Measuring Patients’ Trust in their Primary Care Providers (original) (raw)
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An improved scale for assessing patients’ trust in their physician
Health Marketing Quarterly, 2001
Patients' trust in their primary care physician is a critical concept for healthcare practitioners and scholars. At the clinical level, such trust buttresses patient-physician treatment relationships; at the organizational level, such trust fosters enhanced organizational effectiveness and other positive outcomes. To empirically assess various trust-related issues on both levels, we develop a comprehensive, bi-dimensional trust scale specific to patient-physician relationships. Response analysis from two samples suggests that the scale's benevolence dimension comprises understanding patients' individual experiences, expressing caring, communicating clearly and completely, building partnership and sharing power, demonstrating honesty and respect, and keeping information confidential. The scale's technical competence dimension comprises evaluating problems thoroughly, providing appropriate and effective treatment, predisposing factors, and structural and staffing factors.
BMC health services research, 2005
Despite the recent proliferation in research on patient trust, it is seldom a primary outcome, and is often a peripheral area of interest. The length of our original scales to measure trust may limit their use because of the practical needs to minimize both respondent burden and research cost. The objective of this study was to develop three abbreviated scales to measure trust in: (1) a physician, (2) a health insurer, and (3) the medical profession. Data from two samples were used. The first was a telephone survey of English-speaking adults in the United States (N = 1117) and the second was a telephone survey of English-speaking adults residing in North Carolina who were members of a health maintenance organization (N = 1024). Data were analyzed to examine data completeness, scaling assumptions, internal consistency properties, and factor structure. Abbreviated measures (5-items) were developed for each of the three scales. Cronbach's alpha was 0.87 for trust in a physician (te...
Patient Trust: Is It Related to Patient-Centered Behavior of Primary Care Physicians
Medical Care, 2004
Background: Patients' trust in their health care providers may affect their satisfaction and health outcomes. Despite the potential importance of trust, there are few studies of its correlates using objective measures of physician behavior during encounters with patients. Methods: We assessed physician behavior and length of visit using audio tapes of encounters of 2 unannounced standardized patients (SPs) with 100 community-based primary care physicians participating in a large managed care organization. Physician behavior was assessed via 3 components of the Measure of Patient-Centered Communication (MPCC) scale. The Primary Care Assessment Survey (PCAS) trust subscale was administered to 50 patients from each physician's practice and to SPs. We used multilevel modeling to examine the associations between physicians' Patient-Centered Communication during the SP visits and ratings of trust by both patients and SPs. Results: Component 1 of the MPCC, which explored the patient's experience of the disease and illness, was independently associated with patient's rating of trust in their physician. A 1 SD increase in this score was associated with 0.08 SD increase in trust (95% confidence interval 0.02-0.14). Each additional minute spent in SP visits was also independently associated with 0.01 SD increase in patient trust. (95% confidence interval 0.0001-0.02). Component 1 and visit length were also positively associated with SP trust ratings. Conclusions: Physician verbal behavior during an SP encounter is associated with trust reported by SPs and patients. Research is needed to determine whether interventions designed to enhance physicians' exploration patients' experiences of disease and illness improves trust.
Assessment of Trust in Physician: A Systematic Review of Measures
PLoS ONE, 2014
Over the last decades, trust in physician has gained in importance. Studies have shown that trust in physician is associated with positive health behaviors in patients. However, the validity of empirical findings fundamentally depends on the quality of the measures in use. Our aim was to provide an overview of trust in physician measures and to evaluate the methodological quality of the psychometric studies and the quality of psychometric properties of identified measures. We conducted an electronic search in three databases (Medline, EMBASE and PsycInfo). The secondary search strategy included reference and citation tracking of included full texts and consultation of experts in the field. Retrieved records were screened independently by two reviewers. Full texts that reported on testing of psychometric properties of trust in physician measures were included in the review. Study characteristics and psychometric properties were extracted. We evaluated the quality of design, methods and reporting of studies with the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was assessed with Terwee's 2007 quality criteria. After screening 3284 records and assessing 169 full texts for eligibility, fourteen studies on seven trust in physician measures were included. Most of the studies were conducted in the USA and used English measures. All but one measure were generic. Sample sizes range from 25 to 1199 participants, recruited in very heterogeneous settings. Quality assessments revealed several flaws in the methodological quality of studies. COSMIN scores were mainly fair or poor. The overall quality of measures' psychometric properties was intermediate. Several trust in physician measures have been developed over the last years, but further psychometric evaluation of these measures is strongly recommended. The methodological quality of psychometric property studies could be improved by adhering to quality criteria like the COSMIN checklist.
