Respect for Patients’ Rights in Hospital Practice: Associations with Physicians’ Legal Knowledge, Defensive Medicine, and Patient-Centered Care

Background/Objectives: This study examined associations of physicians’ legal knowledge, defensive medicine, and patient-centered orientation with self-reported respect for patients’ rights. Methods: A single-center cross-sectional study (February–June 2026) included 96 physicians. The primary outcome was the Patients’ Rights Respect Score (PRRS, 0–100). The confirmatory analysis compared PRRS between legal-knowledge groups (adequate ≥70/100). Multivariable regression was secondary; mediation and prediction were exploratory. Results: Adequate legal knowledge (34/96, 35.4%) was associated with higher PRRS (76.8 ± 7.1 vs. 71.0 ± 8.4; difference 5.8, 95% CI 2.6–9.0, p < 0.001, d = 0.73) and lower Defensive Medicine Scale scores (44.5 ± 6.8 vs. 48.5 ± 9.3, p = 0.016). Patient–Practitioner Orientation Scale scores were independently associated with PRRS (B = 6.64 per point, p < 0.001; model R2 = 0.513); the adjusted legal-knowledge coefficient was not statistically significant (B = 1.09 per 10 points, p = 0.094). In exploratory parallel mediation models, 41.8% of the knowledge–PRRS association was statistically accounted for by indirect associations, mainly through patient-centered orientation; concurrent measurement precludes causal ordering. An exploratory model for PRRS < 70 had an optimism-corrected AUC of 0.789 (internal validation only). Conclusions: Legal knowledge was associated with greater self-reported respect in unadjusted comparisons. Indirect associations were hypothesis-generating, and predictive performance does not establish clinical utility. Confirmation requires multicenter, longitudinal studies with objective measures of practice.

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Journal
Healthcare
Published
2026-10-06
DOI
https://doi.org/10.3390/healthcare14193332
Primary Topic
Ethics and bioethics in healthcare
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article
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article

Respect for Patients’ Rights in Hospital Practice: Associations with Physicians’ Legal Knowledge, Defensive Medicine, and Patient-Centered Care

Bogdan Hoinoiu, Ştefania Dinu, Adriana Pădure, Sorin Dan Chiriac et al.
Healthcare
Ethics and bioethics in healthcare
article

Respect for Patients’ Rights in Hospital Practice: Associations with Physicians’ Legal Knowledge, Defensive Medicine, and Patient-Centered Care

Bogdan Hoinoiu, Ştefania Dinu, Adriana Pădure, Sorin Dan Chiriac, Alina Doina Tănase, Codruţa-Eliza Ille, Cristina Ioana Talpoș Niculescu
article en

Abstract

Background/Objectives: This study examined associations of physicians’ legal knowledge, defensive medicine, and patient-centered orientation with self-reported respect for patients’ rights. Methods: A single-center cross-sectional study (February–June 2026) included 96 physicians. The primary outcome was the Patients’ Rights Respect Score (PRRS, 0–100). The confirmatory analysis compared PRRS between legal-knowledge groups (adequate ≥70/100). Multivariable regression was secondary; mediation and prediction were exploratory. Results: Adequate legal knowledge (34/96, 35.4%) was associated with higher PRRS (76.8 ± 7.1 vs. 71.0 ± 8.4; difference 5.8, 95% CI 2.6–9.0, p < 0.001, d = 0.73) and lower Defensive Medicine Scale scores (44.5 ± 6.8 vs. 48.5 ± 9.3, p = 0.016). Patient–Practitioner Orientation Scale scores were independently associated with PRRS (B = 6.64 per point, p < 0.001; model R2 = 0.513); the adjusted legal-knowledge coefficient was not statistically significant (B = 1.09 per 10 points, p = 0.094). In exploratory parallel mediation models, 41.8% of the knowledge–PRRS association was statistically accounted for by indirect associations, mainly through patient-centered orientation; concurrent measurement precludes causal ordering. An exploratory model for PRRS < 70 had an optimism-corrected AUC of 0.789 (internal validation only). Conclusions: Legal knowledge was associated with greater self-reported respect in unadjusted comparisons. Indirect associations were hypothesis-generating, and predictive performance does not establish clinical utility. Confirmation requires multicenter, longitudinal studies with objective measures of practice.

HealthcareVol. 14(19)
Victor Babeș University of Medicine and Pharmacy Timișoara (RO)
Openalex Percentile: Top 9%
Ethics and bioethics in healthcare
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