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Journals / Hacettepe Sağlık İdaresi Dergisi / 2026 / Cilt: 29 Sayı: 1

THE MEDIATING ROLE OF SYSTEM DISTRUST IN THE REFLECTION OF HEALTH COMMUNICATION PROBLEMS ON PHYSICIAN PERCEPTION

SAĞLIK İLETİŞİMİ SORUNLARININ HEKİM ALGISINA YANSIMASINDA SİSTEM GÜVENSİZLİĞİNİN ARACI ROLÜ

Begüm Yalçın(İstanbul Beykent Üniversitesi)0000-0002-3149-4854
Pages
113–130
Publication Date
2026-03-17
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In conclusion, the mediating role of system distrust suggests that individuals may be more prejudiced towards physicians due to communication problems they experience and their general distrust in the health system.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:A trust-based patient-physician relationship is an crucial component of high-quality care.
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Key Findings & Data:For this purpose, data were collected through face-to-face surveys from 341 individuals receiving treatment services at a university hospital in Istanbul, Turkey.
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Conclusion & Impact:In conclusion, the mediating role of system distrust suggests that individuals may be more prejudiced towards physicians due to communication problems they experience and their general distrust in the health system.
🔬Design:Survey & Empirical Study
📍Scope:Comprehensive Sample
⚙️Variables:Sağlık iletişimi sorunları · Sistem güvensizliği · Hekim algısı.

Abstract

A trust-based patient-physician relationship is an crucial component of high-quality care. However, communication breakdowns and systemic problems may damage this relationship of trust and harm physician perception, which in turn may reduce the quality of care. This study examines how communication problems affect physician perception by considering distrust in the healthcare system as an explanatory intermediate mechanism. For this purpose, data were collected through face-to-face surveys from 341 individuals receiving treatment services at a university hospital in Istanbul, Turkey. SPSS and AMOS software were used to analyze the collected data. Confirmatory Factor Analysis was applied using Structural Equation Modeling, and hypotheses were tested. According to the research findings, physicians perception was found to statistically fully mediated the effect of healthcare communication problems on individuals' distrust of the healthcare system. In the model in question, communication problems affect system distrust positively (β=0.79, p<0.001) and physician perception negatively (β=-0.68, p<0.001). Accordingly, individuals who experience communication problems are more likely to be distrustful of the system and this situation weakens their perception of physicians. In conclusion, the mediating role of system distrust suggests that individuals may be more prejudiced towards physicians due to communication problems they experience and their general distrust in the health system. Based on these findings, it is recommended that effective communication, empathy, and trust-based training be provided regularly and mandatorily to all personnel working in healthcare institutions and organizations. Additionally, standard communication protocols can be developed within the institution, particularly for issues such as information processes and patient referrals, and patient feedback mechanisms can be strengthened. Finally, public communication campaigns should be used to develop the reputation and trust of physicians. In this regard, policymakers should adopt transparent practices and participatory management mode.

Özet

Güvene dayalı bir hasta-hekim ilişkisi, yüksek kaliteli bakımın önemli bir bileşenidir. Ancak iletişim aksaklıkları ve sistemsel sorunlar, bu güven ilişkisini zedeleyerek hekim algısına zarar verebilir ve bu da bakım kalitesini düşürebilir. Bu çalışma, sağlık sistemine duyulan güvensizliği açıklayıcı bir ara mekanizma şeklinde değerlendirerek, iletişim sorunlarının hekim algısını nasıl etkilediğini incelemektedir. Bu amaç doğrultusunda İstanbul’da yer alan bir üniversite hastanesinde tedavi hizmeti alan 341 bireyden yüz yüze anket yöntemi aracılığıyla veri toplanmıştır. Toplanan verileri analiz etmek için SPSS ve AMOS yazılımları kullanılmıştır. Yapısal Eşitlik Modellemesi kullanılarak Doğrulayıcı Faktör Analizi uygulanmış ve hipotezler test edilmiştir. Araştırma bulgularına göre sağlık iletişimi sorunlarının bireylerin sağlık sistemine olan güvensizliğine etkisinde hekim algısının istatistiksel olarak tam aracılık ettiği bulunmuştur. Söz konusu modelde iletişim sorunları sistem güvensizliğini pozitif (β=0,79, p<0,001), hekim algısını ise negatif (β=-0,68, p<0,001) yönde etkilemektedir. Buna göre iletişim sorunları yaşayan bireylerin sisteme karşı güvensizlik duyma olasılıkları çok daha yüksektir ve bu durum da onların hekim algılarını zayıflatmaktadır. Sonuç olarak, sistem güvensizliğinin aracı rolü, bireylerin deneyimlediği iletişim sorunları ve sağlık sistemine duydukları genel güvensizlik nedeniyle hekimlere karşı daha önyargılı yaklaşılabileceklerini göstermektedir. Bu sonuçlardan yola çıkarak sağlık kurum ve kuruluşlarında görev yapan tüm personele yönelik etkili iletişim, empati ve güven temelli eğitimlerin düzenli ve zorunlu olarak verilmesi önerilmektedir. Ayrıca kurum içinde özellikle bilgilendirme süreçleri, hasta yönlendirmeleri gibi konularda standart iletişim protokolleri geliştirilebilir ve hasta geri bildirim mekanizmaları güçlendirilebilir. Son olarak, kamu iletişim kampanyalarıyla hekimlere yönelik itibar ve güven geliştirilmelidir. Bu açıdan politika yapıcılar şeffaf uygulamaları ve katılımcı yönetim modellerini benimsemelidir.

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Cite This Article

Yalçın, B. (2026). THE MEDIATING ROLE OF SYSTEM DISTRUST IN THE REFLECTION OF HEALTH COMMUNICATION PROBLEMS ON PHYSICIAN PERCEPTION. Hacettepe Sağlık İdaresi Dergisi, Cilt: 29 Sayı: 1, 113–130. https://doi.org/10.61859/hacettepesid.1740252

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