The Influence of Physician and Nurse Patient-Centered Care Behaviors on American Indian and Alaskan Native Male Patient Satisfaction

PURPOSES: The purposes of this study were first to determine the effects of physician and nursing patient-centeredness on American-Indian and Alaskan Native male hospital patient satisfaction, likelihood to recommend, and ratings of care, and secondly, to determine if the effects were stable (invariant) across national random samples. METHODS: A three-factor multigroup structural equation modeling design was used with randomly selected national test and cross-validation samples of American-Indian and Alaskan Native male hospital patients, N₁=311 and N₂=213. Experiments conducted to test the hypothesized model’s plausibility included: goodness of fit, measurement invariance, and a post hoc competing model challenge. RESULTS: The model fit, providing evidence that physician and nursing patient-centeredness influence American-Indian and Alaskan Native male hospital patients’ satisfaction, likelihood to recommend the hospital, and ratings of care. Physician and nursing patient-centered behavior accounted for 76% of patients’ satisfaction. A standardized increase in physician patient-centeredness increased patients’ satisfaction, likelihood to recommend, and ratings of care by .779, .709, and .733 units respectively, while the like effects for nursing patient-centeredness were .573, .521, and .539. Effects were stable (invariant) across both the test and cross-validation samples. When the competing model was when compared to the hypothesized model, the latter was sustained. DISCUSSION: The results of this investigation provided evidence that physician and nursing patient-centeredness significantly influences American-Indian and Alaskan Native male hospital patients’ satisfaction and other outcomes, and care behavior patterns that move towards rather than against patients’ needs are rated favorably by patients. These effects were stable across national random samples of American-Indian and Alaskan Native male hospital patients. The Primary Provider Theory and this study offer an evidence-based model for future research, with implications for the measurement and improvement of male American Indian and Alaskan Native hospital patients’ satisfaction, likelihood to recommend, ratings of care, physician and nursing patient-centeredness.