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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 doctorpatient 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

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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…

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 doctorpatient 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

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Article
Publication date: 4 December 2020

Hualong Yang, Helen S. Du and Wei Shang

Despite the prevalent use of professional status and service feedback in online healthcare markets, the potential interaction relationship between two types of information…

Abstract

Purpose

Despite the prevalent use of professional status and service feedback in online healthcare markets, the potential interaction relationship between two types of information is still unknown. This study used the signaling theory to examine the substitute relationship between professional status and service feedback in patients' doctor choice, as well as the moderating effect of illness severity.

Design/methodology/approach

To test the paper's hypotheses, we constructed a panel data model using 418 doctors' data collected over a period of six months from an online healthcare market in China. Then, according to the results of the Hausman test, we estimated a fixed-effects model of patients' choice in online healthcare markets.

Findings

The empirical results showed that the effect of a doctor's professional status and service feedback on a patient's doctor choice was substitutable. Moreover, patients' illness severity played a moderating role, in that the influence of professional status on a patient with high-severity illness was higher than that on a patient with low-severity illness, whereas the influence of service feedback on a patient with low-severity illness was higher than that of a patient with high-severity illness. In addition, we found that illness severity negatively moderated the substitute relationship between professional status and service feedback on a patient's choice.

Originality/value

These findings not only contribute to signaling theory and research on online healthcare markets, but also help us understand the importance of professional status and service feedback on a patient's choice when seeking a doctor online.

Details

Internet Research, vol. 31 no. 4
Type: Research Article
ISSN: 1066-2243

Keywords

Content available
Article
Publication date: 20 July 2021

Elena Bellio and Luca Buccoliero

Delivering patient-centered healthcare is now seen as one of the basic requirements of good quality care. In this research, the impact of the perceived quality of three…

Abstract

Purpose

Delivering patient-centered healthcare is now seen as one of the basic requirements of good quality care. In this research, the impact of the perceived quality of three experiential dimensions (Physical Environment, Empowerment and Dignity and PatientDoctor Relationship) on patient's Experiential Satisfaction is assessed.

Design/methodology/approach

259 structured interviews were performed with patients in private and public hospitals across Italy. The research methodology is based in testing mediation and moderation effects of the selected variables.

Findings

The study shows that: perceived quality of Physical Environment has a positive impact on patient's Experiential Satisfaction; perceived quality of Empowerment and Dignity and perceived quality of PatientDoctor Relationship mediate this relationship reinforcing the role of Physical Environment on Experiential Satisfaction; educational level is a moderator in the relationship between perceived quality of PatientDoctor Relationship and overall Satisfaction: more educated patients pay more attention to relational items. Subjective Health Frailty is a moderator in all the tested relationships with Experiential Satisfaction: patients who perceive their health as frail are more reactive to the quality of the above-mentioned variables.

Originality/value

Physical Environment items are enablers of both Empowerment and Dignity and PatientDoctor Relationship and these variables must be addressed all together in order to improve the value proposition provided to patients. Designing a hospital, beyond technical requirements that modern medicine demands and functional relationships between different medical departments, means dealing with issues like the anxiety of the patient, the stressful working environment for the hospital staff and the need to build a sustainable and healing building.

Details

The TQM Journal, vol. 33 no. 7
Type: Research Article
ISSN: 1754-2731

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Article
Publication date: 9 February 2015

Barend Van Den Assem and Victor Dulewicz

The purpose of this paper is to provide a greater understanding of the general practitioner (GP)-patient relationship for academics and practitioners. A new model for…

Abstract

Purpose

The purpose of this paper is to provide a greater understanding of the general practitioner (GP)-patient relationship for academics and practitioners. A new model for dyadic professional relationships specifically designed for research into the doctor-patient relationship was developed and tested. Various conceptual models of trust and related constructs in the literature were considered and assessed for their relevance as were various related scales.

Design/methodology/approach

The model was designed and tested using purposefully designed scales measuring doctors’ trustworthiness, practice orientation performance and patient satisfaction. A quantitative survey used closed-ended questions and 372 patients responded from seven GP practices. The sample closely reflected the profile of the patients who responded to the DoH/NHS GP Patient Survey for England, 2010.

