Hasta Memnuniyeti ile Psikolojik İyi Oluş Arasındaki İlişkide Hasta– Hekim İletişiminin Aracı Rolü

Öz

Hasta–hekim iletişimi, toplumun bütününü etkileyen birçok süreci etkileyen çok yönlü bir olgudur. Hastalar ve hekimler arasında kurulan nitelikli iletişim, hem hastaların tedavi süreçlerini hem de psikolojik iyi oluşlarını olumlu yönde etkileyebilmektedir. Bu çalışma, bireylerin sağlık hizmetlerinden algıladıkları memnuniyetin psikolojik iyi oluşlarıyla nasıl ilişkili olduğunu ve iletişimin bu ilişkide açıklayıcı bir mekanizma olarak rol oynayıp oynamadığını incelemeyi amaçlamaktadır. Araştırmanın örneklemini, Türkiye’deki devlet hastanelerinden sağlık hizmeti alan ve kartopu örnekleme yöntemiyle ulaşılan 18–66 yaş arası 317 gönüllü katılımcı (Ort. = 32.7, SS = 11.1) oluşturmaktadır. Veriler çevrimiçi olarak Hasta–Hekim İletişimi Ölçeği, Hasta Memnuniyeti Ölçeği ve Psikolojik İyi Oluş Ölçeği kullanılarak toplanmıştır. Araştırma hipotezlerini test etmek amacıyla Pearson korelasyon analizi ve aracılık analizi (Model 4) kullanılmıştır. Bulgular, hasta memnuniyeti, hasta–hekim iletişimi ve psikolojik iyi oluş arasında pozitif yönlü anlamlı ilişkiler olduğunu göstermiştir. Aracılık analizi sonuçları, hasta–hekim iletişiminin hasta memnuniyeti ile psikolojik iyi oluş arasındaki ilişkide kısmi aracı rol oynadığını ortaya koymuştur. Model toplam varyansın %12’sini açıklamış olup, hekimlerle kurulan nitelikli iletişimin hizmet memnuniyeti ile psikolojik iyi oluş arasındaki ilişkide açıklayıcı bir mekanizma olarak işlev görebileceğini göstermiştir. Bulgular kamu sağlığı politikaları, kurumsal düzenlemeler ve klinik iletişim eğitimleri çerçevesinde tartışılmıştır.

Anahtar Kelimeler

• psikolojik iyi oluş
• hasta-hekim iletişimi
• hasta memnuniyeti
• kamu sağlığı

Etik Beyan

Etik Kurul izni dosya olarak yüklenmiştir.

The Mediating Role of Patient–Physician Communication in the Relationship Between Patient Satisfaction and Psychological Well-Being

Öz

Patient–physician communication is a multidimensional phenomenon that influences numerous processes affecting society. High-quality communication established between patients and physicians can positively affect both patients’ treatment processes and their psychological wellbeing. This study examines how individuals’ perceived satisfaction with healthcare services is associated with their psychological well-being and whether communication serves as an explanatory mechanism in this relationship. The study sample consisted of 317 volunteer participants (M = 32.7, SD = 11.1), aged 18 to 66, who received healthcare services at public hospitals in Türkiye and were recruited using snowball sampling. Data were collected online using the Patient–Physician Communication Scale, the Patient Satisfaction Scale, and the Psychological Well-Being Scale. Pearson correlation analysis and mediation analysis (Model 4) were employed to test the study hypotheses. The results indicated significant positive relationships among patient satisfaction, patient–physician communication, and psychological well-being. The mediation analysis showed that patient–physician communication partially mediates the relationship between patient satisfaction and psychological well-being. The model explained 12% of the total variance, indicating that high-quality communication with physicians may function as an explanatory mechanism linking service satisfaction and psychological well-being. The findings are discussed within the framework of public health policies, institutional regulations, and clinical communication training.

Anahtar Kelimeler

• psychological well-being
• patient–physician communication
• patient satisfaction
• public health

Etik Beyan

The Ethics Committee approval document has been uploaded.

