 483 hospitalized patients distributed in Shanxi province, China by using a self-administered survey.

Findings

The results indicated that psychological contract violation is positively associated with patient antisocial behaviour via patient trust. Moreover, the study found that doctor-patient communication moderates the mediated effects of psychological contract violation on patient’s antisocial behaviour through patient trust; that is, the mediated effect on antisocial behaviour is weaker when both doctor and patients have more communication.

Research limitations/implications

Due to a cross-sectional design in nature, the causal relationship cannot be developed based on the results. Despite the limitation, the present study provides insights for improving doctor-patient relationship by emphasizing the importance of increasing patient trust and doctor-patient communication.

Practical implications

To improve the quality of doctor-patient relationship, this study addresses the significance of properly showing understandings and care to regain mutual trust and reducing the likelihood of patient’s antisocial behaviour.

Social implications

The research findings have implications for both the health system and medical schools in China to reinforce the professional ethics and improve their medical humanities as the main concerns to generate a more sustainable doctor–patient relationship.

Originality/value

This study includes patient trust as a mediator and doctor-patient communication as a moderator to investigate the moderated mediation relationship among patients and medical professionals. By further examining the doctor-patient relationship, the results may not only help improve the efficient implementation of medical practices but also support the institutes and develop medical professionals for more positive doctor-patient relationships.

Details

International Journal of Conflict Management, vol. 31 no. 4
Type: Research Article
ISSN: 1044-4068

Keywords

Article
Publication date: 25 January 2011

Sanjaya Singh Gaur, Yingzi Xu, Ali Quazi and Swathi Nandi

The aim of this paper is to examine how patients' loyalty, and confidence in their doctors, are influenced by doctors' interaction behavior, namely, listening and…

3602

Abstract

Purpose

The aim of this paper is to examine how patients' loyalty, and confidence in their doctors, are influenced by doctors' interaction behavior, namely, listening and explaining behavior.

Design/methodology/approach

Primary data were collected through a survey of patients in an advanced developing economy – India. Patients visiting the same specialist doctor more than three times a year, in selected clinics in the city of Mumbai, were asked to complete the study instrument. All the constructs were measured using multiple items and well‐established scales were revalidated to suit the context of the research. A total of 320 responses were analyzed to test the proposed hypotheses.

Findings

Results confirm that the doctor‐patient relationship is positively influenced by the interaction behavior of service providers, i.e. doctors. The study demonstrates that doctors' interaction behavior is instrumental in developing an effective relationship with their patients and boosts patients' confidence in their doctors. Furthermore, effective interaction enhances patients' loyalty to their service providers.

Originality/value

This would appear to be the first study of its kind conducted in the context of an advanced developing economy. The study suggests that development of effective communication skills in doctors warrants due attention in medical education. Furthermore, this study validates relevant measurement scales in India's context.

Details

Managing Service Quality: An International Journal, vol. 21 no. 1
Type: Research Article
ISSN: 0960-4529

Keywords

Article
Publication date: 29 August 2008

Atie van den Brink‐Muinen, Heidi‐Ingrid Maaroos and Heli Tähepõld

This paper aims to investigate doctor‐patient communication in consultations of newly qualified general practitioners (GPs) in a newly reorganised health care system and…

1164

Abstract

Purpose

This paper aims to investigate doctor‐patient communication in consultations of newly qualified general practitioners (GPs) in a newly reorganised health care system and differences in consultation characteristics and communication patterns between new European Union (EU)‐countries (Estonia, Poland and Romania) and the old West‐European EU‐countries.

Design/methodology/approach

Observation of videotaped doctor‐patient consultations by means of Roter's Interactional Analysis System; GP, patient and observer questionnaires. Data were collected from 92 GPs and 1,376 patients in Estonia, Poland and Romania and compared with known data from old EU countries. Main outcome measures were verbal and nonverbal communication of GPs and patients, as well as consultation characteristics.

