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Thesis Abstract

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nihalayad

thesis titled "The role of non-verbal communication elements in affecting customer evaluation of the service encounter: An application on private Egyptian hospitals

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The Arab Academy for Science, Technology and Maritime Transport Graduate School of Business The role of non-verbal communication elements in affecting customer evaluation of the service encounter: An application on private Egyptian hospitals A thesis submitted in partial fulfilment of Masters of Art in Marketing Degree Supervisors: Dr. Farid El Sahn Dr. Dalia Farrag Submitted by: NIHAL ISMAIL AHMAD AYAD
DECLARATION I certify that all the material in this thesis that is not my own work has been identified, and that no material is included for which a degree has previously been conferred on me. The content of this thesis reflect my own personal views, and are not necessarily endorsed by the university. (Signature) ------------------------------------------------------------------------------- (Date) ------------------------------------------------------------------------------- ------------------- We certify that we have read the present work and that in our opinion it is fully adequate in scope and quality as thesis towards the partial fulfilment of the Master Degree requirements in the Masters of Art in Marketing. Specialization --------------------------------------- From College of --------------------------------------- (AASTMT) Date --------------------------------------- Supervisor (s): Name: --------------------------------------- Position: --------------------------------------- Signature: --------------------------------------- Name: --------------------------------------- Position: --------------------------------------- Signature: --------------------------------------- Examiners: Name: --------------------------------------- Position: --------------------------------------- Signature: --------------------------------------- Name: --------------------------------------- Position: --------------------------------------- Signature: --------------------------------------- ii
Abstract The purpose of this study is to investigate the effect of the service providers non- verbal communication on the customers evaluation of the service encounter in private Egyptian hospitals. Furthermore, the customers response to different elements of the service delivery in private Egyptian hospitals has been evaluated. Finally the importance of the effect of personal characteristics on the overall evaluation of the service encounter in private Egyptian hospitals was examined. Qualitative and quantitative methods were applied. The in-depth interviews examined the nature of the patients check-in & check-out service process inside private Egyptian hospitals, inspected the nature of services delivered inside private Egyptian hospitals and identified which services have the highest employees/patients contact ratio inside private Egyptian hospitals. As for the quantitative method three hundred and fifty questionnaires were administered to patients of two Hospitals from each district in Cairo and seven hospitals from Alexandria. The qualitative phase revealed that all private Egyptian hospitals have the same check-in /check-out process, that some of the statements used by other researchers had to be eliminated as they could not be visualized by patients and finally that the highest employee/patient contact ratio was done with doctors, nurses and receptionists. After testing the hypotheses understudy, correlation analysis discovered that the receptionists non-verbal communication, the doctors non- verbal communication, the nurses non-verbal communication and artifacts have a positive moderate to strong relationship with service encounter evaluation. And through regression analysis it was found out that the personal characteristics increased the model fitness between the receptionists non-verbal communication, the doctors non-verbal communication and the nurses non-verbal communication and service encounter evaluation and that the model fitness differs from receptionist to nurses to doctors inside private hospitals. iii
