Level Of Trust In Physician Research Articles

Unveiling Patient Trust in Physicians Across China: Insights from a Nationwide Cross-Sectional Study.

Trust is a major factor affecting patient-physician relationship and healthcare quality. However, there has been a lack of comprehensive study on the extent of and major factors affecting patient trust in healthcare providers of China, the world's largest developing country. The objective of this study is to elucidate the current status of outpatient trust in physicians in China and its influencing factors, providing empirical evidence to enhance doctor-patient trust and improve doctor-patient relationships. Between December 2017 and January 2018, 28,760 patients seeking care at the outpatient departments of 136 tertiary hospitals were interviewed, where they were asked to rate their trust in physicians. We applied a multilevel logistic regression model to explore the association between patients trust and characteristics of hospitals, physicians and patient characteristics. We conducted a series of sensitivity analysis to check the robustness of our findings. Among 28,760 participants included in this study, 91.54% expressed trust in their physicians, while 7.52% showed moderate trust. Only 0.94% expressly distrusted or strongly distrusted their physicians. Outpatients of hospitals with convenient payment, volunteer guidance and enough seats available in the rest and waiting area showed higher levels of trust. Physicians who had a senior title, showed patience and protection of the patient's privacy were more likely to be trusted by their patients in the outpatient setting. Compared to their female counterparts, male outpatients showed a higher degree of trust. While this study highlights an overall high level of Trust in physicians (TIP) among patients in China's tertiary hospitals, it is found to vary with patient demographic factors as well as provider's attributes. Hospitals with a more keen sense of protecting patients privacy and better meeting patients' need for efficient and caring service provision process appeared to yield a higher level of trust.

Use of social media as a source of health information among patients with chronic low back pain.

To evaluate the use of social media (SM) as a source of health information among patients with chronic low back pain (LBP) and to evaluate the factors associated with this use. This was a cross-sectional study involving patients with chronic LBP. Information on their sociodemographics, LBP characteristics, and comorbidities was collected. With the use of a questionnaire, we evaluated the use of SM as a source of information, examining the frequency of use, the type of SM used, and degree of confidence and application of information found. Catastrophising, trust in physicians, and concerns regarding medicines were assessed through the Pain Catastrophizing Scale (PCS), Trust in Physician Scale (TPS) and Beliefs about Medicines Questionnaire (BMQ Specific Concerns). A regression analysis was conducted to identify factors associated with the use of SM. A total of 118 patients were included. The mean age was 53.01±14.09years. Of the sample, 68.6% sought information regarding their LBP on social networks. The main source was YouTube (30%). Eighteen point six percent of patients trusted the information found through SM, and 16.1% have already acted on some of this information. The majority of patients (82%) would prefer to have healthcare professionals in their virtual spaces to answer their questions. In a multivariate analysis, only the degree of trust in the physician was negatively associated with SM use (OR=0.95 IC 95% [0.91-0.99]; p=0.03). This survey showed that a proportion of patients suffering from chronic LBP use SM, YouTube in particular, as a source of health information. The level of trust in physicians was the strongest factor that impelled people to use SM as a source of health information.

AN EXAMINATION OF ADVANCED CARE PLANNING IN BLACK AMERICANS: DIRECTION TO IMPROVE ENGAGEMENT

Abstract Past studies have found that older Black Americans are less likely to establish advance care directives (ACDs) than their White age peers, and medical distrust has been identified as one possible cause. Others have suggested the formulaic approach of ACD documentation which may conflict with the spiritual and cultural nature of these decisions. The Five Wishes ACD was developed partially to address this need. This study seeks to 1) replicate past findings regarding race and ACD adoption, and test the hypotheses that 2) Race will differentially predict Advanced Care Planning (ACP) engagement scores between conditions (Five Wishes vs State Directive), and 3) level of trust in physicians will relate to ACP engagement. The sample (N = 186) was recruited from Amazon Mechanical Turk and Prolific. Participants ranged from 50 to 77 years, were predominantly female (56.8%), White (51.61%), married (52.6%), and college-educated (70 .6%). ANCOVA results were a nonsignificant main effect of ACP engagement by race (F(1, 185) = 1.93, p = .166) and nonsignificant interaction of race by condition (F(1, 185) = 0.16, p < .69). Trust in physician scale scores predicted ACP engagement (F(1, 185) = 16.15, p < .001). The lack of an effect of race on ACP utilization may be explained by educational and SES characteristics of the sample by contrast to prior studies. The Five Wishes and State Directive ACD documents resulted in similar ACD engagement. These results suggest that trust in physicians is a primary barrier to ACP utilization.

