Analyzing Individuals’ Perceptions of The Concept of Patient- Friendly Hospitals Through a Word Association Test

Abstract

The concept of a patient-friendly hospital is a significant concept representing patient-centered healthcare services. Today, one way to improve the quality of healthcare is to meet patient expectations. Therefore, determining how the concept of a patient-friendly hospital is shaped in patients' minds is crucial for developing patient-friendly practices and improving the quality of healthcare services. This study aims to analyze how patients perceive the concept of a "patient-friendly hospital" through a word association test (WAT) and to reveal patients' cognitive structures related to this concept. Among the 718 words obtained, the highest frequency words were reliable (81), privacy (41), smiling-face (40), caring (30), clean (25), hygiene (22), and communication (20), resulting in a total of 172 different words. Content analysis conducted as part of the word association analysis yielded eight themes: communication, trust, accessibility, quality, service, staff, treatment, and environment. Individuals define patient-friendly hospitals not only as places with good physical conditions but also as institutions that value, respect, and have an understanding approach to patients. It can be said that in order to improve the quality of health services, more importance should be given to areas such as communication, ethical values and accessibility.

Keywords

• Patient-friendly hospital
• Word association test
• Health services.

References

1. Acharya, S., Boyd, A. D., Cameron, R., Lopez, K. D., Martyn-Nemeth, P., Dickens, C... Di Eugenio, B. (2019). What happened to me while ı was in the hospital? challenges and opportunities for generating patient-friendly hospitalization summaries. Journal of Healthcare Informatics Research, 3, 107–123. https://doi.org/10.1007/s41666-018-0036-7
2. Ahlfeldt, H., Borin, L., Daumke, P., Grabar, N., Hallett, C., Hardcastle, D., ... & Willis, A. (2006). Literature review on patient-friendly documentation systems.
3. Aksoy, E. and Aydın, D. (2022). Hastane tasarımlarının geçmişten günümüze değişiminin hasta odaları üzerinden incelenmesi. Bodrum Journal of Art and Design, 1(2), 221-240.
4. Arab, M., Tabatabaei, S. G., Rashidian, A., Forushani, A. R. and Zarei, E. (2012). The effect of service quality on patient loyalty: a study of private hospitals in Tehran, Iran. Iranian Journal of Public Health, 41(9), 71.
5. Arslanoğlu, A., Kileci, Y. S., Arslan, Ş. F. and Arslan, Z. (2023). Hasta dostu hastane: bir eğitim araştırma hastanesi uygulaması. Sağlık Akademisyenleri Dergisi, 10(2), 283-290. https://doi.org/10.52880/sagakaderg.1280779
6. Bahar, M. and Özatlı, N. S. (2003). Kelime iletişim test yöntemi ile lise 1. sınıf öğrencilerinin canlıların temel bileşenleri konusundaki bilişsel yapılarının araştırılması. Balıkesir Üniversitesi Fen Bilimleri Enstitüsü Dergisi, 5(2), 75-85.
7. Baker, S. K. (2023). Thirty ways to make your practice more “patient-friendly”. In Communication for Doctors (pp. 4-5). CRC Press.
8. Buchwald, D., Buchwald, D. and Melgaard. D. (2023). The ımpact of a family-friendly hospital: a patient perspective. Health Environments Research & Design Journal, 17(1), 127-134. doi:10.1177/19375867231201630