Findings

Differences were found in the communication patterns of the new EU‐countries Estonia, Poland and Romania compared to the old EU‐countries. For instance, the verbal contribution of the GPs in the new EU‐countries was greater than in the old EU‐countries. Differences were also found between the three new EU‐countries. In Romania there was more psychosocial talk than in the two other new EU‐countries, whereas in Poland and Estonia there was more biomedical talk. The Estonian communication was more affective, the Polish and Romanian more instrumental. In general, the differences were not found to be related to a “new‐old” or “east‐west” distinction. Clearly, cultural norms and values play an important role in doctor‐patient communication.

Research limitations/implications

The sampling method differed somewhat from one country to another.

Practical implications

With the integration of Europe in progress, cross‐cultural aspects should be addressed when doctors are being trained in communication skills in their undergraduate and postgraduate education.

Originality/value

This is the first study to investigate doctor‐patient communication in newly reorganised health care systems and differences in doctor‐patient communication between new and old EU‐countries.

Details

Health Education, vol. 108 no. 5
Type: Research Article
ISSN: 0965-4283

Keywords

Article
Publication date: 4 August 2022

Korina Katsaliaki

The purpose of this study is to investigate and compare the views of doctors, nursing staff and hospitalized patients on the level of information they provide and receive…

Abstract

Purpose

The purpose of this study is to investigate and compare the views of doctors, nursing staff and hospitalized patients on the level of information they provide and receive respectively in public hospitals, focusing on the factors that affect their communication.

Design/methodology/approach

The study used a cross-sectional survey with a sample of 426 participants from two general hospitals in Greece–Pella and KAT Attica. Data were collected through a questionnaire in March–May 2020 and was analyzed with mean comparisons and correlations.

Findings

The results showed discrepancy in the satisfaction rate, with 67.3% satisfied patients from doctors' communication vs. 83.7% satisfied doctors. Improvements in hospital staff – patient communication are required especially on alternative therapies' discussion and time spent on communication. All respondents agreed that staff shortage is a deterrent factor for effective communication. Seamless for all respondents' groups, the factors that affect the communication satisfaction level are the duration of communication, time allowed for expressing questions and interest in patients' personal situation.

Practical implications

Strengthening the communication skills of medical staff and providing clear guidelines on when and how to inform patients are essential.

Originality/value

This study contributes to the growing body of research on doctor–patient communication. Its originality lies on the fact that communication satisfaction level was examined simultaneously for doctors, nurses and patients. The study provides additional evidence supporting the link among satisfaction and duration of communication and personalized relationship. The study's findings are important in the training of medical staff and the management of patients' expectations.

Details

International Journal of Health Care Quality Assurance, vol. 35 no. 1
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 11 May 2015

Elena A. Platonova and Richard M. Shewchuk

The purpose of this paper is to examine how patient assessment of primary care physician (PCP) communication is related to patient satisfaction with the PCP, patient…

Abstract

Purpose

The purpose of this paper is to examine how patient assessment of primary care physician (PCP) communication is related to patient satisfaction with the PCP, patient perception of PCP professional competence, patient assessment of the relationship with the doctor and patient demographic characteristics using a segmentation approach.

Design/methodology/approach

The authors surveyed 514 adult patients waiting for appointments with their PCPs in two US primary care clinics. A latent class analysis was used to identify mutually exclusive unobserved homogeneous classes of patients.

Findings

The authors identified three distinct classes/groups with regard to patient assessment of physician communication and the physician-patient relationship. The largest group (53 percent of the sample) assessed their PCP communication and other doctor-patient relationship aspects as excellent. However, 37 percent provided mostly negative assessments, expressed high general dissatisfaction with the physician and disagreed with the statement that their PCP was well qualified to manage their health problems. These patients were on average more educated and affluent and the group included more males. About 10 percent of patients expressed generally lower satisfaction with the PCP, though their dissatisfaction was not as extreme as in the highly dissatisfied group.

