End-of-visit experience and patient trust in traditional Chinese medicine outpatient care: a cross-sectional study informed by the peak-end rule

Background Patient experience has become a central dimension of healthcare quality evaluation. However, conventional satisfaction measures that average across the entire visit may overlook the disproportionate influence of specific moments on patients' retrospective evaluations. The Peak-End Rule suggests that overall judgments of an experience are predominantly shaped by the most intense moment (peak) and the final moment (end), yet its application in Traditional Chinese Medicine (TCM) outpatient settings remains unexplored. The rule holds under boundary conditions on valence, intensity, duration and the interval before evaluation, and these are seldom stated in health services research. Methods A cross-sectional survey was conducted among 324 outpatients recruited by convenience sampling at a TCM hospital in Xinjiang, China, between 26 February and 26 March 2026. Instruments included a self-developed Peak-End Experience Questionnaire (assessing process, perceived peak, and end-of-visit experience), the 10-item Consultation and Relational Empathy (CARE) Measure, and the 5-item Wake Forest Physician Trust Scale. The end of each consultation was timed, so the retention interval is known for every participant (median 4.1 min, maximum 26.0). Spearman's rank correlations and bootstrap mediation analysis (PROCESS Model 4, 5,000 resamples) were used. Results Ratings were given a median of 4.1 min after the consultation ended (maximum 26.0), placing the whole sample within the short retention interval. End-of-visit experience correlated most strongly with trust (ρ = 0.861, p < 0.01), ahead of process experience (ρ = 0.839) and perceived peak experience (ρ = 0.830), and also correlated with overall satisfaction (ρ = 0.711) and revisit intention (ρ = 0.714). Trust partially mediated the path from end-of-visit experience to revisit intention [indirect effect = 0.378, 95% CI (0.235, 0.538); 43.1% of the total effect], rising to 64.7% when the three artifact items were removed from the composite. Waiting time was unrelated to the experience and trust measures (all ε 2 ≤ 0.014). The QR-code-inclined group ( n = 114) scored lower than the non-QR-code group ( n = 210) on every measure (all p < 0.001, r = 0.50–0.62). Conclusion These findings provide preliminary evidence that end-of-visit experience is positively associated with patient trust and revisit intention in TCM outpatient care, with trust potentially serving as a partial mediator. The paradoxical finding that QR-code-inclined patients reported lower experience ratings warrants further investigation. Recording the retention interval and waiting time locates this consultation within the rule's boundary conditions. These findings partially support the application of the Peak-End Rule in TCM outpatient care and provide a foundation for future theory-driven research on the Peak-End Rule in TCM outpatient settings.