The Influence of an Unexpected Symbolic Gift on Postoperative Arthroplasty Patients' Press Ganey Scores.

INTRODUCTION: Hospitals use Press Ganey surveys to evaluate patient satisfaction. The goal of our study was to evaluate whether surgeon-driven gifting to patients post-operatively affects Press Ganey Survey responses. METHODS: There were 1,468 patients undergoing arthroplasty at our institution who were randomized to receive a thank you gift, a small bouquet of flowers, and a note from their provider after surgery, or nothing for completing their pre-operative arthroplasty registry questionnaire. Press Ganey surveys were sent to patients who received and did not receive flowers immediately after their hospital stay and after the patients' first post-operative visit. Scores were reported as the mean score and the fraction of responses with a top-box rating. One-sided student t-tests and Fischer Exact tests were used to assess statistical significance. RESULTS: Hospital Discharge Patients who received flowers had higher Press Ganey survey scores than patients who did not receive flowers. For example, for "Physician's concerns for questions," they had higher scores (mean difference: 3.7 ± 1.6 points, P = 0.012) and a 9% higher top-box rating (P = 0.032). For "Staff attitude towards visitors," they also had higher scores (mean difference: 2.8 ± 1.3 points, P = 0.019) and a 7% higher top-box rating (P = 0.049). First Follow-up Patients who received flowers had a higher top-box rating for "Concern provider showed for questions" and "Amount of time provider spent with you" by 6% (P = 0.046) and 11% (P = 0.009), respectively. They also had higher scores for "Information provider gave about medications" (mean difference: 4.0 ± 1.6 points, P = 0.009) and 11% higher top-box rating (P = 0.006). DISCUSSION: Press Ganey Surveys were higher in orthopaedic patients who received bouquets of flowers from their arthroplasty surgeons compared to patients who did not. At follow-up, improved Press Ganey scores persisted if the patient received flowers. The gift of flowers generates patient loyalty to their surgeon.

Exploring the Chatbot usage intention-A mediating role of Chatbot initial trust.

Chatbots, an integral part of Digitalization, are becoming the cornerstone of modern-day marketing practices. This study's main objective is to identify the Chabot traits that have a bearing on users' confidence, acceptability, and engagement. Chatbots hold much potential for customer support in terms of service efficiency, cost savings, and customer experience. In addition to saving business costs, chatbots improve customer engagement, by reducing time and effort they need to spend in doing their business transactions. Aspiring, well-educated, and tech-savvy Gen Z customers perceive chatbots as highly compatible with their preferred method of seeking product-related information. As chatbots play a significant role in the marketing process, this study aims to identify the chatbot traits that influence customers' confidence, acceptance, and engagement with chatbots. Using the PLS-SEM tool/technique we computed a structural equation measurement model to test the traits leading to Chabot trust. The study also found that perceived ease of use, performance expectations, and social influence of chatbots are all greatly enhanced by trust on the part of the customers. Detailed statistical analysis showed that the trust that consumers have in chatbots strongly influences consumers' intentions, loyalty, and engagement levels. While gender had no impact on consumer intentions to use chatbots, the age of the respondents played a substantial role in their plans to use chatbots.

Sequential organization and interactional functions of patient loyalty in routine chronic encounters.

Doctor-patient communication is pivotal for the delivery of effective health care, patient satisfaction and retention, and the development of patient loyalty to the provider. However, the interactional dynamics of loyalty in real-life communication are left underexplored. In this regard, this study aims to examine and analyze loyalty in naturally occurring routine chronic encounters. Based on audio-recordings collected in a state-run tier-three hospital in China, the study uses conversation analysis to examine the sequential placement of loyalty display and its interactional functions in different environments. The findings report two sequential environments where loyalty display emerges: the opening and closing phases. The findings also show that loyalty is mainly produced by the patient to display affiliation and commitment, indicate their preferred treatment options, and rekindle a disconnected relationship. This work contributes to a more nuanced understanding of loyalty display in service and institutional encounters.