Research limitations/implications

Further studies are needed to help physicians develop skills to communicate with different patients.

Originality/value

Patient segmentation can be an important tool for healthcare quality improvement particularly for emerging approaches to primary care such as patient-centered care.

Details

International Journal of Health Care Quality Assurance, vol. 28 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 9 August 2011

Thorsten Gruber and Fabricio Frugone

The purpose of this paper is to uncover the desired qualities and behaviours that patients believe general practitioners (GPs) should have in medical (service recovery…

1533

Abstract

Purpose

The purpose of this paper is to uncover the desired qualities and behaviours that patients believe general practitioners (GPs) should have in medical (service recovery) encounters. In particular, the authors try to reveal the qualities and behaviours of GPs that patients value, to understand the underlying benefits that they look for during personal (service recovery) encounters, and to graphically illustrate the findings in a so‐called hierarchical value map. This will prove to be important in order to understand patients' needs and desires correctly.

Design/methodology/approach

An exploratory research study using the qualitative laddering interviewing technique was regarded as appropriate as it allows researchers to gain a deeper insight into an underdeveloped research subject. In total, in‐depth laddering interviews with 38 respondents were conducted.

Findings

In case of a service recovery encounter, patients believe that GPs need to show competence, friendliness and empathy in order to restore trust in them. GPs should also listen actively and do the appropriate checks in order to find the root cause of the problem. “Health” was the main value sought by patients. This value is considered by patients to be the gateway to moving on with their everyday lives and search the attainment of other values such as well‐being, belongingness, accomplishment, and self‐realization. Moreover, respondents would like to gain knowledge about their disease in order to prevent them in the future and to have some sense of control over the decision of the treatment. Patients also want a more active role in the medical (service recovery) encounter, which calls for a more shared approach by GPs in the interaction with their patients.

Originality/value

This paper gives a valuable first insight into the desired qualities and behaviours of GPs during medical (service recovery) encounters. The study results especially indicate that complaining patients are people first and patients second, where the primary importance is the satisfaction of basic social needs. The fact that this study has revealed the highest number of values in published laddering studies so far shows how crucial these medical (service recovery) encounters in general and GP qualities and behaviours in particular are for patients. Another strong contribution of this paper is the finding that all the identified concepts from the laddering interviews that are shown in the hierarchical value maps must not been seen in strict isolation, as in previous research, but have to be understood as a network of interrelated concepts.

Details

Journal of Service Management, vol. 22 no. 4
Type: Research Article
ISSN: 1757-5818

Keywords

Article
Publication date: 11 September 2007

Irvine Lapsley

The purpose of this paper is to investigate the impact of accounting on clinical practices.

956

Abstract

Purpose

The purpose of this paper is to investigate the impact of accounting on clinical practices.

Design/methodology/approach

This paper reviews existing studies of clinical budgeting; analyses publicly available data on cost‐effectiveness recommendations for the NHS; analyses publicly available data on the influence of accounting in medical dilemmas.

Findings

The paper finds that there is limited evidence of clinical budgeting dominating clinical decisions, but there is some evidence of central agency directions on appropriateness of treatments, but this is on a cost‐effectiveness basis. Numerous examples of adverse medical outcomes are cited in this paper – but with limited influence of accounting in these decisions.

Originality/value

The paper shows that the combination of accounting and medical data in a topical matter makes this an original and distinctive study.

Details

Journal of Health Organization and Management, vol. 21 no. 4/5
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 3 July 2020

Leticia Suárez-Álvarez, Ana Suárez-Vázquez and Ana-Belén del Río-Lanza

The increase of life expectancy leads to the elderly living with one or more chronic illnesses. Communication between the elderly and the health-care professional is…

Abstract

Purpose

The increase of life expectancy leads to the elderly living with one or more chronic illnesses. Communication between the elderly and the health-care professional is fundamental but can be difficult. For that reason, it is common to find the patient with an accompanying family member in the doctor’s surgery. The purpose of this paper is to analyze one of the possible actions of the companion during the provision of the medical service: the co-creation of value (through its two dimensions: coproduction and value-in-use) and its effects on the satisfaction of both the companion and the elderly patient.

