En-Chung Chang

ED Services: The Impact of Caring Behaviors on Patient Loyalty

INTRODUCTION This article describes an observational study of caring behaviors in the emergency departments of 4 Ascension Health hospitals and the impact of these behaviors on patient loyalty to the associated hospital. These hospitals were diverse in size and geography, representing 3 large urban community hospitals in metropolitan areas and 1 in a midsized city. METHODS Research assistants from Purdue University (West Lafayette, IN) conducted observations at the first study site and validated survey instruments. The Purdue research assistants trained contracted observers at the subsequent study sites. The research assistants conducted observational studies of caregivers in the emergency departments at 4 study sites using convenience sampling of patients. Caring behaviors were rated from 0 (did not occur) to 5 (high intensity). The observation included additional information, for example, caregiver roles, timing, and type of visit. Observed and unobserved patients completed exit surveys that recorded patient responses to the likelihood-to-recommend (loyalty) questions, patient perceptions of care, and demographic information. RESULTS Common themes across all study sites emerged, including (1) the area that patients considered most important to an ED experience (prompt attention to their needs upon arrival to the emergency department); (2) the area that patients rated as least positive in their actual ED experience (prompt attention to their needs upon arrival to the emergency department); (3) caring behaviors that significantly affected patient loyalty (eg, making sure that the patient is aware of care-related details, working with a caring touch, and making the treatment procedure clearly understood by the patient); and (4) the impact of wait time to see a caregiver on patient loyalty. A number of correlations between caring behaviors and patient loyalty were statistically significant (P < .05) at all sites. DISCUSSION The study results raised considerations for ED caregivers, particularly with regard to those caring behaviors that are most closely linked to patient loyalty but that occurred least frequently. The study showed through factor analysis that some caring behaviors tended to occur together, suggesting an underlying, unifying dimension to that factor.

What makes consumers believe: the impacts of priming and sequential service experiences on consumer emotions and willingness to pay

Purpose – The purpose of this study is to explore the effects of priming on consumer emotions and willingness to pay as consumers experience two services with two opposite valences. Design/methodology/approach – A 2 (service experience sequence: failure–success, success–failure) × 3(priming: positive, negative, no priming) between-subject experiment was conducted with 230 college students in China. Findings – Results indicate that when priming information is included, people give greater decision weight to the second service. Specifically, in the failure–success scenario, priming information between two services increases positive emotions and decreases negative emotions, raising willingness to pay. In the success–failure scenario, priming information decreases positive emotions and increases negative emotions, thus lowering willingness to pay. Practical implications – First, if businesses discover the possibility of a service failure, then disclosing negative information is better than whitewashing the t...

Two- or one-dimensional view of arousal?: Exploring tense and energetic arousal routes to consumer attitudes

Purpose – The purpose of this paper is to test whether separate tense and energetic forms of arousal impact consumer attitudes and provide a more complete understanding of the role of arousal in product evaluations. Past consumer research has treated arousal as a single dimension and found mixed results of the relation of arousal to consumer attitudes. Design/methodology/approach – Study 1 was an online survey of consumers’ experiences with interactive products. The study tested whether the two hypothesized types of arousal were associated with different product features and related to attitudes in different (opposite) patterns. Study 2 was an experiment in which the type of arousal used to describe a vacation location was manipulated. The study tested the role of the two types of arousal in determining the effectiveness of the advertisements for people with different arousal-related orientations. Findings – In Study 1, tense arousal mediated effects on the ergonomic qualities of the product on attitudes,...

Replacement between Conformity and Counter-Conformity in Consumption Decisions

This study assessed, in a Chinese context, how self-esteem interacts with perceived similarity and uniqueness to yield cognitive dissonance, and whether the dissonance leads to self-reported conformity or counter-conformity behavior. Participants were 408 respondents from 4 major Chinese cities (M age = 33.0 yr., SD = 4.3; 48% men). Self-perceptions of uniqueness, similarity, cognitive dissonance, self-esteem and need to behave in conformity or counter-conformity were measured. A theoretical model was assessed in four situations, relating the ratings of self-esteem and perceived similarity/uniqueness to the way other people at a wedding were dressed, and the resultant cognitive dissonance and conformity/counter-conformity behavior. Regardless of high or low self-esteem, all participants reported cognitive dissonance when they were told that they were dressed extremely similarly to or extremely differently from the other people attending the wedding. However, the conforming/counter-conforming strategies used by participants to resolve the cognitive dissonance differed. When encountering dissonance induced by the perceived extreme uniqueness of dress, participants with low self-esteem tended to say they would dress next time so as to conform with the way others were dressed, while those with high self-esteem indicated they would continue their counter-conformity in attire. When encountering dissonance induced by the perceived extreme similarity to others, both those with high and low self-esteem tended to say they would dress in an unorthodox manner to surprise other people in the future.

The Categories, Rules, and Demonstrations of Guanxi in Chinese Society

ABSTRACT Purpose: Guanxi is one of the most important success factors in China. Because of differences in Eastern and Western relationships, it is essential to investigate the system of guanxi in China. Based on the differential mode of association (chaxugeju), the present study aims to construct a framework for the mechanism of guanxi in Chinese society. Methodology/approach: A questionnaire survey of middle and senior managers was conducted to test the proposed hypotheses. A sample consisting of 212 middle or senior managers who worked in China and had direct interactions with business partners was used. The participants were mainly from firms in the pharmaceutical technology, telecommunication, and retailing industries. Findings: Guanxi categories, guanxi rules, and guanxi demonstrations were found to be correspondingly related. Business partners who had family guanxi applied the rule of need and presented intimacy interactions, whereas partners who had acquaintance guanxi often followed the rule of favor and demonstrated higher levels of reciprocity. These two corresponding paths positively influenced the strength of guanxi: The partners were more willing to sacrifice self-interest for and provide high priority in resource allocation to each other. Business partners who had stranger guanxi used the rule of equity and built trust relationships, which had negative impacts on the strength of guanxi. Practical implications: Because guanxi affects the performance of companies in China, maintaining guanxi networks with business partners is an important but challenging task for managers, especially for those from non-eastern cultures. The current study suggests that it is essential for managers to identify different types of guanxi (family, acquaintance, or stranger) by differential intimacy and distance, and to apply different rules when interacting with partners with different guanxi. To be specific, managers should follow the rule of need with business partners who have family guanxi, and their guanxi should be demonstrated as intimacy interaction. When doing business with acquaintances and friends, managers should mainly follow the rule of favor, and their guanxi should be demonstrated as reciprocity interaction. When doing business with strangers, managers should follow the rule of equity and emphasize trust. This correspondence also has an influence on how managers make decisions according to the strength of guanxi with different partners based on the guanxi type. In short, guanxi affects the degree of willingness to sacrifice self-interest for, and to prioritize resource allocations to, business partners.