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Health tourism is recognised as a recent new pattern of taking a break while accessing health-care services overseas. Past studies have explored this research area, but few have focussed on the theoretical perspective. Applying an appropriate theoretical model to guide interventions in planning and programme development is crucial, particularly when the focus of the study is on the cognitive mediation processes of change in individual behaviour. This study aims to examine the effectiveness of the protection motivation theory with the influence of threat appraisal and coping appraisal. The purpose is to trigger the behavioural intention to engage in international health tourism.

A total of 299 international tourists participated in the survey. The partial least squares structural equation modelling technique was used to test the research framework. Both the measurement model and the structural model were assessed as adequate.

The empirical results demonstrate that tourists’ high risk perception must be complemented by coping ability to produce a motivational response. Further, the adaptive behaviours of international tourists are focussed more on perceived efficacy than on the perception of threats related to behavioural intentions towards health tourism.

The study presents an effective theoretical model intervention applicable to health tourism. Future studies should conduct a more comprehensive assessment to generate strong decision-making effectiveness from the theoretical model.

共有299名国际游客参加了此次调查。使用偏最小二乘结构方程建模技术来测试研究框架。测量模型和结构模型均被评估为足够。

健康旅游业被公认为是最近在海外获得医疗服务时休息的新模式。过去的研究已经探索了这个研究领域, 但是很少有人关注理论观点。应用适当的理论模型来指导计划和程序开发的干预措施至关重要, 特别是当研究的重点是个人行为改变的认知中介过程时。本研究在威胁评估和应对评估的影响下检验了保护动机理论（PMT）的有效性。目的是激发从事国际健康旅游的行为意图。

实证结果表明, 游客的高风险感知必须通过应对能力来补充, 以产生激励反应。此外, 国际游客的适应行为更多地集中在感知的效能上, 而不是感知与针对健康旅游的行为意图有关的威胁。

该研究提出了一种适用于健康旅游的有效理论模型干预措施。未来的研究应进行更全面的评估, 以从理论模型中产生强大的决策效力。

关键词 健康旅游, 行为意图, 保护动机理论, 国际游客, 马来西亚

文章类型： 研究型论文

Un total de 299 turistas internacionales participaron en la encuesta. Se utilizó la técnica de modelización de ecuaciones estructurales por mínimos cuadrados parciales para probar el marco de investigación. Tanto el modelo de medición como el modelo estructural se consideraron adecuados.

El turismo de salud se reconoce como un nuevo modelo reciente de descanso para acceder a los servicios sanitarios en el extranjero. Estudios anteriores han explorado esta área de investigación, pero pocos se han centrado en la perspectiva teórica. La aplicación de un modelo teórico adecuado para guiar las intervenciones en la planificación y el desarrollo de programas es crucial, especialmente cuando el estudio se centra en los procesos de mediación cognitiva del cambio en el comportamiento individual. Este estudio examina la eficacia de la teoría de la motivación de la protección (PMT) con la influencia de la valoración de la amenaza y la valoración del afrontamiento. El objetivo es activar la intención conductual de realizar turismo sanitario internacional.

Los resultados empíricos demuestran que la percepción de alto riesgo de los turistas debe complementarse con la capacidad de afrontamiento para producir una respuesta motivacional. Además, los comportamientos adaptativos de los turistas internacionales se centran más en la eficacia percibida, que en la percepción de las amenazas relacionadas con las intenciones de comportamiento hacia el turismo de salud.

El estudio presenta un modelo teórico de intervención eficaz aplicable al turismo de salud. Futuros estudios deberían realizar una evaluación más exhaustiva para generar mayor eficacia en la toma de decisiones a partir del modelo teórico.

Turismo de salud; Intención de comportamiento; Teoría de la motivación de la protección; Turistas internacionales; Malasia

Trabajo de investigación

Few studies have adopted social psychology theories to understand the medical tourism decision-making process. The purpose of this study is to fill the said gap by suggesting the adoption of two social cognition models: the theory of planned behaviour (TPB) and protection motivation theory (PMT), to predict medical tourism behavioural intention, as well as compare their predictive power by integrating TBP and PMT in a single model.