9. Dijs-Elsinga, J., Otten, W., Versluijs, M. M., Smeets, H. J., Kievit, J., Vree, R., ... Marang-van de Mheen, P. J. (2010). Choosing a hospital for surgery: the importance of information on quality of care. Medical Decision Making, 30(5), 544-555.
10. Dooley S.K. (2006). The patient-friendly practice. Journal of Medical Practice Management, 21(6), 358-61.
11. Douglas, C.H. and Douglas, M.R. (2004). Patient-friendly hospital environments: exploring the patients’ perspective. Health Expectations, 7(1), 61–73. doi:10.1046/j.1369-6513.2003.00251.x
12. Farahani, M., Esmaeili, M., Ashrafizadeh, H., Hajibabaee, F., Haghani, S. and Ariyamloo, P. (2022). Patient safety friendly hospital standards and customer orientation among Iranian nurses during the COVID-19 pandemic. BMJ Open Quality, 11(2), e001903.
13. Fatima, T., Malik, S. A. and Shabbir, A. (2018). Hospital healthcare service quality, patient satisfaction and loyalty: An investigation in context of private healthcare systems. International Journal of Quality & Reliability Management, 35(6), 1195-1214.
14. Filiz, M. and Güngör, S. (2022). Sağlık hizmetlerinin sunumunda hasta dostu kavramı üzerinde bir değerlendirme. Trakya Üniversitesi Sosyal Bilimler Dergisi, 24(2), 657-674. https://doi.org/10.26468/trakyasobed.1058916
15. Fredericks, J. E. and Bunting Jr, R. F. (2010). Implementation of a patient‐friendly medication schedule to improve patient safety within a healthcare system. Journal of Healthcare Risk Management, 29(4), 22-27.
16. Kılıç, T. and Bostan, S. (2021). Sağlık hizmetlerinin değerlendirilmesinde, hasta odaklı yaklaşım: hasta dostu ölçeği tasarımı. Hacettepe Sağlık İdaresi Dergisi, 24(3), 555-570.
17. Koca, G. Ş. and Erigüc, G. (2021). Hasta-hekim ilişkisinde güven iletişimi: hastaların bakış açısıyla ölçmeye yönelik bir ölçek geliştirme çalışması. Manisa Celal Bayar Üniversitesi Sosyal Bilimler Dergisi, 19, 186-202.
18. Kim, J., Gao, J., Amiri-Kordestani, L., Beaver, J. A. and Kluetz, P. (2019). Patient-Friendly Language to Facilitate Treatment Choice for Patients with Cancer. The Oncologist, 24(8), 1011–1012. https://doi.org/10.1634/theoncologist.2018-0761
19. Lasserre, C. (2010). Fostering a culture of service excellence. Journal of Medicine Practice Management, 26(3), 166-169.
20. NHS (2019). The NHS patient safety strategy. Safer culture, safer systems, safer patients.
21. Penchansky, R., & Thomas, J. W. (1981). The concept of access: definition and relationship to consumer satisfaction. Medical care, 19(2), 127–140. https://doi.org/10.1097/00005650-198102000-00001
22. Raikhola, P. S. (2025). Decoding patient satisfaction: examining the hospital facilities, staff behavior, and accessibility. Contemporary Research: An Interdisciplinary Academic Journal, 8(1), 134-150.
23. Spath, P. (2007). Tips to make your hospital patient-friendly environment. Hospital Peer Review, 32(5), 60-62.
24. Şendur, G., Özbayrak, Ö. and Uyulgan, M.A. (2011). A study of determination of pre-service chemistry teachers’ understanding about acids and bases, Procedia: Computer Sciences, 3, 52-56.
25. Şener, E. (2020). Dost metaforu ı̇şletmeler ı̇çin bir erdem arayışı mı? eleştirel bir değerlendirme. Business &Management Studies: An International, 8(2), 1289-1309
26. van Mens, H. J., Hannen, G. E., Nienhuis, R., Bolt, R. J., de Keizer, N. F. and Cornet, R. (2023). Evaluation of patient-friendly diagnosis clarifications in a hospital patient portal. Applied Clinical Informatics, 14(03), 455-464.
27. Varga, A. I., Spehar, I. and Skirbekk, H. (2023). Trustworthy management in hospital settings: a systematic review. BMC Health Services Research, 23(1), 662.
28. Weller, S. C., Vickers, B., Bernard, H. R., Blackburn, A. M., Borgatti, S., Gravlee, C. C., & Johnson, J. C. (2018). Open-ended interview questions and saturation. PloS one, 13(6), 1-18. e0198606.
29. Yıldırım, A., & Şimşek, H. (2021). Qualitative research methods in the social sciences (12th ed.). Seçkin Publishing.
30. Zarei, E., Daneshkohan, A., Pouragha, B., Marzban, S. and Arab, M. (2014). An empirical study of the impact of service quality on patient satisfaction in private hospitals, Iran. Global journal of health science, 7(1), 1–9. https://doi.org/10.5539/gjhs.v7n1p1
31. Zaretsky, J., Kim, J. M., Baskharoun, S., Zhao, Y., Austrian, J., Aphinyanaphongs, Y., ... and Feldman, J. (2024). Generative artificial intelligence to transform inpatient discharge summaries to patient-friendly language and format. JAMA Network Open, 7(3), e240357-e240357