The influencing factors of game brand loyalty.

Our research aims to investigate the impact mechanism of brand loyalty among gamers during the gaming process within the framework of brand loyalty theory and cognitive theory. We surveyed game players from Zhejiang Province, China. The research methods include a questionnaire survey and structural equation modelling. Results show that game experience, interaction, and impression are positively correlated with game trust, while game trust is positively correlated with game brand loyalty. Game trust, as a mediator variable, plays a complete mediation role. The clustering results of player gender and age as moderating effects are not significant. Based on the analysis results, we have suggested corresponding policy recommendations and reflections. Our research contributes to the analysation of impact mechanism of brand loyalty during the gaming process through the establishment of a structural equation model and provides suggestions and reflections on the development of the gaming industry.

The impact of value co-creation behavior on customer loyalty in the service domain.

As per the tenets of Service-Dominant Logic theory, consumers play an incessant role as proactive participants and collaborative stakeholders within commercial transactions. This orchestrated involvement of consumers in the process of service production enables service providers to discern and address consumer's needs, thus fortifying their competitiveness. As a result, consumers benefit from heightening service performances and competitiveness of the company. The principal aim of this study is to ascertain the foundational underpinnings of value co-creation behavior, particularly as exhibited within the context of utilizing gym services at the California Fitness Center located in Ho Chi Minh City, Vietnam. A comprehensive investigation encompassing a sample size of 315 respondents was conducted using SPSS and AMOS software. The findings of this investigation establish a robust linkage between customer participatory behavior, customer citizenship behavior, and the premise of customer co-creation conduct. However, it is noteworthy that the factor of information-seeking within customer participation did not garner empirical support. Notably, there is a relationship between active co-creator behavior and customer loyalty.

Ethical challenges in health care during collective hunger strikes in public or occupied spaces.

Public collective hunger strikes take place in complex social and political contexts, require medical attention and present ethical challenges to physicians. Empirical research, the ethical debate to date and existing guidelines by the World Medical Association focus almost exclusively on hunger strikes in detention. However, the public space differs substantially with regard to the conditions for the provision of health care and the diverse groups of healthcare providers or stakeholders involved. By reviewing empirical research on the experience of health professionals with public collective hunger strikes, we identified the following ethical challenges: (1) establishment of a trustful physician-striker relationship, (2) balancing of medico-ethical principles in medical decision-making, (3) handling of loyalty conflicts and (4) preservation of professional independence and the risk of political instrumentalization. Some of these challenges have already been described and discussed, yet not contextualized for public collective strikes, while others are novel. The presence of voluntary physicians may offer opportunities for a trustful relationship and, hence, for ethical treatment decisions. According to our findings, it requires more attention to how to realise autonomous medical decisions in the complex context of a dynamic, often unstructured and politically charged setting, which ethical norms should shape the professional role of voluntary physicians, and what is the influence of the hunger strikers' collective on individual healthcare decisions. Our article can serve as a starting point for further ethical discussion. It can also provide the basis for the development of potential guidelines to support health professionals involved in public collective hunger strikes.

Qualitative analysis of the factors associated with whistleblowing intentions among athletes from six European countries.

Although whistleblowing is thought to represent an effective mechanism for detecting and uncovering doping in sport, it has yet to become a widely adopted practice. Understanding the factors that encourage or discourage whistleblowing is of vital importance for the promotion of this practice and the development of pedagogical material to enhance the likelihood of whistleblowing. The current study employed a qualitative methodology to explore the personal and organisational factors that underpin intentions to blow the whistle or that may lead to engagement in whistleblowing behaviours in sport. Thirty-three competitive athletes across a range of sports took part in a semi-structured interview which sought to explore what they would do should they encounter a doping scenario. Content analysis revealed that whistleblowing is a dynamic process characterised by the interaction of a range of personal and organisational factors in determining the intention to report PED use. These factors included moral reasoning, a desire to keep the matter "in-house", perceived personal costs, institutional attitudes to doping, and social support. Analysis revealed a number of "intervening events", including a perceived lack of organisational protection (e.g., ethical leadership) within some sporting sub-cultures, which present an important obstacle to whistleblowing. The intention to report doping was underpinned by a "fairness-loyalty trade-off" which involved athletes choosing to adhere to either fairness norms (which relate to a sense that all people and groups are treated equally) or loyalty norms (which reflect preferential treatment towards an in-group) when deciding whether they would blow the whistle. The promotion of fairness norms that emphasise a group's collective interests might encourage athletes to view whistleblowing as a means of increasing group cohesiveness and effectiveness and thereby increase the likelihood of this practice.