A quantitative method has been adopted. There were 265 international tourists from various regions who visited Malaysia (one of the main medical tourism players in Asia), who were asked to complete the survey questionnaire. Data was analysed using the partial least squares structural equation modelling technique.

The results of this study provided support and validated the well-developed research models of TPB and PMT. Although PMT appears to be a more concrete and specific framework, the TPB model results have a slight advantage. TPB results emphasised the important roles of attitude, subjective norms and perceived behavioural control in developing behavioural intentions, and thus directly linked to the development of pull marketing strategies. PMT results emphasised the important roles of perceived threats and coping appraisal of health care in developing push strategies for medical tourism.

The research illustrates the need for rigorous examination of the ability of behavioural theories. The findings can aid in scrutinising their shortcomings and their readiness to modify, integrate and enhance in a more constructive manner when they address the health-education interventions, especially in a medical tourism context.

很少有研究采用社会心理学理论来理解医疗旅游的决策过程。这项研究的目的是通过建议采用两种社会认知模型（计划行为理论（TPB）和保护动机理论（PMT））来填补上述空白。通过将TBP和PMT集成到一个模型中, 预测医疗旅游行为意愿并比较其预测能力。

采用定量方法。样本包括265名访问了马来西亚（亚洲主要的医疗旅游公司之一）的国际游客, 他们被邀请填写调查问卷。研究使用偏最小二乘结构方程建模技术分析数据。

这项研究的结果支持并验证了TPB和PMT完善的研究模型。尽管PMT似乎是一个更具体的框架, 但TPB模型结果却有一点优势。TPB模型的结果强调了态度, 主观规范和感知的行为控制在形成行为意愿中的重要作用, 因此直接与拉动式营销策略的发展相关。 PMT结果强调了感知到的威胁和对医疗保健的应对评估在制定医疗旅游推动策略中的重要作用。

该研究阐述了严格检验行为理论能力的必要性。当研究结果针对健康教育干预措施时, 尤其是在医疗旅游领域, 这些发现可以帮助审查它们的缺点以及它们是否准备好以更具建设性的方式进行修改, 整合和改善。

医疗旅游, 游客的行为意愿, 保护动机理论, 计划行为理论, 模型比较, 马来西亚

研究论文

Pocos estudios han adoptado teorías de psicología social para comprender el proceso de toma de decisiones de turismo médico. El objetivo de esta investigación es llenar dicho vacío sugiriendo la adopción de dos modelos de cognición social: la teoría del comportamiento planificado (TPB) y la teoría de la motivación de protección (PMT), para predecir la intención conductual del turismo médico y comparar su poder predictivo integrando TBP y PMT en un solo modelo.

se ha adoptado un método cuantitativo. Hubo 265 turistas internacionales de diversas regiones que visitaron Malasia (uno de los principales actores del turismo médico en Asia) a quienes se les pidió que completaran el cuestionario de la encuesta. Los datos se analizaron utilizando la técnica de modelado de ecuaciones estructurales de mínimos cuadrados parciales.

Los resultados de este estudio brindaron apoyo y validaron los modelos de investigación bien desarrollados de TPB y PMT. Aunque PMT parece ser un marco más concreto y específico, los resultados del modelo TPB tienen una ligera ventaja. Los resultados del TPB enfatizaron los roles importantes de las actitudes, las normas subjetivas y el control conductual percibido en el desarrollo de las intenciones conductuales y, por lo tanto, directamente vinculados con el desarrollo de estrategias de marketing pull. Los resultados de PMT enfatizaron los roles importantes de las amenazas percibidas y la evaluación de la atención médica en el desarrollo de estrategias de empuje para el turismo médico.

La investigación ilustra la necesidad de un examen riguroso de la capacidad de las teorías conductuales. Los hallazgos pueden ayudar a analizar sus deficiencias y su disposición a modificar, integrar y mejorar de una manera más constructiva cuando abordan las intervenciones de educación sanitaria, especialmente en un contexto de turismo médico.