Acknowledgment It is a pleasure to thank the many people who made this thesis possible after Gods grace. I would like to express my deep and sincere gratitude to my supervisor, Professor Dalia Farrag, Professor of Marketing. Her wide knowledge and her logical way of thinking have been of great value for me. Her understanding, encouraging and personal guidance have provided a respectable basis for the present thesis. I am deeply grateful to my supervisor, Professor Farid El Sahn, Professor of Marketing, for his detailed and constructive comments, and for his important support throughout this work. During this work I have collaborated with many colleagues from The Arab Academy for Science, Technology & Maritime Transport for whom I have great regard, and I wish to extend my warmest thanks to all of them. I am especially grateful to Youmna El Herraoui, Sarah Maher, Shahenda el Garhy, Sherine Atef, Sahar Raafat and Mariam El Mallah. I am indebted to my many Masters of Art in Marketing colleagues for providing a stimulating and fun environment in which to learn and grow. I am especially grateful to Eiman Negm, Dina Gamal, Heba Sadek, Hanzada Ashraf, Mahinaz hafez and Aline Kalidjian. I owe my loving thanks to my father Ismail Ayad, my mother Hoda El Sobky and my brother Ahmed Ayad. Without their encouragement and understanding it would have been impossible for me to finish this work. My special gratitude is due to my husband Youssef Abou Youssef and his family for their loving support. Alexandria, Egypt, July 2011 Nihal Ismail Ahmad Ayad iv
Table of Content Declaration ii Abstract iii Acknowledgment iv Table of contents v-vi List of Tables vii-viii List of Figures viii Chapter 1: Introduction 1-6 1.1 Background 1 1.2 The Research Problem 2 1.3 Importance of Research Problem 5 Chapter 2: Literature Review 7-31 2.1 The Evolution of Services Marketing 7 2.2 The Service Encounter 12 2.3 Verbal and Non-verbal Communication 14 2.4 Service evaluation in Private Egyptian Hospitals 21 Chapter 3: Research Methodology 32-44 3.1 Research Model 32 3.2 Research Variables 33 3.3 Research Questions 35 3.4 Research Hypothesis 36 3.5 Research Design 38 3.5.1 Qualitative Research 38 3.5.2 Quantitative Research 41 Chapter 4: Research Findings 45-74 4.1 Qualitative phase 45-49 4.1.1 The nature of the services 45 4.1.2 Employees/patients contact ratio 46 4.1.3 The service encounter process in private 47 Egyptian hospitals v
4.2 Quantitative phase 49-74 4.2.1 Reliability of Scales 49 4.2.2 Validity of Scales 50 4.2.3 Sample Description 54 4.2.4 Hypothesis testing 57 Chapter 5: Discussion and Recommendations 75-90 5.1 Discussion 75 5.2 Managerial Implications 84 5.3 Directions for Future Research 89 Appendices 91-118 A. Overview of Egyptian health sector 92 B. Study Questionnaire (English) 97 C. Study Questionnaire (Arabic) 102 D. Interview transcripts 106 References 119-135 vi
List of Tables Table Table Name Page 2.1 The emergence of a new service quality abstraction 11 2.2 A summary of literature on elements of communication 20 Summary of the main NHA findings, 2.3 24 1994/95, 2001/02, 2007/08 Egypt in comparison with other middle-income countries 2.4 26 in the region, 2008 Socioeconomic and demographic indicators for Egypt 2.5 27 and Cuba, 2000. 3.1 Conceptual and operational definitions of research variables 33 3.2 Sample Frame 39 3.3 Private sector hospitals in Egypt 41 3.4 Private sector hospitals in Egypt: sample frame 43 4.1 The nature of the services 45 4.2 Employee/patient contact ratio 46 4.3 Reliability of scales 49 4.4 Validity of NVC scales: Discriminant 50 4.5 Validity of personal characteristics scales: Discriminant 52 4.6 Validity of service encounter evaluation scales: Discriminant 53 4.7 Demographics: Services acquired in private hospital 54 4.8 Demographics: Age 55 4.9 Demographics: Gender 55 4.10 Demographics: Household Income 55 4.11 Demographics: Occupation 56 4.12 Demographics: City of residence 56 4.13 Correlations: non-verbal communication: Receptionist 58 4.14 Correlations: non-verbal communication: Doctor 60 4.15 Correlations: non-verbal communication: Nurse 62 4.16 Correlations: non-verbal communication: Artifacts 64 vii
4.17 chi square of variables under study 65 4.18 Regression: Model summary 1 66 4.19 Regression: Model summary 2 67 4.20 Regression: Model summary 1 69 4.21 Regression: Model summary 2 69 4.22 Regression: Model summary 1 71 4.23 Regression: Model summary 2 72 4.24 One-way ANOVA 74 4.25 Post Hoc Test 74 A Overview of Egyptian health sector 92 List of Figures Figure Figure Name Page 2.1 Evolution of Services Marketing Field 8 2.2 Recent Stages of Service Evolution 10 Model adapted from D.S. Sundaram and 2.3 30 Cynthia Webster (2000) 3.1 Research Model 33 4.1 The service encounters process 47 viii