Engagement and loyalty in mobile applications for restaurant home deliveries.

This study examines user engagement and loyalty in mobile applications for restaurant home deliveries during the COVID-19 pandemic. It explores the concepts of loyalty, engagement, and interactivity, with convenience and safety as drivers for continued use. Using Partial Least Squares Structural Equations Modelling (PLS-SEM), data from 349 users of restaurant ordering apps in Colombia was analysed. Results indicate that engagement, convenience, and safety positively influence loyalty. Interactivity indirectly affects loyalty through engagement. This research sheds light on the factors impacting engagement and loyalty, specifically during the pandemic. It addresses underexplored marketing relationships and guides companies operating such apps to understand key drivers of user loyalty.

The Post-Effects of the Authenticity of Rural Intangible Cultural Heritage and Tourists' Engagement.

Amidst the burgeoning interest in rural Intangible Cultural Heritage (ICH) tourism, this study, anchored in the Stimulus-Organism-Response (S-O-R) theoretical framework, chose Meizhou Island in Fujian Province as a case study to examine the impacts of tourists' perceptions of authenticity and their engagement levels on the destination image and loyalty towards rural ICH tourism. Utilizing Structural Equation Modeling (SEM) to analyze survey data, findings revealed that higher perceptions of a destination's preservation of original characteristics and traditional values correlate with a more favorable overall perception of the destination, albeit with smaller impact on emotional connections. Conversely, depth of tourist engagement was shown to enhance both understanding and emotional bonds with the destination. Further, familiarity with the destination was found to foster affection, thereby increasing the likelihood of repeat visits or recommendations. The more tourists know about a place, perceiving it as authentic, the more likely they are to remain loyal; similarly, deeper engagement enhances understanding and affection, increasing the probability of revisiting or recommending the place. These outcomes not only offer new insights into tourist behavior but also provide theoretical and practical guidance for the protection and development of rural ICH tourism, destination marketing, and management strategies, thus promoting the sustainable development of rural ICH tourism.

The impact of characteristic factors of the direct-to-consumer marketing model on consumer loyalty in the digital intermediary era.

In the era of digital intermediaries, the direct-to-consumer (DTC) marketing model is gaining prominence in the retail and brand marketing domains. This model exhibits a distinct advantage over traditional models in cultivating loyalty. Consequently, this study employs a survey-based approach and utilizes the Stimulus-Organism-Response (SOR) theory to construct a structural equation model and investigate the relationship between the DTC marketing model's characteristic factors and consumer loyalty. The results indicate that cost-effectiveness and social media marketing directly and positively influence consumer loyalty, while product features indirectly contribute to loyalty through perceived emotional value. Multi-channel integration indirectly influences loyalty through perceived functional value. Additionally, the varying degrees of influence highlight social media marketing as the most impactful factor and product features as the least influential. The research findings underscore the importance of strengthening social media marketing, optimizing product features, reducing information asymmetry, and integrating multiple channels to enhance consumer loyalty. This study enriches the understanding of the DTC theoretical framework in the field of marketing and provides new perspectives for formulating marketing strategies.

Understanding the Interplay between Wellness Motivation, Engagement, Satisfaction, and Destination Loyalty.