Social media has fundamentally changed the leisure travel behavior of Singapore residents. The purpose of this paper is to focus on Facebook and its impact on travel behavior. The study focuses on Singapore residents.

A total of 16 input and five output variables were tested, with a sample of 203 Facebook users residing in Singapore. Primary data modeling was done using ADANCO, a structural equation modeling tool that uses composite modeling approach for hypothesis testing. The analysis performed an estimated structural model and then determined the best model fit by measuring reliability, validity and path analysis and estimating model parameters.

Research findings indicate that Facebook has had a strong behavioral influence on the frequency of travel, itinerary planning and social sharing, while it had no impact during the destination-selection stage of travel planning.

Facebook’s influence on leisure travel behavior confirms the theory of planned behavior proposed by Icek Ajzen. From Facebook’s perspective, the outcome of this study is helpful in recommending the best use of the platform for destination providers.

This paper aims to study the factors that influence customer loyalty toward the internet service providers in Malaysia. The five factors used are corporate image, perceived quality, perceived value, price fairness and promotion. The mediating variable of this study is customer satisfaction, while customer loyalty is the study variable.

The primary data collection has been done by distributing survey questionnaires to 338 internet users in Malaysia. The data collected have been analyzed with SAS software.

The results showed that perceived quality has the strongest influence on customer satisfaction toward internet service providers in Malaysia. However, corporate image has no relationship with customer satisfaction toward internet service providers in Malaysia. Furthermore, customer satisfaction has a significant and positive relationship to customer loyalty toward the internet service providers in Malaysia.

European Customer Satisfaction Index has been adopted and combined with price fairness and promotion as a new research model that other researchers may look into it further. This research may also serve as a guide to internet service providers as they may learn about the underlying factors that affect the satisfaction and loyalty of customers and which factor has the strongest impact.

The success of self-assessment tax system is voluntary compliance with the tax laws. When tax evasion is seen as unacceptable, taxpayers will tend to evade tax less. Hence, the understanding of taxpayers’ attitude on tax morality towards a tax system has to be enhanced to minimize tax evasion cases. The purposes of this study are to examine the relationship between tax fairness, tax knowledge, enforcement level and social exchange towards taxpayers’ attitude of tax morality under the self-assessment system in Malaysia and also to identify the relationship between taxpayers’ attitude of tax morality and taxpayers’ perceptions on tax evasion.

Data were collected from 400 taxpayers through a questionnaire and analysed.

From the analysis, it has been found out that tax knowledge is the most important tax system characteristic that affects taxpayers’ attitude of tax morality. In addition, taxpayers’ attitude of tax morality is significant to taxpayers’ perceptions on tax evasion in Malaysia.

The findings of this study would be useful for the government to further improve the present tax system to increase voluntary tax compliance.

The purpose of this paper is to examine whether different corporate social responsibility (CSR) dimensions, namely, workplace economic responsibility, legal responsibility, ethical responsibility, philanthropic responsibility and environmental responsibility, have different influence on job pursuit intention among undergraduate students in Malaysia.

The target respondents are undergraduate business students from five leading private universities in Malaysia. Primary data were collected through survey questionnaires via face-to-face method. Five-point Likert scale was used to assess the variables and to measure the items. Collected data were tested through SAS software and analysed with descriptive and inferential analyses.

Four out of the five CSR dimensions significantly influence job pursuit intention with ethical responsibility being the exception.

This study proved that the adoption of CSR in an organisation will become a competitive advantage to attract new talents. Also, this is an improved research model by adopting multi-dimensional perspectives of CSR.

This proposed framework with a combination of five CSR dimensions (workplace economic responsibility, legal responsibility, ethical responsibility, philanthropic responsibility and environmental responsibility) is useful to future researchers as it enables them to have a broader view on CSR and its effect on job pursuit intention.

The privacy of the information is a major challenge in the communication process. In the present modern generation, the cryptography plays a vital role in providing security for data, such as text, images and video while transmitting from source to destination through internet or intranet. The Rivest-Shamir-Adleman (RSA) is an asymmetric key cryptographic system, where the security of the method works on the strength of the key.