Kaynakça

1. Al-Zyoud, W., Oweis, T., Al-Thawabih, H., Al-Saqqar, F., Al-Kazwini, A., & Al-Hammouri, F. (2021). The psychological effects of physicians’ communication skills on COVID-19 patients. Patient Preference and Adherence, 15, 677–690. https://doi.org/10.2147/ppa.s303869
2. Asan, O., Crotty, B., Nagavally, S., & Egede, L. E. (2018). Patient-centered communication and e-health information exchange patterns: Findings from a national cross-sectional survey. IEEE Journal of Translational Engineering in Health and Medicine, 7, 1–7. https://doi.org/10.1109/JTEHM.2018.2884925
3. Asnani, M. R. (2009). Patient–physician communication. West Indian Medical Journal, 58(4), 357–361. https://www.mona.uwi.edu/fms/wimj/category/keywords/patient-physician-communication
4. Atilla, G., Oksay, A., & Erdem, R. (2012). Hekim-hasta iletişimi üzerine nitel bir ön çalışma. İstanbul Üniversitesi İletişim Fakültesi Dergisi, 43, 23–37. https://izlik.org/JA29KM97XN
5. Barrier, P. A., Li, J. T.-C., & Jensen, N. M. (2003). Two words to improve physician–patient communication: What else? Mayo Clinic Proceedings, 78(2), 211–214. https://doi.org/10.4065/78.2.211
6. Belasen, A., & Belasen, A. T. (2018). Doctor–patient communication: A review and a rationale for using an assessment framework. Journal of Health Organization and Management, 32(7), 891–907. https://doi.org/10.1108/JHOM-10-2017-0262
7. Bulut, B. P., & Bozo, Ö. (2022). A helix of anxiety: A qualitative analysis of the personal experiences of individuals with health anxiety. Studies in Psychology, 42(1), 165–198. https://doi.org/10.26650/SP2021-935379
8. Campos, C. F. C., Olivo, C. R., de Arruda Martins, M., & Tempski, P. Z. (2024). Physicians’ attention to patients’ communication cues can improve patient satisfaction with care and perception of physicians’ empathy. Clinics, 79, 1-6. https://doi.org/10.1016/j.clinsp.2024.100377