Increased awareness of negative psychological symptoms and the negative impact of the pandemic has led to a rising demand for wellness-related travel experiences. There is a need for research on tourists' experiential and reflective engagement in order to maximize positive outcomes such as overall satisfaction, positive WOM, and recommendations. These positive outcomes are crucial for attracting tourists and strengthening destinations' brands. As there are few empirical studies, research on the effects of engagement on satisfaction and behavioral intentions is necessary. This study aimed to examine the relationships between wellness motivation, engagement, satisfaction, and destination loyalty among wellness tourists. It also aimed to examine the mediating effects of two engagement factors, experiential and reflective engagement, between wellness motivation and positive outcomes. A total of 319 respondents were used for the analysis, and structural equation modeling (SEM) was conducted. The results found that wellness motivation is composed of six wellness motivation components, namely physical motivation, transcendence, relaxation, social motivation, self-esteem, and escape, each representing first-order factors. Wellness motivation is positively associated with reflective and experiential engagement. Engagement positively affects satisfaction and destination loyalty. This study provides several implications, theoretically and practically.

Optimizing brand loyalty through user-centric product package design: A study of user experience in dairy industry.

Objective: With the arrival of the experience economy era, changes in the marketing environment, and the evolution of consumer psychological needs, a good user experience will bring them freshness. Based on user experience, this paper analyzes the relationship among product brand image, brand trust, and brand loyalty, aiming to promote product values and improve brand loyalty and trust. Methods: Through case analysis, consumers' favorite brands were selected and conducted positioning analysis on brand color, image, package form, and so on. The study proposed a hypothetical model of user experience on brand loyalty and performed a questionnaire survey on 357 consumers. The relational model of the impact of user experience on consumers was verified using the SEM (Structural Equation Model) method. Results: It is shown that sensory experience, emotional experience, behavioral experience, and thinking experience have significant impacts on brand image; brand image apparently affects brand trust; and brand trust and image remarkably influence brand loyalty. Conclusions: Extending the concept of user experience to the fast-moving consumer goods industry will contribute to the package design of products and the theory and practice of brand loyalty. The research findings can provide effective strategies and approaches for marketers to improve product market competitiveness and enhance consumer brand stickiness.

Sensory brand experience and brand loyalty: Mediators and gender differences.

Sensory brand experience is a fundamental and central brand experience. Its influencing mechanism on brand outcome variables still needs to be clarified. This study proposed a new SEM model to explore the influencing mechanism from sensory brand experience to brand loyalty and tested it using SmartPLS 4 software. Data were gathered through a web-based questionnaire survey of 304 Chinese consumers. The results show that sensory brand experience is vital in fostering brand loyalty. It impacts brand loyalty both directly and indirectly. The mediating effect of brand attitude is much higher than the mediating effect of brand-self connection, which means that in some situations, a strong emotional bond is not essential for brand success. The results also reveal the moderating effect of gender on relationships in the model. The key gender difference is that the male group does not have a mediation path through brand-self connection, while the female group has. This study expands the research on brand experience and sheds light on developing brand loyalty. Gender differences should be considered when developing sensory marketing strategies. Especially for women, creating sensory brand experiences that elicit strong emotional connections has positive effects on brand loyalty.

Corporate social Responsibility's impact on passenger loyalty and satisfaction in the Chinese airport industry: The moderating role of green HRM.

Corporate social responsibility has been extensively discussed and linked to the firm performance by the researchers. However, a significant research gap remains unexplored and that is measuring the association between corporate social responsibility, passenger satisfaction, and loyalty in the context of two international airports in China. This research also measures the moderating impact of green human resources management on the relationship between CSR, passengers' satisfaction, and loyalty. Data from two international airports in China were collected through a questionnaire. A total of 269 questionnaires were used for statistical analysis using Smart PLS 3.3. The findings from the statistical analysis revealed that corporate social responsibility in the airport affected passenger satisfaction and loyalty positively and significantly. Moreover, green human resource management in an airport plays a moderating role between corporate social responsibility, passengers' satisfaction, and loyalty. Overall, the study's findings enrich the literature on CSR, customer satisfaction, and loyalty, portray GHRM's role in the airport setting, and suggest practical indications for services industries. Discussions, limitations, and future recommendations are also given.

