Interlocking Doctor-Patient Trust in Patient-Hood: A Gender Perspective Among Mental Health Care Users (original) (raw)
Related papers
2016
The article aims at exploring the trust establishment among patients with depression during their journey to psychiatric patient-hood. This study was undertaken in government hospital involving 29 psychiatric outpatient users in Kedah and Pulau Pinang respectively. Phenomenology study and gender lens employed to scrutinize on the patients’ lived experiences in mental health care, at the same time magnifying the gender differences in perceiving the service. Semi-structured in-depth interview and non-participant observation were the tools used in data collection. The data then explicated with the aid of a qualitative data analysis tool, Atlas.ti., version 7.5. Through the findings, the study identified “Trust” appears critical in the accounts of the patients in shaping the doctor-patient relationship; with at least five interlocking sub-themes describing the health professional’s characteristic while giving the service. The sub-themes include doctor’s integrity, concern, competencies,...
Women’s customer trusts in hospital's inpatient services
Padjadjaran Journal of Dentistry
Introduction: Customer trust is a tribute to officers or institutions performances and sacrifices. In the health marketing system, the relationship among health workers, doctors, patients or health service users is essential. The declining of women’s health will have an impact on the overall life qualities of the community and eventually will decrease the Indonesian Human Development Index. The purpose of this research was to analyze the customer trust of women’s inpatient in hospitals at West Java and determine the most influential dimensions and indicators of the women’s inpatient customer trust. Methods: This research was explanatory research conducted with the survey method with the sample size of 398 respondents. The unit of analysis was a hospital in West Java, while the observation unit was the inpatient community group which considers inadequate and gets health financing subsidies from the government in 42 hospitals from 28 cities or regencies in the West Java provinces. The...
Indian Journal of Medical Ethics, 2015
Trust in physicians is the patient's optimistic acceptance of vulnerability and the expectation that the physician will do what is best for his/her welfare. This study was undertaken to develop a conceptual understanding of the dimensions and determinants of trust in physicians in healthcare settings in resource-poor, developing countries. A cross-sectional household survey was conducted on a sample of 625 men and women from urban and rural areas in Tamil Nadu, India. The sample was selected using a multistage sampling method and a pre-tested structured questionnaire was utilised. The questionnaire covered the five dimensions of trust: perceived competence of the physician, assurance of treatment, confidence in the physician, loyalty towards him/her, and respect for him/her. Items covering four main factors that influence trust, ie shared identity, the physician's behaviour, personal involvement of the physician and level of comfort with him/her, were included in the questionnaire. A structural equation model was constructed with the dimensions of trust on one hand and the four factors influencing trust on the other. Trust in physicians is based more on notional constructs, such as assurance of treatment (β=0.714, p<0.001) and respect for the physician (β=0.763, p<0.001),than objective assessments, such as the physician's competence (β=0.607, p<0.001). Feeling comfortable with the physician (β=0.630, p<0.001) and the physician's communication skills (β=0.253, p<0.001) significantly influence the level of trust. The former is correlated with the personal involvement of the physician (r=0.124, p<0.001), and so is the latter (r=0.152, p<0.001). The overall model has a good statistical fit. The factors that give rise to trust in physicians vary with the sociocultural context.
the Journal of Research …, 2001
Honesty and trust are crucial in patient-practitioner relationships. Gender also can exert a powerful influence on how patients experience health care. This article investigates the interplay of trust and honesty with gender, as lived by patients of primary health care practitioners in New Zealand. Research found that honesty was integral to patient trust across a range of primary health care providers and that gender was key in shaping both honesty and trust within patient-practitioner relationships. The research used the qualitative methodology of Memory-work and involved two groups of participants, one comprising five women, the other four men. The groups both met for five sessions, each session lasting at least three hours. Between them participants wrote 43 individual narratives (two absences) and generated more than 30 hours of recorded group work. Honesty emerged as a major theme for both the female and the male participants. There were three important similarities in how the women and men lived and understood honesty: the importance of the practitioner telling the truth, the 'location' of honesty in the practitioner as the other significant person in the consumer-provider relationship, and honesty being interpreted as a mark of respect for the individual patient. There were also fundamental differences between the women and the men relating to the importance of genuineness of health care providers and patients' assessments of practitioner honesty. These insights provide a rich starting point for designing improvements to current health care practice that are valued by the patient, and respectful of gender differences in the needs and wants of individual consumers. ARTICLE "You can trust honesty -you can't trust dishonesty" (Jane).
