Abstract
BACKGROUND AND OBJECTIVE: To enhance healthcare service quality and foster harmonious doctor-patient relationships, it is necessary to explore the impact of physicians' overwork on patient satisfaction, with the mediating roles of physician-nurse collaboration and patients' medical risk perception in these relationships. METHODS: Using a stratified random sampling method, questionnaire surveys were conducted from June to September 2023 among 90 physicians and 550 inpatients in 13 Grade A tertiary public hospitals across five provinces in China. This survey collected data on physicians' overwork, physician-nurse collaboration, patient's medical risk perception, and patient satisfaction. The data were analyzed using the PROCESS macro (Model 6) in SPSS 23 to examine the chain mediation model. RESULTS: A total of 81 physicians and 512 inpatients were included. Physicians' overwork had a significant negative effect on patient satisfaction (β = -0.426, p < 0.001). Physician-nurse collaboration (β = 0.463, p < 0.001) and patients' medical risk perception (β = -0.260, p < 0.001) acted as partial mediators, accounting for 24.41% and 5.87% of the total effect, respectively. Furthermore, physicians' overwork indirectly affected patient satisfaction through a chain mediation pathway involving physician-nurse collaboration followed by patients' medical risk perception (β = -0.014, p < 0.001), accounting for 3.29% of the total effect. CONCLUSION: Physicians' overwork demonstrates a significant negative predictive effect on patient satisfaction, encompassing both direct and indirect effects mediated by physician-nurse collaboration and patients' medical risk perception. To improve healthcare quality and satisfaction, governments should address physicians' overwork and patient risk perception. Future research could explore physician-patient trust as a mediator or analyze how different dimensions of risk perception influence chain-mediated pathways.