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      Hospital Culture and Healthcare Workers' Provision of Patient-Centered Care: A Moderated Mediation Analysis

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          Abstract

          Background

          Patient-centered care (PCC) is globally recognized as a high-quality and high-value healthcare service. It emphasizes the broad participation of patients and families in health-related decision-making and the provision of healthcare services that cater to patients' needs, preferences, and values. However, the mechanisms driving healthcare workers' provision of PCC are yet to be fully uncovered.

          Methods

          Using stratified random sampling, we recruited 1,612 healthcare workers from different levels of public hospitals in Hangzhou. We conducted survey interviews using questionnaires based on psychometrically sound scales. Structural equation modeling was used to analyze the effects of hospital culture, self-efficacy, and achievement motivation on the perceived provision of PCC by healthcare workers and to explore the mechanisms underlying their relationships.

          Results

          Self-efficacy had a positive mediating effect in the relationship between hospital culture and healthcare workers' perceived provision of PCC (β = 0.424, p < 0.001). Furthermore, the pursuit of success positively moderated the mediating role of self-efficacy (β = 0.128, p < 0.001), whereas, the avoidance of failure negatively moderated the mediating role of self-efficacy (β = -0.017, p < 0.001).

          Conclusion

          The findings suggest that hospitals should foster patient-centered and innovative cultures and develop strategies focusing on both internal motivation (self-efficacy and achievement motivation) and external environments (hospital culture) to help and encourage healthcare workers to implement PCC. For example, hospitals could further communication skills training, enhance leadership, build team spirit, and promote collaboration among healthcare workers.

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          Most cited references57

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          Patient-centredness: a conceptual framework and review of the empirical literature.

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          A 'patient-centred' approach is increasingly regarded as crucial for the delivery of high quality care by doctors. However, there is considerable ambiguity concerning the exact meaning of the term and the optimum method of measuring the process and outcomes of patient-centred care. This paper reviews the conceptual and empirical literature in order to develop a model of the various aspects of the doctor-patient relationship encompassed by the concept of 'patient-centredness' and to assess the advantages and disadvantages of alternative methods of measurement. Five conceptual dimensions are identified: biopsychosocial perspective; 'patient-as-person'; sharing power and responsibility; therapeutic alliance; and 'doctor-as-person'. Two main approaches to measurement are evaluated: self-report instruments and external observation methods. A number of recommendations concerning the measurement of patient-centredness are made.
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            Hayes, Andrew F. (2013). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. New York, NY: The Guilford Press

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              Social foundations of thoughts and action: A social cognitive theory

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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Public Health
                Journal ID (iso-abbrev): Front Public Health
                Journal ID (publisher-id): Front. Public Health
                Title: Frontiers in Public Health
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-2565
                Publication date (Electronic): 06 June 2022
                Publication date Collection: 2022
                Volume: 10
                Electronic Location Identifier: 919608
                Affiliations
                [1] 1Department of Health Policy and Management, School of Public Health, Hangzhou Normal University , Hangzhou, China
                [2] 2Department of Administration, School of Public Administration, Hangzhou Normal University , Hangzhou, China
                Author notes

                Edited by: Carmen María Galvez-Sánchez, University of Jaén, Spain

                Reviewed by: Xiaohe Wang, Hangzhou Normal University, China; Catalina Sau Man Ng, The Education University of Hong Kong, Hong Kong SAR, China; Roslina Othman, International Islamic University Malaysia, Malaysia

                *Correspondence: Xiaoting Zhang zxtbing@ 123456hznu.edu.cn

                This article was submitted to Public Mental Health, a section of the journal Frontiers in Public Health

                †These authors share first authorship

                Article
                DOI: 10.3389/fpubh.2022.919608
                PMC ID: 9207761
                SO-VID: c192dc4b-4f12-4b0f-bf12-2b1d4f17ae94
                Copyright © Copyright © 2022 Huang, Gao, Chen, Zhang and Zhang.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 13 April 2022
                Date accepted : 13 May 2022
                Page count
                Figures: 2, Tables: 7, Equations: 0, References: 58, Pages: 14, Words: 9331
                Categories
                Subject: Public Health
                Subject: Original Research

                Keywords: hospital culture,healthcare worker,patient-centeredness,self-efficacy,achievement motivation
                Data availability:
                Keywords: hospital culture, healthcare worker, patient-centeredness, self-efficacy, achievement motivation

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