The Role of Health Consciousness, Patient–physician Trust, and Perceived Physician’s Emotional Appraisal on Medical Adherence

Adriana Espinosa*, Selma Kadić-Maglajlić

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review


Poor adherence to medical recommendations is a well-recognized catalyst for public health consequences worldwide. The literature highlights health consciousness as a likely antecedent to patient–physician trust, which in turn promotes medical adherence. Nevertheless, principles of patient-centered care suggest that patient perceptions of their doctor’s appraisal of their emotions may influence the path between trust and medical adherence. Accordingly, this study tested the mediating role of patient–physician trust in the relation between health consciousness and medical adherence and assessed whether patient ratings of their doctor’s appraisal of their own and their patients’ emotions moderated the mediated relation. Data were collected via self-report questionnaires from two culturally and economically diverse countries: Bosnia-Herzegovina (N = 262) and the United States (N = 314). Participants were young, healthy adults who visited their primary care physician in the past year. The study employed confirmatory factor analysis, mediation, and moderated mediation analyses. The results indicate that health consciousness positively related to patient–physician trust, which was in turn related to higher medical adherence and which mediated 28% of the total effect of health consciousness. Nevertheless, among patients who rated their physicians to have low appraisal for their patients’ emotions but high appraisal for their own emotions, the path from trust to adherence was not significant. These results highlight the importance of promoting health consciousness among young individuals, all while training practitioners to be attuned to their patients’ emotions and circumstances above their own. However, additional findings indicate that the interrelation between doctors’ emotional attributes and adherence is not necessarily one directional and warrants further investigation.
Original languageEnglish
JournalHealth Education and Behavior
Issue number6
Pages (from-to)991-1000
Number of pages10
Publication statusPublished - Dec 2019
Externally publishedYes


  • Health consciousness
  • Medical adherence
  • Others’ emotion appraisal
  • Patient-physician trust
  • Self-emotion appraisal

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