In an asymmetric key crypto system, a pair of keys is generated one public key for encryption and one private key for decryption. The major challenge of implementing the RSA is the power function which becomes tedious and time consuming as the exponential value increases. The Chinese remainder theorem proves to be the best for data encryption when it comes to execution time of the algorithm. The proposed novel RSA algorithm with lookup table (LUT) is an extension to the Chinese remainder algorithm, which works better for image and video in terms of time complexity.

This paper presents a LUT approach for implementing the RSA with a minimal processing time. The proposed algorithm was compared with the standard algorithms like, Chinese remainder theorem, binary approach and squared multiplication approach. As the size of the exponent value increases, the proposed method shows better performance compared to other standard methods.

This paper presents a LUT approach for implementing the RSA with a minimal processing time. The proposed algorithm was compared with the standard algorithms like, Chinese remainder theorem, binary approach and squared multiplication approach. As the size of the exponent value increases, the proposed method shows better performance compared to other standard methods.

The topic of visitor consumption is of great interest to international organizations and scientific research because of its particular significance. The analysis of tourism activity's economic impact on the host country might be carried out by implementing ex post methods and approaches based mainly on the System of National Accounts. These methods refer to the tourism contribution to the national economy and the analysis of direct and indirect economic effects. The aim of this kind of tourism expenditure's analysis is to obtain the necessary information and to acquire the knowledge needed to formulate and implement the appropriate economic policy, as well as to elaborate the adequate planning and rational tourism management. Tourism activity has specific characteristics rendering its economic analysis a difficult task. In the present paper the main methods attempting to estimate the tourism's economic impact are reviewed, with emphasis on those allowed to obtain the most reliable results; tourism satellite accounts and input‐output analysis. This review is followed by a presentation of the evaluation criteria permitting to estimate their value. In the second section we summarise the scientific debate on tourism economic impact, which primarily focuses on two main issues — the theoretical approach and the adequate methodological instrument. The paper concludes by highlighting the actual state of art in this research field.

This case is in four parts, highlighting the crossroads at which the protagonist Savita finds herself in and the difficulties she faces in balancing her career aspirations with family responsibilities. A Fellow of Indian Institute of Management (IIM) Ahmedabad, Savita's dilemmas concern working in a prestigious management institute in Kolkata versus getting a job in Mumbai in order to psychologically and financially support her family and get married; joining her husband in China on his posting versus going to the US on a prestigious fellowship prioritizing her career, and finally, starting a family versus postponing the decision till the couple were together and reasonably settled in their respective careers.

Scarcity of resources and ever-changing customer demand has driven the manufacturing organization to opt for an integrated sustainable-green-lean-six sigma-agile manufacturing system (ISGLSAMS). The purpose of this study is to identify and rank the various drivers for the adoption of ISGLSAMS for the more sustainable development of the industries.

Using a survey questionnaire, data were collected for the 14 ISGLSAMS drivers, identified through the literature review, from 108 Indian manufacturing industries. The sign test is used to check the relevance and significance of drivers. ISGLSAMS drivers are ranked based on the median and standard deviation. A multiple regression model was employed to investigate the effects of other drivers on the highest-ranked driver to strengthen the understanding of the drivers.

Competition, customer demand, technological changes, supply chain pressure, cost benefits, incentives, top management commitment and future legislation are found the strongest drivers for ISGLSAMS. For administering the competition for ISGLSAMS policymakers must focus on the availability of organization resources, customer demand, future legislation, incentives, supply chain pressure and technological developments.

The study contributes to a better understanding of ISGLSAMS drivers. Through this study government, stakeholders and policymakers may plan the policy, roadmap and strategies to drive the manufacturing organizations for the adoption of ISGLSAMS for more sustainable development of industries in India.

This work contributes to the identification and prioritization of the drivers for the more sustainable manufacturing system, i.e. ISGLSAMS (7 Rs based, i.e. 6 Rs of sustainability with 7th R, reconfiguration). The research also contributes to the (1) ISGLSAMS literature (2) the awareness and demand of (a) ISGLSAMS (b) reconfigurable, sustainable and modular products (c) redesign, recovery and refurbishing of the product to increase the product life cycle.