Effect of the Japanese medical office system on job satisfaction, loyalty, engagement, and organizational commitment of medical practitioners: a survey of cardiologists in the acute care setting.

BACKGROUND: In Japan, medical doctors have traditionally been assigned from university medical offices, under the medical office system. The present study examined the effects of the medical office system on job satisfaction, engagement, loyalty, and organizational commitment among cardiologists. METHODS: In this study, a survey of 156 cardiologists was conducted, from April 22, 2023, to May 21, 2023, to examine the effect of the medical office system on employee job satisfaction, employee engagement, and organizational commitment. RESULTS: Compared with the group that belonged to a medical office system (affiliated group, n = 117), the group that did not belong to a medical office system (non-affiliated group, n = 39) was affiliated to hospitals with a smaller number of beds. The results of the factor analysis showed that four types of hospital management styles were generated, namely, environment-, loyalty-building-, treatment-, and philosophy-oriented hospitals. There is an indication that the philosophy-oriented management style was adopted at the workplaces of the non-affiliated group. The treatment-oriented style also tended to be higher in the non-affiliated group than in the affiliated group. Furthermore, the non-affiliated group had higher organizational commitment, indicating that they were more likely to agree with the management philosophy set forth by hospital executives. CONCLUSION: Although the medical office system did not affect job satisfaction, compared with medical doctors with the affiliated group, those with the non-affiliated group tended to work in hospitals that emphasized philosophy-oriented management, and they received moderate compensation while practicing in an environment suitable for their specialty. These results suggest that the medical office system makes it difficult for medical doctors to have high workplace loyalty, engagement, and commitment to the hospital to which they are dispatched.

Decision-Making for HIV AIDS Prevention: Altruism and the Moral Norm.

The purpose of this enquiry was to understand how gay men form and maintain their attitudes toward HIV transmission preventative behaviors. Autobiographical life histories of sixteen gay men showed that once they acquired knowledge of preventative behavior they consistently adhered to that behavior. They adhered because of fear of HIV infection and because they held a moral norm that obligated them to behave altruistically (Schwartz, 1977) to protect not only themselves, but also their sex partners, loved ones, and their positive self-evaluation. They saw their HIV negative status, and their adherence, as pre-requisite and enabler for achieving their goals in life. Dick and Basu's (1994) Framework for Customer Loyalty, a commercial marketing communications theoretical framework, explains development and maintenance of these men's loyalty (their consistent adherence). This understanding, within a marketing communications framework, will inform development of social marketing communications aiming to increase adherence to behaviors that prevent HIV transmission.

Belief in a just world and organisational loyalty: Trust as an underlying mechanism.

This research examined whether employees' personal belief in a just world (BJW) is associated with their organisational loyalty and whether this relationship is statistically mediated by organisational trust. To test these hypotheses, we conducted two studies with employees from China (study 1, N = 314) and Germany (study 2, N = 189). The results from both studies supported the proposed model. In addition, study 2 revealed that the relationship between BJW and organisational loyalty persisted when controlling for global personality traits. These suggest that managers and organisations may increase employees' loyalty by providing an environment that fosters their sense of justice and trust.

Festival quality, value, and sports environment affecting students' satisfaction and loyalty: basis for continuous extra-curricular activity offering / Qualidade, valor e ambiente esportivo do festival afetam a satisfação e a fidelidade dos alunos: base para oferta continuada de atividades extracurriculares

