The impact that family members\u2019 health care experiences have on patients\u2019 trust in physicians

Nao Oguro,Takafumi Wakita,Kosuke Sakurai,Mark A Hall,Noriaki Kurita,Nobuyuki Yajima,Ryo Suzuki

doi:10.1186/s12913-021-07172-y

Abstract

BackgroundA family member’s negative experiences with medical care have long-term effects on a patient’s attitudes and emotions. However, the impact of family members’ experiences on patients’ trust in their own physicians and in physicians generally is poorly understood. This study aims to quantify these associations.MethodsA cross-sectional online survey involving adults with non-communicable diseases (cardiac disease, diabetes, cancer, depression, and rheumatic disease) was conducted in Japan during April 2020. The main exposure variable was dissatisfaction with the medical care that family members had received. The main outcomes were patients’ (N = 661) own trust in their personal physicians and in physicians generally. The study adopted the Japanese version of the Abbreviated Wake Forest Physician Trust Scales. Both 5-item scales (general and individual physician trust) were translated and validated for the study. The total scores were transformed into a scale of 0-100 points. A series of linear mixed-effects models with consideration for clustering effect by prefectures were fit.ResultsThe results showed a lower rating for trust in physicians generally as compared to trust in the respondent’s personal physician (mean 57.0 vs. 66.4 points; p < 0.001). Furthermore, dissatisfaction with a family member’s medical care was associated with lower trust in physicians generally (mean difference − 9.58, 95 %CI -12.4 to -6.76). Interestingly, dissatisfaction with a family member’s care was also associated with lower trust in the respondent’s personal physician (mean difference − 3.19, 95 %CI -6.02 to -0.36), but the magnitude of this association was weaker. The lower trust in personal physicians may be mediated by reduced trust in physicians generally.ConclusionsWe suggest that physicians enquire about past patients’ negative experiences, including dissatisfaction with family members’ medical care, to repair hidden loss of trust, when they sense that patients doubt them or physicians generally.

Highlights

Among potentially modifiable patient attitudes, future expectations, or trust, toward physicians are important factors in decisions regarding treatment and continued care [1]
Our finding that dissatisfaction is associated with a milder decline in trust toward personal physicians than toward physicians in general confirms that interpersonal physician trust is more resilient than trust in the medical profession generally. [3, 15] Last, we found that, among Japanese respondents diagnosed with chronic diseases, interpersonal physician trust was rated higher than trust in physicians in general
[1] Third, we found that lower general physician trust may mediate lower trust in current physicians associated with dissatisfaction with family members’ medical care

Summary

Introduction

Among potentially modifiable patient attitudes, future expectations, or trust, toward physicians are important factors in decisions regarding treatment and continued care [1]. Patient and family members’ satisfaction is one of the subjective quality metrics of patient expectations and preferences for medical care experienced by patients and their family members [6, 11]. This is evident from the fact that low satisfaction subsequently influences the health-behaviors of patients and/or their family members, [11] and the possibility of medical litigation claims after unfavorable outcomes [6, 12, 13].

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