Restricted accessResearch articleFirst published online 2026
Mapping patient-centered communication and patient trust in healthcare providers: A psychological network approach considering patients’ discussion about online health information
Patient-centered communication (PCC) is considered efficient in building patient trust in healthcare providers, but little is known about how various dimensions of the two constructs interact. Moreover, our understanding of the role of patients’ communicative behaviors in such interactions is limited. Addressing the gaps, this study analyzed survey data (N = 4038) with psychological network analysis to explore multidimensional interactions, identify the central dimensions of the two focal constructs, and compare networks based on whether patients discuss online health information with healthcare providers. Results showed different interconnection patterns among patients who discuss online health information with healthcare providers and patients who do not. This study contributes to the literature by disentangling multidimensional connections between PCC and patient trust in healthcare providers and highlights the significance of patients’ participation and preferences.
BorsboomDDesernoMKRhemtullaM, et al. (2021) Network analysis of multivariate data in psychological science. Nature Reviews Methods Primers1(1): 1–18.
2.
BringmannLFElmerTEpskampS, et al. (2019) What do centrality measures measure in psychological networks?Journal of Abnormal Psychology128(8): 892–903.
3.
BurgerJIsvoranuA-MLunanskyG, et al. (2023) Reporting standards for psychological network analyses in cross-sectional data. Psychological Methods28(4): 806–824.
4.
EgedeLEEllisC (2008) Development and testing of the Multidimensional Trust in Health Care Systems Scale. Journal of General Internal Medicine23(6): 808–815.
5.
EpskampSBorsboomDFriedEI (2018) Estimating psychological networks and their accuracy: A tutorial paper. Behavior Research Methods50(1): 195–212.
6.
EpskampSFriedEI (2018) A tutorial on regularized partial correlation networks. Psychological Methods23(4): 617–634.
7.
EpsteinRMFranksPFiscellaK, et al. (2005) Measuring patient-centered communication in patient–physician consultations: Theoretical and practical issues. Social Science & Medicine61(7): 1516–1528.
HallMADuganEZhengB, et al. (2001) Trust in physicians and medical institutions: What is it, can it be measured, and does it matter?Milbank Quarterly79(4): 613–639, v.
12.
HaslbeckJMBRyanORobinaughDJ, et al. (2022) Modeling psychopathology: From data models to formal theories. Psychological Methods27(6): 930–957.
13.
HuXBellRAKravitzRL, et al. (2012) The prepared patient: Information seeking of online support group members before their medical appointments. Journal of Health Communication17: 960–978. https://doi.org/10.1080/10810730.2011.650828
14.
JiangSWuZZhangX, et al. (2024) How does patient-centered communication influence patient trust?: The roles of patient participation and patient preference. Patient Education and Counseling122: 108161.
15.
JonesPJMaRMcNallyRJ (2021) Bridge centrality: A network approach to understanding comorbidity. Multivariate Behavioral Research56(2): 353–367.
16.
KinmonthALWoodcockAGriffinS, et al. (1998) Randomised controlled trial of patient centred care of diabetes in general practice: Impact on current wellbeing and future disease risk. The diabetes care from diagnosis research team. BMJ317(7167): 1202–1208.
17.
LiQZhengYZhaoX, et al. (2025) When chitchat fosters trust: Phatic communication and personal connections facilitate patient trust in China through patient-centered communication. Chinese Journal of Communication19(1): 1–19.
18.
LiSWangK (2022) Sharing online health information with physicians: Understanding the associations among patient characteristics, directness of sharing, and physician-patient relationship. Frontiers in Psychology13: 839723.
19.
LiuPLZhangLMaX, et al. (2023) Communication matters: The role of patient-centered communication in improving old adults’ health competence and health outcomes. Health Communication39(2): 363–375.
20.
LuoAQinLYuanY, et al. (2022) The effect of online health information seeking on physician-patient relationships: Systematic Review. Journal of Medical Internet Research24(2): e23354.
21.
MarchettiI (2019) Hopelessness: A network analysis. Cognitive Therapy and Research43(3): 611–619.
22.
MurgicLHébertPCSovicS, et al. (2015) Paternalism and autonomy: Views of patients and providers in a transitional (post-communist) country. BMC Medical Ethics16: 65.
PaivaDAbreuLAzevedoA, et al. (2019) Patient-centered communication in type 2 diabetes: The facilitating and constraining factors in clinical encounters. Health Services Research54(3): 623–635.
25.
PerlisRHOgnyanovaKUsluA, et al. (2024) Trust in physicians and hospitals during the COVID-19 pandemic in a 50-State Survey of US Adults. JAMA Network Open7(7): e2424984.
26.
R Core Team (2023) R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing. Available at: https://www.R-project.org/ (accessed 13 October 2023)
27.
SchrimpffCLinkEFisseT, et al. (2023) Communication matters when it comes to adverse events: Associations of adverse events during implant treatment with patients’ communication quality and trust assessments. Patient Education and Counseling110: 107675.
28.
StreetRL (2017) The many “disguises” of patient-centered communication: Problems of conceptualization and measurement. Patient Education and Counseling100(11): 2131–2134.
29.
TanSSGoonawardeneN (2017) Internet health information seeking and the patient-physician relationship: A systematic review. Journal of Medical Internet Research19(1): e9.
30.
TrivediNPatelVJohnsonC, et al. (2021) Barriers to accessing online medical records in the United States. American Journal of Managed Care27(1): 33–40.
31.
van BorkuloCDvan BorkRBoschlooL, et al. (2023) Comparing network structures on three aspects: A permutation test. Psychological Methods28(6): 1273–1285.
32.
WangTLuoJYanZ, et al. (2021) Chinese helath professional suvey 2021. Tsinghua University and Chinese Medical Doctor Association. Available at: https://www.soc.tsinghua.edu.cn/info/1198/1454.htm (accessed 23 August 2024).
33.
WangWZhangJLuJ, et al. (2023) Patient views of the good doctor in primary care: A qualitative study in six provinces in China. Global Health Research and Policy8: 24.
34.
WatterDN (2018) Protecting my patients’ story: Beneficent or paternalistic?Patient Education and Counseling101(4): 758–759.
35.
XiaYMaZ (2023) Network structure of the links between extracurricular time-use and delinquent behaviors: Moving forward and beyond linear relations. Child Development94: 1697–1712. https://doi.org/10.1111/cdev.13953
36.
ZhaiJNieJ (2024) Is more patient empowerment always better? Examining the moderating role of perceived physician’s argument quality. Human Communication Research50: 365–377.
37.
ZouXChengYNieJ (2018) The social practice of medical Guanxi (personal connections) and patient–physician trust in China: An anthropological and ethical study. Developing World Bioethics18(1): 45–55.