RESUMO Eventos extracurriculares como o festival desportivo, onde os alunos podem demonstrar as suas competências desportivas e recreativas organizadas, são essenciais no ensino superior. Os alunos também podem desenvolver liderança, camaradagem e espírito esportivo enquanto competem em cada jogo. Os festivais esportivos incentivam os alunos a serem ativos e saudáveis ​​por meio de jogos. Este estudo examinou as percepções dos alunos sobre qualidade, valor e ambiente esportivo, o que afeta sua satisfação e lealdade às atividades extracurriculares. Mais importante ainda, o estudo ajudará o departamento e a administração a decidir se os festivais desportivos podem ser realizados regularmente para melhorar a cultura física do campus. Os entrevistados deste estudo são alunos de uma faculdade local que participaram do recente Festival Esportivo realizado pelos alunos e pelo departamento. A Pesquisa de Satisfação do Festival (FSS) foi modificada para atender ao estudo atual, eliminando o aspecto do souvenir. Além disso, o Youth Sport Environment Questionnaire (YSEQ) foi utilizado para incluir os dois componentes da primeira medida como construções extras. Uma ANOVA/Kruskal-Wallis H unidirecional foi realizada para investigar diferenças de FS e FL com base na demografia. A análise de Spearman Rho descreveu relações variáveis. Por fim, utilizou-se regressão múltipla para avaliar se o QVSE influencia a satisfação e a lealdade. Com base nos resultados, a satisfação e a lealdade do festival não diferiram entre os grupos (excluindo o grupo do ano). Além disso, o QVSE tem uma relação significativa com FS e FL. Por último, o QVSE tem influência direta sobre FS e FL. Para proporcionar aos alunos uma experiência significativa e desenvolver e preservar a cultura física do campus, o departamento e a administração podem oferecer regularmente atividades como o festival esportivo.

ABSTRACT Extracurricular events like the sports festival, where students can demonstrate their skills in organized sports and recreation, are essential in higher education. Students can also develop leadership, camaraderie, and sportsmanship while competing in each game. Sports festivals encourage students to be active and healthy through games. This study examined students' perceptions of quality, value, and sports environment, which affects their satisfaction and loyalty to extracurricular activities. Most importantly, the study will help the department and administration decide if sports festivals can be held regularly to enhance campus physical culture. The respondents for this study are students from a local college who participated in the recent Sports Festival conducted by the students and department. The Festival Satisfaction Survey (FSS) was modified to meet the current study by eliminating the souvenir aspect. Additionally, the Youth Sport Environment Questionnaire (YSEQ) was employed to include the two components in the former measure as extra constructs. A one-way ANOVA/Kruskal-Wallis H was performed to investigate FS and FL differences based on demographics. Spearman Rho's analysis described variable relationships. Finally, multiple regression was used to assess if QVSE influence satisfaction and loyalty. Based on the findings, festival satisfaction and loyalty did not differ between groups (excluding year level group). Also, QVSE has a significant relationship with FS and FL. Lastly, QVSE has a direct influence on FS and FL. To give students a meaningful experience and develop and preserve campus physical culture, the department and administration may regularly offer activities like the sports festival.

Building student loyalty in higher education: the role of corporate reputation.

Background: Reputation is a vital asset for Higher Education Institutions (HEIs) as it constitutes a source of competitive advantage because it works as a quality sign for the stakeholders. Because of globalisation, decreasing funding and the changing environment in the Mozambican higher education market, HEIs need to build a favourable reputation to stay relevant. This research aims to study how a university's reputation can influence student loyalty. Methods: Utilizing a descriptive and analytical methodology, a quantitative investigation was carried out by surveying 402 students enrolled in higher education institution (HEI) courses in Mozambique. The research employed a survey questionnaire to directly collect information from the study participants. Results: The study concluded that university reputation affects student loyalty, as the relationship between both variables is statistically significant. All dimensions of HEIs reputation, namely, academic competence, social attractiveness, and responsible management, positively impact student loyalty. Although, the latter variable did not have a statistically significant impact, contradicting the current theoretical framework. Conclusions: The study's findings suggest that corporate reputation has a favorable impact on student loyalty, demonstrating a significant relationship between the two factors. Therefore,improve student retention, HEIs should seek to enhance their academic competence and social attractiveness. Furure research: The study suggests future research should address sample composition issues by increasing representation from underrepresented groups. It recommends a more in-depth exploration of the responsible management construct, advocating for the inclusion of context-specific indicators. Furthermore, the study proposes investigating additional factors to enhance the understanding of the relationship between university reputation and student loyalty.