Findings

Hierarchical regression and partial least squares both accounted for 74 per cent of the variance in “overall patient satisfaction”, the dependent variable. Trust accounted for 39 per cent of the variance explained, with the other independent variables accounting for the other 35 per cent. ANOVA showed good model fit.

Practical implications

The findings on the factors which affect patient satisfaction and the doctor-patient relationship have direct implications for GPs and other health professionals. They are of particular relevance at a time of health reform and change.

Originality/value

The paper provides: a new model of the doctor-patient relationship and specifically designed scales to test it; a greater understanding of the effects of doctors’ trustworthiness, practice orientation and performance on patient satisfaction; and a new framework for examining the breadth and meaning of the doctor-patient relationship and the management of care from the patient’s viewpoint.

Details

International Journal of Health Care Quality Assurance, vol. 28 no. 1
Type: Research Article
ISSN: 0952-6862

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Book part
Publication date: 12 October 2011

Scott V. Savage

Using data from the General Social Survey (2002), structural equation modeling is employed to examine the intersections and relationships between various socio-demographic…

Abstract

Using data from the General Social Survey (2002), structural equation modeling is employed to examine the intersections and relationships between various socio-demographic and contextual variables, patient trust, and patient preference for behaviors that indicate a desire to be an active health care participant. In so doing, a gap in the literature is addressed by uniting previous research on patient trust with research on patient participation. Findings reveal that patient trust in doctors and various socio-demographic and contextual variables are associated with people wanting to participate in the health care process by learning about medical issues on their own and by contributing to medical decisions. Results also shed new light on past research, which finds a relationship between various socio-demographic variables and patient trust. Specifically, they highlight the importance of distinguishing between patient trust in doctors and patient trust in the broader health care institution and the economic pressures it exerts on doctors. A discussion of what these findings might mean for our understanding of the doctor-patient relationship and the delivery of health care concludes the chapter.

Details

Access to Care and Factors that Impact Access, Patients as Partners in Care and Changing Roles of Health Providers
Type: Book
ISBN: 978-0-85724-716-2

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Article
Publication date: 10 June 2021

Sergio Riotta and Manfredi Bruccoleri

This study formulates a new archetypical model that describes and re-interprets the patient–physician relationship from the perspective of two widespread phenomena in the…

Abstract

Purpose

This study formulates a new archetypical model that describes and re-interprets the patient–physician relationship from the perspective of two widespread phenomena in the healthcare delivery process: value co-creation (VCC) and defensive medicine (DM).

Design/methodology/approach

Grounded in the existing literature on VCC and DM, the authors designed and conducted 20 in-depth interviews with doctors (and patients) about their past relationships with patients (and doctors). After putting the recorded interviews through qualitative analysis with a three-level coding activity, the authors built an empirically informed model to classify patient–physician relationships.

Findings

The authors identified four archetypes of patient–physician relationships. Each archetype is described along with its representing characteristics and explained in terms of its consequences as they relate to VCC and DM.

Research limitations/implications

This research contributes to the literature on both VCC in healthcare and DM, in addition to the patient–physician's relationship literature.

Practical implications

Being aware of patient–physician relationship mechanics, building long-term relations with patients and investing in service personalization and patient-centred care can effectively mitigate the risks of DM behaviours on one side while increasing the likelihood of VCC actualization on the other.

Originality/value

Although strictly linked to the interactions between patients and doctors, VCC and DM are typically considered disentangled. In this research paper, the authors identified four archetypes of patient–physician relationships in relation to these two phenomena.

Details

Journal of Service Theory and Practice, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2055-6225

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Article
Publication date: 18 August 2014

Barend Van Den Assem and Victor Dulewicz

The purpose of this paper is to examine the doctor-patient relationship from the patients’ perspective. It tests a number of hypothesized relationships with respect to the…

Abstract

Purpose

The purpose of this paper is to examine the doctor-patient relationship from the patients’ perspective. It tests a number of hypothesized relationships with respect to the interaction inside the doctor-patient relationship including the continuity of care, doctors’ practice orientation and performance, which help enhance the understanding of patient trust and satisfaction.