Design/methodology/approach

A model has been tested through a system of structural equations using the statistical package EQS 6.2. The sample used is made up of 1,814 informants (907 companions and 907 patients).

Findings

The importance of coproduction between the accompanying person and the health-care professional is shown, to obtain greater levels of satisfaction (of the companion and the patient), whereas a negative role is conferred to the dimension value-in-use. This paper shows a positive impact of the satisfaction of the companion on that of the patient.

Practical implications

It is necessary to have health-care professionals who play a proactive role when facilitating the participation in the appointment with the doctor so as not to leave the initiative of participation in the hands of the companions.

Originality/value

Chronic illnesses are an important focal point of medical attention. Good management of the relations between those involved is fundamental for the diagnosis and adherence to treatment.

Details

Journal of Services Marketing, vol. 35 no. 1
Type: Research Article
ISSN: 0887-6045

Keywords

Article
Publication date: 10 August 2022

Joather Alwali and Wafaa Alwali

This paper examines the effect of job satisfaction on job performance among physicians in Iraq's public hospitals. It also determines the mediating role of job…

Abstract

Purpose

This paper examines the effect of job satisfaction on job performance among physicians in Iraq's public hospitals. It also determines the mediating role of job satisfaction on the relationship between emotional intelligence and job performance. It further unveils the mediating role of job satisfaction on the nexus between transformational leadership and job performance. As physicians form the bulk of health-care professionals, their performance at work is crucial in determining patient satisfaction regarding care quality.

Design/methodology/approach

A quantitative approach with structural equation modelling via partial least squares (PLS-SEM) and bootstrapping estimation was used to test the hypotheses developed. A total of 157 responses were utilized in the data analysis.

Findings

Evidence from the study indicates that job satisfaction has a positive relationship with job performance. The study also provides evidence that job satisfaction plays a positive mediating role in the relationship between emotional intelligence and job performance. Similarly, job satisfaction has a positive mediating effect on the nexus between transformational leadership and job performance among physicians in Iraq's public hospitals.

Originality/value

To the best of the authors' knowledge, this is the first study to investigate the relationship between physician job satisfaction and job performance in Iraqi public hospitals. Studies using Eastern samples are scarce, so the findings of this study will add to the body of knowledge from a cross-cultural standpoint.

Details

Leadership & Organization Development Journal, vol. 43 no. 6
Type: Research Article
ISSN: 0143-7739

Keywords

Book part
Publication date: 21 October 2008

Adina Nack

Medical encounters are interactional/interpersonal processes taking place within contexts shaped by macro-level social structures. In the case of sexually transmitted…

Abstract

Medical encounters are interactional/interpersonal processes taking place within contexts shaped by macro-level social structures. In the case of sexually transmitted diseases (STDs), medical encounters occur at a stigmatized crossroads of social control and gendered norms of sexual behavior. When women are diagnosed and treated for chronic STDs, practitioner demeanor has an important impact on how patients will view not only their health status but also their moral status. This chapter draws on in depth interviews with 40 women diagnosed with genital infections of herpes and/or human papillomavirus (HPV – the cause of genital warts) to explore three models of patient–practitioner interaction. The analysis focuses on the relationship between gender, construction of illness, and practitioner interaction style. In a broader context, the health risks posed by particular interaction styles to female STD patients shed light on larger public health implications of combining morality with medicine for the broader range of patients with stigmatizing diagnoses.

Details

Care for Major Health Problems and Population Health Concerns: Impacts on Patients, Providers and Policy
Type: Book
ISBN: 978-1-84855-160-2

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