The health care relationship (HCR) trust scale: Development and psychometric evaluation
Research in Nursing & Health, 2006
A sequential multi-method approach using focus groups, individual interviews, and quantitative instrument development procedures was used to develop and evaluate a scale to measure patient trust in health care providers (HCPs). The resulting 15-item Health Care Relationship (HCR) Trust Scale was tested for internal consistency, test-retest reliability, and construct validity. The Cronbach alphas were .92 (time 1) and .95 (time 2), respectively. Test-retest reliability was .59 (p < .01). The HCR Trust Scale did not correlate with the Marlowe-Crowne Social Desirability Scale (r ¼ .20, p ¼ .07) or the Rapid Estimate of Adult Literacy in Medicine scale (r ¼ À.21, p ¼ .13). Principal component factor analysis with varimax rotation revealed a three-factor solution that explained 69% of the estimated common variance in the HCR trust scale. Cronbach alphas for the 3 factors ranged from .81 to .89. Findings of this study support the use of the HCR Trust Scale for measuring trust in various HCPs by diverse patient populations. More work is needed to test the usefulness of the scale with a greater number of patients and in other chronic illness populations.
Measuring Patients' Trust In Physicians When Assessing Quality Of Care
Health Affairs, 2004
PROLOGUE: It's been broken, misplaced, abused, shaken, and violated. Occasionally it's repaired and rebuilt. Trust is a vulnerable and fragile commodity, vaunted in the marketplace, acknowledged in every profession, yet perniciously difficult to quantify. Marketers measure its value in brand loyalty, customer retention, product satisfaction, and sales. In the health care marketplace, the absence or presence of trust in patient-provider relations can have life-changing consequences. A person who trusts a provider is more likely to seek care, to comply with treatment recommendations, and to return for follow-up care than a person who has little trust in a specific provider or health care system. Doesn't that alone make it something worth measuring?
Psychometric properties of primary health care trust questionnaire
BMC Health Services Research, 2019
Background: Trust has been introduced as the cornerstone of the public and health providers' relation. Public trust in primary health care (PHC) is crucial and must be measured. The aim of this study was to develop and validate PHC trust measurement tool. Methods: This was a psychometric study to develop PHC trust measuring tool done in Tabriz, East-Azerbaijan with participation of 600 households in 2016. Item generation was done through literature review and experts opinions. The content validity, reliability and construct validity of the PHC trust tool were assessed using several statistical methods including modified Kappa, Kendall's Tau and intra-class correlation coefficient (ICC) as well as exploratory factor analysis (EFA). Data were analyzed using STATA 14 statistical software package. Results: A 30-item questionnaire was developed. The Modified Kappa coefficient as an indicator of content validity assessment was 0.94. With respect to reliability assessment, a high internal consistency was observed with 0.98 Cronbach-Alpha score and the test-retest reliability for overall scale (assessed by ICC) was 0.94 (CI: 0.87-0.97). Exploratory factor analysis emerged 2 factors. Factor 1 consisted of 25 items accounting for 74.1% of the variance (eigenvalue = 22.47) followed by Factor 2 consisting of 5 items accounting for 19.2% of the variance (eigenvalue = 1.6). Conclusion: PHC trust measuring tool could be used as a valid and reliable tool by health systems in Iran and similar contexts to investigate how they are trustful from the public viewpoint.
Trust in GPs: A Review of the Literature and Analyses of the GP/Patient Survey Data
2014
The purpose of this paper is to initially review the conceptual landscape of trust within the social sciences in order to highlight under what circumstances trust becomes a crucial concern for human interactions. From this basis, the concept of trust is unpacked alongside similar concepts, such as confidence, and goes on to explore trust within the context of a salient concern with the UK health profession, that is, trust between patients and general practitioners (GPs). As will be demonstrated, issues of trust are heightened under greater situations of vulnerability and uncertainty, which means that health researchers interested in trust between patients and GPs need to be sensitive to the types of medical conditions patients have when examining trust in patient/GP relationships. Building on recent focus group work in the UK specifically designed to explore issues of trust with patient/GP relations (Wiles 2014), and using data from the GP/Patient Survey, a set of multivariate analy...