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Thesis Abstract

  • 1. The Arab Academy for Science, Technology and Maritime Transport Graduate School of Business The role of non-verbal communication elements in affecting customer evaluation of the service encounter: An application on private Egyptian hospitals A thesis submitted in partial fulfilment of Masters of Art in Marketing Degree Supervisors: Dr. Farid El Sahn Dr. Dalia Farrag Submitted by: NIHAL ISMAIL AHMAD AYAD
  • 2. DECLARATION I certify that all the material in this thesis that is not my own work has been identified, and that no material is included for which a degree has previously been conferred on me. The content of this thesis reflect my own personal views, and are not necessarily endorsed by the university. (Signature) ------------------------------------------------------------------------------- (Date) ------------------------------------------------------------------------------- ------------------- We certify that we have read the present work and that in our opinion it is fully adequate in scope and quality as thesis towards the partial fulfilment of the Master Degree requirements in the Masters of Art in Marketing. Specialization --------------------------------------- From College of --------------------------------------- (AASTMT) Date --------------------------------------- Supervisor (s): Name: --------------------------------------- Position: --------------------------------------- Signature: --------------------------------------- Name: --------------------------------------- Position: --------------------------------------- Signature: --------------------------------------- Examiners: Name: --------------------------------------- Position: --------------------------------------- Signature: --------------------------------------- Name: --------------------------------------- Position: --------------------------------------- Signature: --------------------------------------- ii
  • 3. Abstract The purpose of this study is to investigate the effect of the service providers non- verbal communication on the customers evaluation of the service encounter in private Egyptian hospitals. Furthermore, the customers response to different elements of the service delivery in private Egyptian hospitals has been evaluated. Finally the importance of the effect of personal characteristics on the overall evaluation of the service encounter in private Egyptian hospitals was examined. Qualitative and quantitative methods were applied. The in-depth interviews examined the nature of the patients check-in & check-out service process inside private Egyptian hospitals, inspected the nature of services delivered inside private Egyptian hospitals and identified which services have the highest employees/patients contact ratio inside private Egyptian hospitals. As for the quantitative method three hundred and fifty questionnaires were administered to patients of two Hospitals from each district in Cairo and seven hospitals from Alexandria. The qualitative phase revealed that all private Egyptian hospitals have the same check-in /check-out process, that some of the statements used by other researchers had to be eliminated as they could not be visualized by patients and finally that the highest employee/patient contact ratio was done with doctors, nurses and receptionists. After testing the hypotheses understudy, correlation analysis discovered that the receptionists non-verbal communication, the doctors non- verbal communication, the nurses non-verbal communication and artifacts have a positive moderate to strong relationship with service encounter evaluation. And through regression analysis it was found out that the personal characteristics increased the model fitness between the receptionists non-verbal communication, the doctors non-verbal communication and the nurses non-verbal communication and service encounter evaluation and that the model fitness differs from receptionist to nurses to doctors inside private hospitals. iii
