Abstract
Objectives: To investigate the communication mechanism between international students and Chinese physicians by evaluating the influence of the transaction process on patient satisfaction, self-rating anxiety and self-efficacy. Methods: A cross-sectional survey was conducted among international students living in Central, Northern and Eastern China; enrolled at Chinese universities and experienced outpatient and inpatient healthcare services. Guided by the elements of King's transaction process: IR, Initiating and Responding; IP, Identifying Problems; MGS, Mutual Goal Setting; and EM, Exploring means and agreeing on means to achieve goals. We used spearman correlation analysis to calculate the correlation of the variables: patient satisfaction, self-efficacy, transaction process, IR, IP, MGS, and EM and regression analysis to measure the influence of transaction process on patient satisfaction, self-rating anxiety and self-efficacy. Results: Four hundred and four (404) participants were investigated for this study. The results of correlation analysis showed that there was a significant positive correlation among patient satisfaction, self-efficacy, transaction process, IR, IP, MGS, and EM (p < 0.05). Regression analysis showed that the higher scores of IR (β = 0.176, p = 0.003) and MGS (β = 0.249, p = 0.002) was associated with the higher score of patient satisfaction; the higher the score of IR and IP was associated with the higher self-efficacy score (β = 0.148,0.225; p = 0.016,0.001); and higher the MGS score was associated the lower the self-rating anxiety (β = -0.220, p = 0.022). Conclusion: The influence of transaction process on patient satisfaction, self-rating anxiety and self-efficacy between Chinese physicians and international students (Patients) was established. Findings support the urgent implementation of tools at healthcare facilities to improve the communication between Chinese doctors and international students, therefore improving patient satisfaction and self-efficacy, and reducing anxiety.