Gender and trust in medicine: Vulnerabilities, abuses, and remedies
International Journal of Feminist Approaches to Bioethics, 2008
Trust is taken to be one of the foundational values in the doctor-patient relationship, facilitating access to the benefits of health care and providing a guarantee against possible harms. Despite this foundational role, some doctors betray the trust of their patients. Trusting involves granting discretionary powers and makes the truster vulnerable to the trustee. Patients trust medical practitioners to act with goodwill and to act competently. Some patients carry pre-existing vulnerabilities, for reasons such as gender, poverty, age, ethnicity, or disability, and these vulnerabilities can be exacerbated when such patients extend their trust to a doctor. Gender stereotypes reduce women's ability to challenge and thereby assess their doctor's competency. In addition, women are more likely to be distrusted by their doctors and have their experiences of medical symptoms discounted. In this paper, we analyze two extreme examples of breaches of medical trust that exploited the vulnerability of women in the health care system: the "unfortunate experiment" at the National Women's Hospital in New Zealand and the Harold Shipman murders of elderly patients in the United Kingdom, examining the potential role of gender in the outcomes with regard to trust. Major wendy rogers And AngelA bAllAntyne 49
Mental health care: trust and mistrust in different caring contexts
Journal of Clinical Nursing, 2008
Aims and objectives. To identify the factors that make trust within the context of public mental health possible. We also consider the question of patients' trust in the whole caring system. The study is based on individual interviews with 22 psychiatric patients, who were also users of social services. Background. There are theoretical studies concerning trust between human beings in several disciplines within psychiatry and social services but few studies investigate how trust can be created and what makes it possible. The literature reveals that there is need for research concerning trust in psychiatry. In this study we examined two different caring contexts and investigated what makes trust possible in these contexts. The contexts are termed the Integrated Network and Family Model and the Traditional Model. Design. A qualitative method based on the grounded theory approach was used. Methods. The main focus in the analysis was on how the patients had experienced the contexts of the caring systems and how trust was created or not within them. Results. Three categories creating trust were found in the Integrated Network and Family Model and two in the Traditional context. Acceptance of the patient's expertise concerning his/her life situation, openness and joint discussions concerning knowledge are important. Trust is closely connected to autonomy and power: patients feel that trust increases as their experience of autonomy increases and in such situations power is not owned by any one person. Conclusions. Trust between psychiatric patients and personnel can be created in both the Integrated Network and Family Model and traditional context, but in different ways. Relevance to clinical practice. Clinical workers and nursing personnel can use our findings in their practical work with psychiatric patients. Our findings support theoretical considerations concerning trust and can be used as guidelines for nursing personnel in their work.
