Analyzing patient trust through the lens of hospitals managers—The other side of the coin (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.
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.
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...
Various dimensions of trust in the health care system
Emergency Medical Service, 2020
Trust is one of the most important factors in building effective and long-lasting relationships in the entire healthcare sector. Trust becomes a valuable ally in situations of high risk and uncertainty as well as the increasing complexity of tasks that accompany the daily work of all medical professionals, especially paramedics, due to the nature of their work in the medical rescue system. Mutual trust is the basis of social capital thanks to which it is possible to achieve mutual benefits, easier to coordinate activities, create new quality and solutions through cooperation or strong ties. It is a kind of glue that binds various organizational and system links, thanks to which it is easier to plan and introduce necessary improvements and changes within individual medical units or the entire health care system. The high degree of trust increases the quality of clinical communication with the patient and the effectiveness of medical care and strengthens the employees’ motivation and ...
Development and testing of a scale to measure trust in the public healthcare system
Trust is an important factor in improving the performance of the healthcare system. This study aimed to develop a validated scale to measure trust in the public healthcare system. We adopted a sequential exploratory mixed study design, with developmental and testing phases. In the developmental phase, the construct of " healthcare system trust " was conceptualised and items were generated on the basis of information from a review of the literature on trust, in-depth interviews and a review of other scales. Exploratory factor analysis was employed for item reduction. In the testing phase, the reliability and validity measures were established. The face validity, content validity and construct validity of the scale were assessed. The final scale was a Likert-type scale with 23 items, 16 of which measured trust in the healthcare providers and 7, in healthcare institutions. The scale is a valid and reliable tool for measuring trust in the public healthcare system.
Trust in the Physician and in Medical Institutions. Modalities of Comprehension and Analysis
Postmodern Openings, 2014
The issue of trust in the medical profession, in medical institutions, and in the healthcare system, implicitly, has been brought to the scientists' attention lately, taking into account the erosion of trust, determined by the aggressive display in the media of medical personnel migration, of medical malpractice cases, of underfunding and bad management, of the high pressure on the system due to population ageing and to the increase in chronic disease incidence. Other explanations include the modifications in the attitudes, values, and expectations of the public concerning the healthcare system, the emergence of private health insurances and of private institutions, and the erosion of trust in State institutions because of incertitude and economic crises. This paper seeks to pinpoint, in the scientific literature, the definition of trust in the healthcare system, the determinants of trust in the patient-physicianinstitution-system relationship and the importance of social capital in these types of relationships, as well as the way in which the relationship between the patient and the actors within the medical system is created and influences the patient's quality of life in the context of chronic disease.
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.