  • 4. Acknowledgment It is a pleasure to thank the many people who made this thesis possible after Gods grace. I would like to express my deep and sincere gratitude to my supervisor, Professor Dalia Farrag, Professor of Marketing. Her wide knowledge and her logical way of thinking have been of great value for me. Her understanding, encouraging and personal guidance have provided a respectable basis for the present thesis. I am deeply grateful to my supervisor, Professor Farid El Sahn, Professor of Marketing, for his detailed and constructive comments, and for his important support throughout this work. During this work I have collaborated with many colleagues from The Arab Academy for Science, Technology & Maritime Transport for whom I have great regard, and I wish to extend my warmest thanks to all of them. I am especially grateful to Youmna El Herraoui, Sarah Maher, Shahenda el Garhy, Sherine Atef, Sahar Raafat and Mariam El Mallah. I am indebted to my many Masters of Art in Marketing colleagues for providing a stimulating and fun environment in which to learn and grow. I am especially grateful to Eiman Negm, Dina Gamal, Heba Sadek, Hanzada Ashraf, Mahinaz hafez and Aline Kalidjian. I owe my loving thanks to my father Ismail Ayad, my mother Hoda El Sobky and my brother Ahmed Ayad. Without their encouragement and understanding it would have been impossible for me to finish this work. My special gratitude is due to my husband Youssef Abou Youssef and his family for their loving support. Alexandria, Egypt, July 2011 Nihal Ismail Ahmad Ayad iv
  • 5. Table of Content Declaration ii Abstract iii Acknowledgment iv Table of contents v-vi List of Tables vii-viii List of Figures viii Chapter 1: Introduction 1-6 1.1 Background 1 1.2 The Research Problem 2 1.3 Importance of Research Problem 5 Chapter 2: Literature Review 7-31 2.1 The Evolution of Services Marketing 7 2.2 The Service Encounter 12 2.3 Verbal and Non-verbal Communication 14 2.4 Service evaluation in Private Egyptian Hospitals 21 Chapter 3: Research Methodology 32-44 3.1 Research Model 32 3.2 Research Variables 33 3.3 Research Questions 35 3.4 Research Hypothesis 36 3.5 Research Design 38 3.5.1 Qualitative Research 38 3.5.2 Quantitative Research 41 Chapter 4: Research Findings 45-74 4.1 Qualitative phase 45-49 4.1.1 The nature of the services 45 4.1.2 Employees/patients contact ratio 46 4.1.3 The service encounter process in private 47 Egyptian hospitals v
  • 6. 4.2 Quantitative phase 49-74 4.2.1 Reliability of Scales 49 4.2.2 Validity of Scales 50 4.2.3 Sample Description 54 4.2.4 Hypothesis testing 57 Chapter 5: Discussion and Recommendations 75-90 5.1 Discussion 75 5.2 Managerial Implications 84 5.3 Directions for Future Research 89 Appendices 91-118 A. Overview of Egyptian health sector 92 B. Study Questionnaire (English) 97 C. Study Questionnaire (Arabic) 102 D. Interview transcripts 106 References 119-135 vi
  • 7. List of Tables Table Table Name Page 2.1 The emergence of a new service quality abstraction 11 2.2 A summary of literature on elements of communication 20 Summary of the main NHA findings, 2.3 24 1994/95, 2001/02, 2007/08 Egypt in comparison with other middle-income countries 2.4 26 in the region, 2008 Socioeconomic and demographic indicators for Egypt 2.5 27 and Cuba, 2000. 3.1 Conceptual and operational definitions of research variables 33 3.2 Sample Frame 39 3.3 Private sector hospitals in Egypt 41 3.4 Private sector hospitals in Egypt: sample frame 43 4.1 The nature of the services 45 4.2 Employee/patient contact ratio 46 4.3 Reliability of scales 49 4.4 Validity of NVC scales: Discriminant 50 4.5 Validity of personal characteristics scales: Discriminant 52 4.6 Validity of service encounter evaluation scales: Discriminant 53 4.7 Demographics: Services acquired in private hospital 54 4.8 Demographics: Age 55 4.9 Demographics: Gender 55 4.10 Demographics: Household Income 55 4.11 Demographics: Occupation 56 4.12 Demographics: City of residence 56 4.13 Correlations: non-verbal communication: Receptionist 58 4.14 Correlations: non-verbal communication: Doctor 60 4.15 Correlations: non-verbal communication: Nurse 62 4.16 Correlations: non-verbal communication: Artifacts 64 vii
  • 8. 4.17 chi square of variables under study 65 4.18 Regression: Model summary 1 66 4.19 Regression: Model summary 2 67 4.20 Regression: Model summary 1 69 4.21 Regression: Model summary 2 69 4.22 Regression: Model summary 1 71 4.23 Regression: Model summary 2 72 4.24 One-way ANOVA 74 4.25 Post Hoc Test 74 A Overview of Egyptian health sector 92 List of Figures Figure Figure Name Page 2.1 Evolution of Services Marketing Field 8 2.2 Recent Stages of Service Evolution 10 Model adapted from D.S. Sundaram and 2.3 30 Cynthia Webster (2000) 3.1 Research Model 33 4.1 The service encounters process 47 viii