A study on the relationship between perceived value, satisfaction, and behavioral intention in home care for older adult patients under the background of doctor-patient disputes: A cross-sectional observational study

This study investigates the relationships among perceived value, satisfaction, and behavioral intention in home care for older adult patients in the context of doctor-patient disputes and examines the moderating role of trust. This cross-sectional observational study used convenience sampling to recruit 306 older adult patients who had received home care services within the past year. Data were collected via a structured questionnaire comprising 26 items across 7 constructs (functional, emotional, efficiency, and social value; satisfaction; behavioral intention; and trust), each rated on a 5-point Likert scale. The questionnaire demonstrated good reliability and validity. Structural equation modeling was performed using AMOS 24.0 to test path relationships, with model fit evaluated by multiple indices (chi-square to degrees of freedom ratio = 1.289, root mean square error of approximation = 0.031, comparative fit index = 0.983, Tucker-Lewis index = 0.980). Mediation effects were examined using the bootstrap method (5000 resamples), and moderation effects of trust were tested using PROCESS macro (Model 1) in SPSS 26.0. The results showed that social value most strongly predicts satisfaction (β = 0.330, P  < .001), followed by emotional (β = 0.236, P  < .001) and functional value (β = 0.192, P  < .01); efficiency value is nonsignificant (β = 0.080, P  > .05). For behavioral intention, emotional value has the strongest direct effect (β = 0.208, P  < .01), followed by functional (β = 0.172, P  < .01) and efficiency value (β = 0.159, P  < .05), social value is nonsignificant (β = 0.114, P  > .05). Satisfaction significantly predicted behavioral intention (β = 0.285, P  < .001), and partially mediated the relationship between perceived value and behavioral intention. The indirect effect between efficiency value and behavioral intention was not significant (0.027, P  > .05), and the 95% CI was 0 (–0.011, 0.115), thus not playing a mediating role. Trust moderates perceived value’s effect on satisfaction, but not for efficiency value (β = –0.043, P  > .05). Findings suggest a need for human-centered home care models emphasizing emotional support and social recognition, moving beyond technology-driven approaches. This research supports policymakers in evaluating older adult care services and building trust-based, satisfaction-centered, and value-driven doctor-patient interactions for healthy aging and high-quality elder care.