의료파업 상황에서 국민이 인식한 정부·의료진·병원의 이해관심이 부정적 태도와 의료체계 불신에 미치는 영향

This study conceptualizes medical strikes not merely as policy conflicts but as interpretive processes in which perceptions of actors’ self-interest translate into relational distrust through affective evaluations. While prior research has primarily focused on describing patterns of public attitudes or levels of support and opposition in healthcare conflicts, this study seeks to theoretically explain how such conflicts are interpreted and how these interpretations become structured in public perceptions. To address this question, we integrate attribution theory with organizational trust theory and propose a sequential process model in which perceived actor self-interest shapes negative attitudes and subsequently leads to distrust. Using survey data from 1,122 adult citizens in South Korea, we employ partial least squares structural equation modeling (PLS-SEM) to examine the proposed relationships. The results indicate that perceptions of self-interest attributed to the government, medical professionals, and hospitals significantly increase negative attitudes toward the medical strike. In turn, negative attitudes strongly predict healthcare system distrust. At the same time, perceptions of self-interest also exert direct effects on distrust, indicating partial mediation. Notably, perceptions of medical professionals’ self-interest exert the strongest influence among the three actors. These findings suggest that in professional conflicts, trust may be shaped not primarily through the substantive content of policy disputes but through interpretations of actors’ motives. By identifying the cognitive–affective–relational mechanism through which trust erosion occurs, this study contributes to a deeper understanding of how public trust in institutional systems becomes destabilized during professional conflicts.