title: Applying justice and commitment constructs to patient-health care provider relationships.
abstract: OBJECTIVE
  To examine patients' experiences of fairness and commitment in the health care context with an emphasis on primary care providers.
  
  
  METHODS
  Qualitative, semistructured, individual interviews were used to gather evidence for the justice and commitment frameworks across a variety of settings with an emphasis on primary care relationships.
  
  
  METHODS
  Rural, urban, and semiurban communities in Nova Scotia.
  
  
  METHODS
  Patients (ages ranged from 19 to 80 years) with varying health care needs and views on their health care providers.
  
  
  METHODS
  Participants were recruited through a variety of means, including posters in practice settings and communication with administrative staff in clinics. Individual interviews were conducted and were audiotaped and transcribed verbatim. A modified grounded theory approach was used to interpret the data.
  
  
  RESULTS
  Current conceptualizations of justice (distributive, procedural, interpersonal, informational) and commitment (affective, normative, continuance) capture important elements of patient-health care provider interactions and relationships.
  
  
  CONCLUSIONS
  Justice and commitment frameworks developed in other contexts encompass important dimensions of the patient-health care provider relationship with some exceptions. For example, commonly understood subcomponents of justice (eg, procedural consistency) might require modification to apply fully to patient-health care provider relationships. Moreover, the results suggest that factors outside the patient-health care provider dyad (eg, familial connections) might also influence the patient's commitment to his or her health care provider.
authors.affiliation: Departments of Psychology and Management, Saint Mary's University, Halifax, NS B3H 3C3. camilla.holmvall@smu.ca
authors.forename: Camilla
authors.initials: C
authors.lastname: Holmvall
authors.forename: Peter
authors.initials: P
authors.lastname: Twohig
authors.forename: Lori
authors.initials: L
authors.lastname: Francis
authors.forename: E Kevin
authors.initials: EK
authors.lastname: Kelloway
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004644:Emotions; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009674:Nova Scotia; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011320:Primary Health Care; D012935:Social Justice; D055815:Young Adult