The Impact of the Quality of Doctor-Patient Communication Patients' Self-Disclosure in WeChat Groups： The Chain-Mediating Roles ofTrust in Doctors and Psychological Safety
Many hospitals have already established doctor-patient WeChat groups to further improve doctor-patient communication. Often, patients may choose to join the WeChat group and continue to communicate with their doctors online after their offline consultation, which opens up a new channel of communication between doctors and patients. In this study, we focused on the relationship between the quality of patient-doctor communication and patients' self-disclosure in WeChat groups, and on this basis, we examined the chain-mediated effects of patients' trust in the doctor and their sense of psychological security, as well as the moderating effects of online social support.
Study 1 focused on patients' willingness to self-disclosure and conducted a questionnaire survey with 512 patients in a doctor-patient WeChat group as subjects. The results showed that: (1) doctor-patient communication quality positively predicted patients' willingness to self-disclosure; (2) trust in doctors mediated the relationship between doctor-patient communication quality and patients' willingness to self-disclosure; (3) Psychological security mediated the relationship between doctor-patient communication quality and patients' willingness to self-disclose; (4) Trust in doctors and psychological security play a chain mediating role between doctor-patient communication quality and patients' willingness to self-disclosure; (5) Network social support positively moderates the relationship between trust in doctors and psychological safety; the higher the network social support, the stronger the positive relationship between trust in doctors and psychological safety; (6) Network social support positively moderates the chain mediation between doctor-patient communication quality and patients' willingness to self-disclosure; when network social support is high, the chain mediation between doctor-patient communication quality affecting patients' willingness to self-disclosure through trust in doctors and psychological security is stronger.
Study 2 focused on patients' self-disclosure behaviours and collected objective data (e.g., real communication records of doctors and patients in WeChat groups) for content analysis with 73 patients who had recent communication and interaction with doctors in doctor-patient WeChat groups as subjects, supplemented with questionnaires to test the stability of the results of Study 1. The results found that (1) the quality of doctor-patient communication positively predicted patients' self-disclosure behaviours; (2) the mediating role of trust in doctors between the quality of doctor-patient communication and patients' self-disclosure behaviours was not significant; (3) The mediating role of psychological security between doctor-patient communication quality and patient self-disclosure behaviour was not significant; (4) The chain mediating role of trust in doctors and psychological security was significant between doctor-patient communication quality and patients’ self-disclosure behavior; (5) Network social positively moderates the relationship between trust in doctors and psychological safety; the higher the network social support, the stronger the positive relationship between trust in doctors and psychological safety; (6) Network social support positively moderates the chain mediation between doctor-patient communication quality and patients' self-disclosure behaviours; the chain mediation between doctor-patient communication quality affecting patients' self-disclosure behaviours through trust in doctors and psychological security is stronger when network social support is high.
This study reveals the influence of doctor-patient communication quality on patients' self-disclosure and its psychological mechanisms and boundary conditions, which enriches the research results related to doctor-patient communication; at the same time, it provides useful ideas for understanding how doctor-patient WeChat groups influence doctor-patient relationships, and also provides a basis for subsequent intervention practices to improve doctor-patient relationships through doctor-patient WeChat groups.
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