Trust and expectation on psychiatrist and its correlation with satisfaction and
Background: Trust and expectation are important aspect of doctor patient relationship and its role in patient’s satisfaction and medication adherence is unclear. Objective: To study the levels of trust and expectation on psychiatrist and its relationship with patient’s satisfaction and treatment adherence. Methods: One hundred and twenty three consecutive outpatients were recruited on follow-up if they satisfied the selection criteria. They were assessed with socio-demographic and clinical proforma designed for this study, Patient Trust Scale, Patient Satisfaction Survey, Patient Expectations Questionnaire and Medication Adherence Rating Scale. Results: There was a high mean score on trust scale (Mean 38.9, SD 8.5) and expectation questionnaire (Mean 13.5, SD 3.3). On Kruskal-Wallis H test significant group differences were observed in nuclear vs joint family type (c2 = 18.496, h2 = .151, df = 1, Sig. = .000) and knowledge of treatment option (medication only vs medication + psychotherapy) treatment option (c2 = 18.100, h2 = .148, df = 2, Sig. = .000) and occupational status (employed vs unemployed) (c2 = 3.165, h2 =.029, df = 1, Sig. = .056) on the score of PTS. Similar differences were also observed in method of treatment sought before (no treatment vs allopathic) (c2 = .065, h2 = .065, df = 3, Sig. = .005), knowledge about treatment option (medication only vs medication + psychotherapy) (c2 = .026, h2 = .161, df = 2, Sig. = .000) and occupation (employed vs unemployed) (c2 = .061, h2 = .061, df = 1, Sig. = .006) on the score of PEQ. On regression analysis (R2 = .723, F = 156.46, p = .000) value of the score on patient satisfaction was statistically significant as predicted by score on measure of expectation (beta = -0.095, t = -1.966, p = 0.052) and trust (beta = .842, t = 17.504, p = .000). Discussion: Levels of patients trust and expectation on physician varies with knowledge about treatment option & occupational status, and significantly associated with levels of satisfaction.
In patients Trust in Government Hospital
This study assess the level of inpatients’ trust and factors determining the level of inpatients’ trust towards doctors working in government hospital with special focus on central government hospital i.e. Bir hospital of Nepal. An integrative model of organizational trust has been taken as the theoretical basis of this research to assess the level of inpatients’ trust and to identify the factors determining level of inpatient’s trust. This research has used mixed method approach and both primary and secondary sources of data were used to get comprehensive picture of reality. A questionnaire survey was conducted among patients admitted in medical and surgical wards. Data collection also included non-participatory observation and interview with doctors. Content analysis was conducted for observational notes, field notes and responses to opened-ended questionnaires by doctors. In addition, secondary sources were used to strengthen the research. SPSS 16 was used to gather frequency, percentage and cross tabulation of the survey. Findings demonstrated that majority of admitted patients’ has high level of positive trust in their doctor but 28% showed low trust level. Two sets of independent variables were used to find their influence in inpatients trust level; i) identity variables of the patients comprising age, gender, education level, length of stay at hospital, department of hospital, approaches to hospital and patients’ responsiveness; and ii) factors of perceived trustworthiness consisting competence of doctors, compassionate care of doctors and communication skill of the doctors. Among the seven identity variables, only length of stay at hospital, department of hospital and patients’ responsiveness were found influential in determining the trust level in admitted patients. Patients who have stayed less days after admission showed high level of positive trust. This is surprising result in the way that continuous interaction leads to development of trust. But in this study those patients who have stayed longer days showed low level of trust. Similarly patient admitted in surgical ward showed high trust than those admitted in medical wards. This might be because patients admitted in surgical ward have gone through vulnerable situation than that of patients admitted in medical wards. In a similar vein, patients responsiveness was also found statistically significant determining factor that influence inpatients’ trust level.
Indicators for Medical Mistrust in Healthcare–A Review and Standpoint from Southeast Asia
Malaysian Journal of Medical Sciences, 2017
The relationship based on trust is exceptionally important in healthcare, where life or death and quality of health are major concerns. Relational crack jeopardises the provision of quality healthcare when trust is taken for granted. Trust is believed to be the vital key to minimise medical negligence, lawsuits and patient complaints towards healthcare providers while acting as an empowering agent to significant clinical outcomes. Trust is indispensable to healthcare. However, to identify its deterioration is not a simple feature. Moreover, lack of research and public dissemination complicate this topic further. Hence, understanding medical mistrust issues and their associated indicators is urgently needed to ensure the top-notch provision of healthcare. We employed narrative review methodology together with key terms matching for the selected electronic databases for this article. Our review concluded that an "Increasing number of medical litigations and complaints towards physicians", "Physicians' low mastery of interpersonal communication skill" and "Patients' demand, practice, and non-disclosure of alternative treatments" are the possible indicators to predict mistrust. Efforts to restore and strengthen trust can only be made when these indicators are well understood firsthand.