Design/methodology/approach

A quantitative survey using a closed-ended questionnaire provided a useable sample of 372 respondents.

Findings

There was an overall high level of patient trust in and satisfaction with GPs as well as good patient rapport with their GPs. Patients who were most satisfied with their doctor perceived them to be more trustworthy, were more satisfied with their performance and perceived them to have greater preference for a sharing orientation than those patients who were least satisfied.

Practical implications

The research findings suggest ways of maintaining and enhancing trust through training, continuing professional development, appraisals and assessments and revalidation of doctors. The skill sets and competencies related to trust and practice are presented in light of current practice trends and changing health care agendas, including the recent Department of Health White Paper, “Liberating the NHS” (2010). Since the questionnaire was able to discriminate between those patients who were most and least satisfied with their doctors, it identified what patients appreciate and are concerned about with respect to GPs and their practice.

Originality/value

The research provides new insights and understanding of how patient satisfaction in the GP-patient relationship is influenced by GPs’ trustworthiness, practice orientation and performance, for academic and practitioner communities.

Details

Journal of Health Organization and Management, vol. 28 no. 4
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 21 June 2013

Mellina da Silva Terres and Cristiane Pizzutti dos Santos

The purpose of this paper is to address the impact of affect (as opposed to cognition) on patient trust in high‐consequence exchanges. The authors also investigate the…

Abstract

Purpose

The purpose of this paper is to address the impact of affect (as opposed to cognition) on patient trust in high‐consequence exchanges. The authors also investigate the mediator's role of trust in the relationship between affect and cognition, and behavioural intentions.

Design/methodology/approach

Using undergraduate students from a large North American university, three between‐subjects experiments were performed.

Findings

Study 1 findings demonstrate that affect and cognition elements equally influence trust in high‐consequence decisions. Also, trust is an important mediator between affect and cognition and the intention to continue the relationship and to seek a second opinion. Study 2 reinforces the importance of trust for the patient's evaluations, showing that when trust is low, the second opinion influences patient satisfaction. However, when patient trust is high, the second opinion (the same or different, compared with the first diagnosis) does not affect patient satisfaction. Study 3 shows that, in low‐consequence choices, cognition is a more relevant antecedent of trust than affect. Affect is important when cognition aspects (e.g. the competence of the doctor) are perceived as low.

Originality/value

As an original contribution, this study addresses the different impacts of affect and cognition aspects on patient trust, in high‐ and low‐consequence exchanges. Also, it highlights the importance of patient trust in the doctor when a second opinion is sought: a different diagnosis depletes patient satisfaction only for patients with low levels of trust in the doctor.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 7 no. 2
Type: Research Article
ISSN: 1750-6123

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Article
Publication date: 11 June 2018

Mellina da Silva Terres and Kenny Basso

The purpose of this study is to investigate the antecedents of the patient’s initial trust in the doctor. In this sense, it is proposed that trust in the hospital plays a…

Abstract

Purpose

The purpose of this study is to investigate the antecedents of the patient’s initial trust in the doctor. In this sense, it is proposed that trust in the hospital plays a mediating role in the relationship between the physical evidence in the service environment and the patient’s initial trust in the doctor.

Design/methodology/approach

Two experimental studies with factorial between-subjects design with random assignment were used. The data were analyzed through an analysis of variance.

Findings

The results show that design and social factors affect the patient’s initial trust in the doctor through his trust in the hospital. The results also showed that reputation and recommendation affect the initial trust.

Originality/value

This is the first study to consider antecedents of patient’s initial trust in the doctor. Most of the studies about trust focuses on investigating trust in situations where there is a prior relationship; however, this study arises some evidences that trust starts to be constructing even before the patient properly meets the doctor. These findings are valuable because they highlight the importance of physical evidences, reputation and positive word-of-mouth for building initial trust.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 12 no. 2
Type: Research Article
ISSN: 1750-6123

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