Zhou Kairu, Chen Li, Li Min
School of Public Administration, South China University of Technology, Guangzhou, 510640, People's Republic of China.
Department of Clinical Research, Guangdong Second Provincial General Hospital, Guangzhou, 510317, People's Republic of China.
Risk Manag Healthc Policy. 2024 Dec 4;17:2981-2995. doi: 10.2147/RMHP.S482908. eCollection 2024.
The perception of medical risks is ubiquitous, influencing patients' healthcare experiences, yet the "black box" of this influencing process is seldom explored. This study explores the relationship between medical risk perception, trust, and patient satisfaction while taking shared decision-making as a moderator.
A stratified random sample of 450 inpatients from a tertiary public hospital in Guangzhou was selected for investigation, from June 2023 to September 2023. A moderated mediation model was tested using the PROCESS program, wherein medical risk perception was linked to patient satisfaction through trust, with shared decision-making acting as the moderating variable.
Medical risk perception had a significant negative predictive effect on patient satisfaction ( = -0.383, < 0.001), and after introducing the mediating variable, the negative predictive effect of medical risk perception on patient satisfaction remained significant ( = -0.237, < 0.001). Trust partially mediated the relationship between medical risk perception and patient satisfaction, with the mediating effect accounting for 37.86% of the total effect. The interaction term between medical risk perception and shared decision-making ( = 0.211, < 0.001) significantly predicted trust.
This study confirmed the mediating and moderating effects of trust and shared decision-making on the relationship between medical risk perception and patient satisfaction. The theoretical model constructed based on the theory of information asymmetry provides strategies and methods for healthcare managers to improve the quality of healthcare services and alleviate tensions in doctor-patient relationship.
医疗风险认知普遍存在，影响着患者的就医体验，但这一影响过程的“黑匣子”却很少被探究。本研究以共同决策为调节变量，探讨医疗风险认知、信任与患者满意度之间的关系。
于2023年6月至2023年9月，从广州一家三级公立医院选取450名住院患者作为分层随机样本进行调查。使用PROCESS程序检验调节中介模型，其中医疗风险认知通过信任与患者满意度相联系，共同决策作为调节变量。
医疗风险认知对患者满意度有显著的负向预测作用（β = -0.383，p < 0.001），引入中介变量后，医疗风险认知对患者满意度的负向预测作用仍然显著（β = -0.237，p < 0.001）。信任部分中介了医疗风险认知与患者满意度之间的关系，中介效应占总效应的37.86%。医疗风险认知与共同决策的交互项（β = 0.211，p < 0.001）显著预测信任。
本研究证实了信任和共同决策在医疗风险认知与患者满意度关系中的中介和调节作用。基于信息不对称理论构建的理论模型，为医疗管理者提高医疗服务质量、缓解医患关系紧张提供了策略和方法。
