From Relationship Marketing to Outcomes: Exploring the Impact of Trust and Satisfaction among Long-Term Care Residents
Ching-Kuo Wei.
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AbstractPURPOSE: This study aims to explore the cognitive factors of service quality among residents of long-term care (LTC) institutions amidst Taiwan's aging population trend [1]. The core objective is to introduce the Relationship Marketing (RM) model to validate the relationship between RM activities undertaken by institutions and the residents' perceived Relationship Quality (RQ) and final behavioral intentions, defined as Relationship Outcomes (RO) [2]. Furthermore, the study analyzes differences in the perception of these three constructs based on residents' socioeconomic backgrounds and care experiences. METHOD: This study employed purposive sampling, conducting one-on-one questionnaire interviews with 300 conscious residents from 10 long-term care institutions in New Taipei City, Taiwan (including hospital-affiliated nursing homes, independent nursing homes, and residential care centers). A total of 300 valid questionnaires were collected. The questionnaire was assessed by three experts, establishing expert validity. Reliability analysis showed that the Cronbach's a for all major constructs exceeded 0.80, indicating good internal consistency. The research framework, based on an extended model of contemporary relationship marketing theory, defines a path model. It uses the four dimensions of Relationship Marketing (Customer Needs, Relationship Needs, Communication & Respect, Technical Skills & Quality) as antecedent variables, Relationship Quality (Satisfaction & Trust) as mediating variables, and Relationship Outcomes as the final outcome variable (Figure 1). RESULTS AND DISCUSSION: Difference Analysis: Institution type showed significant differences in RQ and RO. Hospital-affiliated nursing homes had significantly higher RQ and RO scores than other types, reflecting a "trust premium" residents place on integrated medical resources. Caregiver nationality also showed significant differences; local (Taiwanese) caregivers scored significantly higher on average across RM, RQ, and RO than foreign caregivers, primarily due to fluency in communication. Significant differences were found in "Technical Skills & Quality" and "Communication & Respect" among respondents with different education and income levels. Those with better mobility reported significantly higher satisfaction and trust. Correlation Analysis: The RM dimensions were significantly positively correlated with each other (r = 0.73-0.79, p < 0.01). Their correlations with Relationship Quality and Relationship Outcomes were also significant (r = 0.78–0.88, p < 0.01), indicating that RQ is an important mediator between RM and RO. Multiple Regression Analysis: The four RM dimensions explained 33.3% of the variance in "Satisfaction" (R² = 0.333), with "Technical Skills & Quality" having the largest impact (ẞ = 0.318, p = 0.001). The dimensions explained 44.0% of the variance in "Trust" (R² = 0.440). "Technical Skills & Quality" (β = 0.432, p = 0.001) and "Communication & Respect" (β = 0.221, p = 0.009) had significant positive effects. The multiple regression of Relationship Quality (Satisfaction and Trust) on "Relationship Outcomes" showed that both Satisfaction (B = 0.603, β = 0.556, t = 9.021, p < 0.001) and Trust (B = 0.408, β = 0.364, t = 6.272, p < 0.001) were significant positive predictors. The overall model yielded R² = 0.805 (Table 1). The results show that Satisfaction and Trust are not only core outcomes of RM but also significantly enhance residents' willingness to return, recommendation behavior, and emotional attachment. This study confirms that Relationship Quality has a high impact on the Relationship Outcomes of long-term care residents [3]. It is recommended that institutions strengthen the service communication and professional quality of caregivers to enhance resident satisfaction and trust. Furthermore, continuous interaction and feedback mechanisms should be established to solidify relational loyalty. Future research could incorporate other mediating variables, such as emotional attachment, perceived value, or brand image, to deepen the theoretical development of customer relationship management in the long-term care industry.Keywords: long-term care, relationship outcomes, trust, satisfaction
Ching-Kuo Wei. (2026). From Relationship Marketing to Outcomes: Exploring the Impact of Trust and Satisfaction among Long-Term Care Residents. Gerontechnology, 25(2), 1-10
https://doi.org/10.4017/gt.2026.25.2.1298.3