9. Chang, C. S., Chen, S. Y., & Lan, Y. T. (2013). Service quality, trust, and patient satisfaction in interpersonal-based medical service encounters. BMC Health Services Research, 13(22), 1-11. https://doi.org/10.1186/1472-6963-13-22
10. Chen, X., Liu, C., Yan, P., Wang, H., Xu, J., & Yao, K. (2025). The impact of doctor-patient communication on patient satisfaction in outpatient settings: implications for medical training and practice. BMC Medical Education, 25(1), 830-840. https://doi.org/10.1186/s12909-025-07433-y
11. Diener, E., Wirtz, D., Tov, W., Kim-Prieto, C., Choi, D., Oishi, S., & Biswas-Diener, R. (2010). New well-being measures: Short scales to assess flourishing and positive and negative feelings. Social Indicators Research, 97(2), 143–156. https://doi.org/10.1007/s11205-009-9493-y
12. Durmuş, A., & Akbolat, M. (2020). The impact of patient satisfaction on patient commitment and the mediating role of patient trust. Journal of Patient Experience, 7(6), 1642–1647. https://doi.org/10.1177/2374373520967807
13. Forsey, J., Ng, S., Rowland, P., Freeman, R., Li, C., & Woods, N. N. (2021). The basic science of patient–physician communication: A critical scoping review. Academic Medicine, 96(2), 109–118. https://doi.org/10.1097/acm.0000000000004323
14. George, D., & Mallery, M. (2010). SPSS for Windows step by step: A simple guide and reference (10th ed.). Pearson.
15. Güney, G. (2025). Hasta-hekim iletişimi, hekime güven ve hasta memnuniyeti arasındaki ilişkilerin incelenmesi [Master’s thesis]. Yalova University.
16. Gültekin, E. (2016). Etik açıdan doğru hekim-hasta iletişimi nasıl olmalıdır? Turkiye Klinikleri Journal of Medical Ethics-Law and History, 24(3), 111-115. https://doi.org/10.5336/mdethic.2016-52044
17. Güzel, Ş., Akman Dömbekci, H., & Arı, A. (2022). Hasta ve hekim iletişimi: Özel hastane örneği. Selçuk Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 48, 38–55. https://doi.org/10.52642/susbed.1096940
18. Ha, J. F., & Longnecker, N. (2010). Doctor–patient communication: A review. Ochsner Journal, 10(1), 38–43. https://www.ochsnerjournal.org/content/10/1/38/tab-article-info
19. Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis. Guilford Press.
20. Johnsen, K., Dickerson, R., Raij, A., Harrison, C., Lok, B., Stevens, A., & Lind, D. S. (2006). Evolving an immersive medical communication skills trainer. Presence, 15(1), 33–46. https://doi.org/10.1162/pres.2006.15.1.33
21. Jiang, S. (2017). Pathway linking patient-centered communication to emotional well-being: Taking into account patient satisfaction and emotion management. Journal of Health Communication, 22(3), 234–242. https://doi.org/10.1080/10810730.2016.1276986
22. Katsaliaki, K. (2022). Evaluating patient and medical staff satisfaction from doctor–patient communication. International Journal of Health Care Quality Assurance, 35(1), 38–55. https://doi.org/10.1108/IJHCQA-03-2022-0033
23. Kaya, B., Çelik, R. ve Antalyalı, Ö. L. (2019). Hasta hekim iletişimi ile hekimin tekrar tercih edilmesi: Bir kamu hastanesi örneği, Sosyal, Beşerî ve İdari Bilimler Dergisi, 2(11), 801-814. https://doi.org/10.26677/tr1010.2019.273
24. Kenny, D. A., Veldhuijzen, W., Van der Weijden, T., LeBlanc, A., Lockyer, J., Légaré, F., & Campbell, C. (2010). Interpersonal perception in the context of doctor–patient relationships: A dyadic analysis of doctor–patient communication. Social Science & Medicine, 70(5), 763–768. https://doi.org/10.1016/j.socscimed.2009.10.065
25. Keyes, C. L., Shmotkin, D., & Ryff, C. D. (2002). Optimizing well-being: The empirical encounter of two traditions. Journal of Personality and Social Psychology, 82(6), 1007–1022. https://doi.org/10.1037/0022-3514.82.6.1007
26. Liu, N., Kumara, S., & Reich, E. (2020). Gaining insights into patient satisfaction through interpretable machine learning. IEEE Journal of Biomedical and Health Informatics, 25(6), 2215–2226. https://doi.org/10.1109/JBHI.2020.3038194
27. Müezzinoğlu, A. E. (2011). Hasta-hekim ilişkilerinde psikolojik yaklaşımlar. İstanbul Aydın Üniversitesi Dergisi, 88–89. https://www.ido.org.tr/lib_yayin/140.pdf
28. Preacher, K. J., & Kelley, K. (2011). Effect size measures for mediation models: Quantitative strategies for communicating indirect effects. Psychological Methods, 16(2), 93–115. https://doi.org/10.1037/a0022658
29. Riedl, D., & Schüßler, G. (2017). The influence of doctor–patient communication on health outcomes: A systematic review. Zeitschrift für Psychosomatische Medizin und Psychotherapie, 63(2), 131–150. https://doi.org/10.13109/zptm.2017.63.2.131
30. Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology, 57(6), 1069–1081. https://doi.org/10.1037/0022-3514.57.6.1069
31. Samir, M. M., Eisa, N. M., Khaled, H., Syed, W., Al-Rawi, M. B. A., Abou Warda, A. E., & Refaee, A. S. (2025). The impact of communication skills training on patient-centered attitude and patient satisfaction: A longitudinal study of Egyptian physicians. Preventive Medicine Reports, 55. https://doi.org/10.1016/j.pmedr.2025.103117
32. Schofield, P. E., Butow, P. N., Thompson, J. F., Tattersall, M. H. N., Beeney, L. J., & Dunn, S. M. (2003). Psychological responses of patients receiving a diagnosis of cancer. Annals of Oncology, 14(1), 48–56. https://doi.org/10.1093/annonc/mdg010
33. Sheikh, M. M., Qayyum, R., & Panda, M. (2019). Relationship of Physicians’ Rapport with Patients’ Satisfaction and Psychological Well-being During Hospitalization. Cureus, 11(6). https://doi.org/10.7759/cureus.4991
34. Street, R. L., Gordon, H., & Haidet, P. (2007). Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor? Social Science & Medicine, 65(3), 586–598. https://doi.org/10.1016/j.socscimed.2007.03.036
35. Street, R. L., Makoul, G., Arora, N. K., & Epstein, R. M. (2009). How does communication heal? Pathways linking clinician–patient communication to health outcomes. Patient Education and Counseling, 74(3), 295–301. https://doi.org/10.1016/j.pec.2008.11.015
36. Sürücü, L., Şeşen, H., & Maslakçı, A. (2023). Regression, mediation/moderation, and structural equation modeling with SPSS, AMOS, and PROCESS macro. Livre de Lyon.
37. Świątoniowska-Lonc, N., Polański, J., Tański, W., & Jankowska-Polańska, B. (2020). Impact of satisfaction with physician–patient communication on self-care and adherence in patients with hypertension: Cross-sectional study. BMC Health Services Research, 20. https://doi.org/10.1186/s12913-020-05912-0
38. Taşcı, B. İ. (2013). Hekim hasta ilişkisinin psikolojik boyutları. Sağlıkta Performans ve Kalite Dergisi, 6(2), 25–36. https://izlik.org/JA46JF52RB
39. Telef, B. B. (2013). Psikolojik iyi oluş ölçeği: Türkçeye uyarlama, geçerlik ve güvenirlik çalışması. Hacettepe Üniversitesi Eğitim Fakültesi Dergisi, 28(28-3), 374–384. https://izlik.org/JA93MA36YU
40. Ünal, Ö., Akbolat, M., & Amarat, M. (2018). The influence of patient-physician communication on physician loyalty and hospital loyalty of the patient. Pakistan Journal of Medical Sciences, 34(4), 999–1003. https://doi.org/10.12669/pjms.344.15136
41. Weiss, B. D. (2007). Health literacy and patient safety: Help patients understand (2nd ed.). American Medical Association Foundation.
42. Zhang, X., Li, L., Zhang, Q., Le, L. H., & Wu, Y. (2024). Physician empathy in doctor–patient communication: A systematic review. Health Communication, 39(5), 1027–1037. https://doi.org/10.1080/10410236.2023.2201735
43. Zheng, Y., Yang, S., Li, Q., & Ling, B. (2025). A good rest makes a caring doctor: Linking physicians’ nonwork time recovery to patient-centered communication with nonwork-to-work enrichment and empathy. Social Science & Medicine, 383, 1-9. https://doi.org/10.1016/j.socscimed.2025.118432