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Abstract This study examined the relative contributions of consumer–provider trust, health care choice, empowerment as well as possible mediation by self-efficacy, to a recovery trajectory model in an Asian collective cultural context. We interviewed 310 adults with severe mental illnesses referred from community rehabilitation centers in Taiwan. They were administered six scales, including the Satisfaction with Services (SS), Quality of Life (QL), Self-Efficacy Scale, Working Alliance Inventory-Short Form, Information and Advice Scale and Personal Empowerment Scale. Quantitative path analysis was used to evaluate the effects of the predictors on the QL and SS. The study revealed a satisfactory model fit. Self-efficacy and trust had significant direct effects and empowerment had a significant indirect effect on subjective QL, while empowerment, health care choices, and trust had significant direct effects on SS. Self-efficacy mediated the influence of empowerment on the QL. In conclusion, SS might be improved by building a trusting relationship, providing information regarding health care choices, and improving consumer empowerment and QL can be improved by strengthening self-efficacy and empowerment. The recovery-promoting competitive model should take cultural characteristics including traditional dependence on authority figures, into consideration in an Asian context.
Wu et al. (Thu,) studied this question.