A Pilot Study of a Measure of Parental Trust in Pediatric Emergency Department Care Teams.

Abstract

To modify and test an existing measure of trust validated in a primary care setting for use in a pediatric emergency department (PED). The study population was parents/guardians who brought their child to an urban PED with a chief complaint of abdominal pain or head injury. We used a 2-phase design with modifications resulting from cognitive interviews with 15 participants followed by a field test with 150 participants. We measured usefulness by percent missing responses and ceiling effects. Cronbach's alpha and greatest lower bound measured reliability. As evidence of validity, we calculated a total trust score by summing the item scale values and correlating the score with measures of constructs shown to be positively associated with trust in other settings. We conducted a similar analysis to test a published shortened version of the same scale. Four items were modified prior to field testing. Ceiling effects for each item ranged from 53% to 67%. Missing data were minimal affecting only 2 items. The modified measure exhibited high reliability (Cronbach's alpha=.88, greatest lower bound=0.93). Total trust scores ranged from 27 to 50 with mean (standard deviation)=45.1 (4.9). The trust score exhibited a high positive correlation with communication and overall satisfaction, and moderate correlation with intent to adhere to physician recommendations. The short version of the scale performed similarly. This study provides evidence that the modified Wake Forest measure of trust is applicable and useful in the PED setting for this patient population.