The Influence of Cognitive and Affective Trust on the Utilization of Family Doctor Services: A Chinese Cross-Sectional Survey Based on McAllister’s Theory

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Purpose: This study explores the impact of cognitive and affective trust on the utilization of family doctor services based on McAllister's theory. It also analyzes the factors influencing these forms of trust. Patients and Methods: A cross-sectional study using stratified random sampling gathered data from 325 adult patients registered with family doctors in six community health centers in Wuhan, China. PLS-SEM was employed to examine the relationships among cognitive trust, affective trust, and the utilization of family doctor services. Logistic regression was utilized to identify the factors influencing cognitive and affective trust. Results: Higher cognitive trust significantly influenced affective trust (β = 0.549, p < 0.01) and was positively associated with service utilization (β = 0.524, p < 0.01). Affective trust also showed a positive association with service utilization (β= 0.481, p < 0.01). Occupation and marital status were found to have a significant impact on both cognitive and affective trust. Specifically, professional and technical workers(OR=9.699, p=0.001;OR=2.309, p=0.011) and non-married individuals(OR=7.591, p=0.001;OR=2.737, p=0.002) demonstrated higher trust levels. Conclusion: The study reveals the importance of cognitive and affective trust in patient engagement with family doctor services. It suggests that family doctors should enhance their professionalism while also demonstrating emotional care to improve overall healthcare quality. Additionally, attention should be given to the influence of factors such as occupation and marital status on patients' trust in family doctors.