Abstract
OBJECTIVE: To develop and validate the Older Patients' Perceived Ageist Behavior of Medical Staff (OPABMS) Scale, assess the current status of OPABMS, and explore the association between OPABMS and older patients' loyalty (OPL), thereby providing an evidence base for reducing ageism and improving patient retention. METHODS: The OPABMS scale was developed through a multi-stage process involving literature review, expert consultation, in-depth interviews, and pilot survey, after which item analysis, exploratory factor analysis, confirmatory factor analysis, convergent validity, discriminant validity, criterion validity, reliability analysis, measurement invariance, and common method bias testing were performed to evaluate its psychometric properties. A total of 1,010 older patients who had visited medical institutions in the past year were recruited as a convenience sample. Data were collected using a sociodemographic questionnaire, the OPABMS Scale, the Patient Loyalty Scale and the Patient Satisfaction Scale. RESULTS: The scale comprises 13 items grouped into three dimensions: Avoidance Behavior (AB), Perfunctory Behaviors (PB) and Complaint Behavior (CB). The overall mean score for OPABMS was 2.08 (SD = 0.65), with AB scoring highest, followed by PB and CB. The mean score for OPL was 3.45 (SD = 0.77). Significant differences in OPABMS were observed across age, usual residence, occupation, education, and household income (p < 0.05). Total and subscale scores of OPABMS were negatively correlated with OPL scores (r = -0.390 to -0.240, p < 0.001). Hierarchical regression showed that AB accounted for 11.6% of the variance in Intention to Recommend; AB and PB together explained 8.4% of the variance in Intention to Revisit and 14.1% in Intention to Spread Positive Word of Mouth. CONCLUSION: The OPABMS Scale demonstrates satisfactory reliability and validity and can thus serve as an appropriate instrument for measuring OPABMS. Older patients perceived a slightly below-moderate level of ageist behaviors from medical staff. These perceived behaviors were negatively associated with OPL. Health authorities, medical institutions, and medical staff should pay greater attention to OPABMS and its potential negative implications.