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1 – 10 of over 12000Sanjaya 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 explaining…
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.
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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 the…
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.
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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 is…
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.
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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 dyadic…
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.
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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 Patient–Doctor 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 Patient–Doctor 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 Patient–Doctor 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 Patient–Doctor 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.
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Jiahe Chen, Ping-Yu Hsu, Yu-Wei Chang, Wen-Lung Shiau and Yi-Chen Lan
Considering both online and offline service scenarios, this study aims to explore the factors affecting doctors' intention to offer consulting services in eHealth and compare the…
Abstract
Purpose
Considering both online and offline service scenarios, this study aims to explore the factors affecting doctors' intention to offer consulting services in eHealth and compare the factors between the free- and paid-service doctors. The theory of reasoned action and social exchange theory are integrated to develop the research model that conceptualizes the role of extrinsic motivations, intrinsic motivations, costs, and attitudes in doctors' behavioral intentions.
Design/methodology/approach
Partial least square structural equation modeling (PLS-SEM) was leveraged to analyze 326 valid sample data. To provide robust results, three non-parametric multigroup analysis (MGA) methods, including the PLS-MGA, confidence set, and permutation test approaches, were applied to detect the potential heterogeneity between the free- and paid-service doctors.
Findings
The results with overall samples reveal that anticipated rewards, anticipated associations, anticipated contribution, and perceived fee are all positively related to attitude, which in turn positively influences behavioral intention, and that perceived fee positively moderates the relationship between attitude and behavioral intention. Attitude's full mediation is also confirmed. However, results vary between the two groups of doctors. The three MGA approaches return relatively convergent results, indicating that the effects of anticipated associations and perceived fee on attitude are significantly larger for the paid-service doctors, while that of anticipated rewards is found to be significantly larger for the free-service doctors.
Originality/value
eHealth, as a potential contactless alternative to face-to-face diagnoses, has recently attracted widespread attention, especially during the continued spread of COVID-19. Most existing studies have neglected the underlying heterogeneity between free- and paid-service doctors regarding their motivations to engage in online healthcare activities. This study advances the understanding of doctors' participation in eHealth by emphasizing their motivations derived from both online and offline service scenarios and comparing the differences between free- and paid-service doctors. Besides, horizontally comparing the results by applying diverse MGA approaches enriches empirical evidence for the selection of MGA approaches in PLS-SEM.
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Using data from the General Social Survey (2002), structural equation modeling is employed to examine the intersections and relationships between various socio-demographic and…
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.
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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.
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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 mediator's…
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.
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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.
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