ABSTRACT
Objective:
To analyze the psychological
contract satisfaction of contracted residents and its impact on their behavioral
intentions under the guidance of incomplete
contract theory, for reference in improving the
effectiveness of contracted
family doctor services.
Methods:
1 100 contracted residents from nine townships/streets in Shandong province were selected as subjects according to stratified random sampling from September 2019 to June 2020, and a
questionnaire survey on the level of
satisfaction of contracted residents′ psychological
contracts(24 items) and assessment of
behavior intentions(9 items) was conducted, and the model of the effect of contracted residents′ psychological
contracts on
behavior intentions was established and analyzed. The correlation was validated by Pearson test and the structural equation
method was used for verifying the model.
Results:
998 valid
questionnaires were recovered. The psychological
contract satisfaction score of the contracted residents was 3.45±0.56 and the behavioral
intention was 2.81±0.29. Both transactional and relational psychological
contracts were correlated with all dimensions of behavioral
intention( P<0.01). Concerning the impacts of residents′ psychological
contracts on behavioral
intentions, the effect coefficients of transactional psychological
contracts on loyalty
intention,
voice intention, exit
intention and neglect
intention were 0.33, 0.24, -0.25 and -0.49 respectively, with an indirect effect on neglect
intention; the effect coefficients of relational psychological
contracts on loyalty
intention,
voice intention, exit
intention and neglect
intention were 0.26, 0.10, -0.14 and -0.50 respectively, with an indirect effect on advice
intention and neglect
intention.
Conclusions:
Residents′ psychological
contract has yet not been effectively satisfied. Satisfying and improving the residents′ psychological
contract can directly enhance their loyalty
intention and reduce their exit
intention, indirectly influencing the
voice and neglect
intentions. In order to enhance the
effectiveness of
family doctor contracted services and improve the
healthcare experience of contracted residents, it is suggested that the relevant departments should actively take the following
measures, including
carrying out a
survey on the psychological
contract of contracted residents, building a provincial-city-county-township collaborative linkage platform, and so on.