Disparities in awareness of and willingness to participate in cancer clinical trials between African American and White cancer survivors

BackgroundCancer clinical trials (CCTs) are essential for cancer care, yet the evidence is scarce when it comes to racial disparities in CCT participation among cancer survivors in the Midwest. This study aimed to 1) assess disparities in the awareness of and willingness to participate in CCTs between African American and White cancer survivors; and 2) compare perceptions about CCTs between the two racial groups.MethodsThe study was based on cross-sectional data from the survey “Minority Patient Participation in Cancer Clinical Trials” that collected information from 147 Black and White cancer survivors from Nebraska between 2015 and 2016. Chi-square tests and logistic regressions were used to assess differences between Black and White cancer survivors regarding their awareness, willingness, and perceptions associated with CCT participation.ResultsAfter adjusting for the effects of socio-demographic, health status, and psychosocial variables, Black cancer survivors were much less likely than White cancer survivors to be aware of CCTs (AOR 0.26; CI 0.08–0.81), to express willingness to participate in CCTs (AOR 0.03; CI 0.01, 0.32) and to actually participate in CCTs (AOR 0.13; CI 0.04–0.38). Black cancer survivors reported a lower level of trust in physicians and were less likely than White cancer survivors to believe that CCTs make a significant contribution to science.ConclusionsRelative to White cancer survivors, Black cancer survivors had much lower awareness of and willingness to participate in CCTs. Part of these differences might be related to the differential perception of CCTs, psychosocial factors, and trust in physicians between the two groups.

Public trust in physicians: empirical analysis of patient-related factors affecting trust in physicians in China

BackgroundTrust between the parties is essential for the efficient functioning of the healthcare market. Physician-patient relationship represents an asymmetric information situation and trust in physicians is critical for improving health and wellbeing of patients. In China, trust in physicians appears to be quite low creating conflicts between physicians and patients. This study aims to identify some general factors associated with trust in physicians in general using a nationally representative survey.MethodsA cross-sectional analysis using data from 2018 China Family Panel Study (CFPS). Survey responses of individuals aged 16 years or above were extracted from CFPS and the final sample consisted of 29,192 individuals. An ordered probit model was used to identify factors causing heterogeneity in the levels of trust in physicians.ResultsHigher educational attainment and having medical insurance coverage are associated with higher likelihood of trusting physicians. Older adults (> = 30 years), males, urban residents, wage-earners, and self-employed persons are less likely to trust physicians. People who are diagnosed as chronic diseases or current smokers indicate lower level of trust in physicians. Higher perceived quality of services improves trust.ConclusionSocioeconomically disadvantaged population groups and uninsured individuals are less likely to trust physicians. Health care delivery system needs to address the concerns of these specific population groups to reduce tensions between physicians and patients. Increasing health insurance coverage and offering insurance with low out-of-pocket expenses should reduce the perception that physicians are more guided by their income rather than the wellbeing of patients. The system should also develop a comprehensive bill of rights of patients to improve patient-physician relationship.

Influence of word of mouth (WOM) in physician selection by the patients in Bangladesh

PurposeThis study aims to examine how word of mouth (WOM) from the patients influences the building of trust in the physician.Design/methodology/approachBased on the review and synthesis of the previous relevant literature, 03 constructs of WOM and their 19 items were derived. The items were confirmed as well as their reliability and validity were measured through confirmatory factor analysis. The structural relationship between WOM factors and trust in physicians was analyzed with data from 330 personal interviews in Bangladesh. Structural equation modeling (SEM) was performed with the application of AMOS.FindingsThis study demonstrates that the trustworthiness of the source, information about medical care facilities and expertise and information about service experience have a significant direct effect on the level of trust in the physicians. This study delivers an understanding of how individualized social and informal communication, WOM, plays a role in the aspects of health-care-related decisions in developing countries.Research limitations/implicationsFindings of this study shed light on the importance of health-care-related communication strategy development and management, which is yet to be emphasized in research and practice in the developing countries contexts. Based on the findings of this study health-care service providers and key touchpoints in health-care delivery and management can develop client's experience-focused service marketing strategies and practices.Originality/valueThe level of trust in physicians regulates the choice of physician decision and the magnitude of service satisfaction and patients' good feeling issues. In health-care service marketing, research is an under-explored area, while the gap is more when developing countries' contexts are concerned. As a customized model and primary data-based study, this paper contributes to addressing the gap mentioned in the previous statement. The sample size could not be extended as no institutional funding was available for this study.

'I'm usually being my own doctor': women's experiences of managing polycystic ovary syndrome in Canada.

Polycystic ovary syndrome (PCOS) is a complex, chronic condition characterized by anovulation, polycystic ovarian morphology and hyperandrogenism that requires lifelong management. To reduce the risk of comorbidity and to manage symptoms, lifestyle management and pharmaceuticals such as oral contraceptives are the most common forms of treatment and should be tailored to the individual patient. The literature to date has shown PCOS patients to experience widespread dissatisfaction with the amount and quality of information they receive from providers, along with lower levels of trust in physicians. Little is known about the lived experiences of women managing PCOS in Canada, across age groups. In-depth remote interviews explored women's lived experiences managing PCOS and the barriers and facilitators they encountered in their management journeys. Data were analyzed using thematic analysis and interpretive description methodology. Twenty-five in-depth, telephone interviews conducted with participants (aged 18-63 y) across Canada revealed participants lacking sufficient information and guidance from physicians, especially in primary care. Areas in need of more guidance included lifestyle management and mental health. Lack of empathy and weight bias among physicians were also perceived by participants. Older participants received little guidance on treatment options postmenopause. Loss of trust and withdrawal from seeking medical care were prominent themes, along with greater self-reliance on self-management, including self-educating and self-experimenting with treatments. Most women in this study were frustrated with the level of involvement and information provision from their doctors. Key recommendations are identified for the provision of care to younger and older patients with PCOS. Improved education for physicians may be needed to improve the quality of healthcare provision for PCOS.

Medical Pluralism in East and West Europe: A Comparison of People Visiting Healthcare Practitioners Specializing in Complementary and Alternative Medicine

Background: Interest in various forms of complementary and alternative medicine (CAM) (e.g., naturopathy, homeopathy, traditional Chinese medicine, osteopathy, and chiropractic) is continuing to grow throughout Europe. Very little is known as to whether the prevalence and patterns of CAM usage are another cross-cutting phenomenon, dividing Europe, or whether they indicate homogenous healthcare settings throughout the continent. By examining data from the general population, the main objective of the study is to conduct a cross-country comparison of medical pluralism in Eastern and Western European countries. Methods: The cross-country comparison was conducted using data obtained through the International Social Survey Programme (ISSP). Data addressing healthcare issues were last collected for the ISSP in 2011. By analysing existing similarities and/or differences in the prevalence of sociodemographic and socioeconomic determinants, which could encourage visits to complementary and alternative practitioners, data from 21 European societies only were included. In addition, the aim was to investigate whether individuals’ scarcity of trust in physicians, as well as a lack of confidence in healthcare systems, may explain visits to CAM practitioners across Europe. Results: While in Eastern countries, a total of 531 (5.5%) respondents reported a visit to/by a CAM healthcare practitioner during the preceding 12 months, in Western Europe, a visit to/by a CAM healthcare practitioner was reported by 11.6% of individuals. In Western Europe, the use of CAM is most prevalent among younger generations of women, those of a lower socioeconomic position and/or with a low level of trust in conventional doctors. In Eastern Europe, CAM practitioners are mainly visited by older generations, city dwellers of a higher socioeconomic position and with a relatively high level of trust in physicians. Conclusion: After collating data from 21 societies, the study concludes that more than three decades after the collapse of the socialist experiment in Eastern Europe, there is evidence that the European continent remains divided in relation to the alternative healthcare sector. The field of non-conventional healthcare represents an indicator supporting the existence of a dividing line between Eastern and Western Europe.

Trust in the Healthcare System and Physicians in Croatia: A Survey of the General Population.

Trust in healthcare systems and physicians is considered important for the delivery of good healthcare. A cross-sectional survey was conducted on a random three-stage sample of the general population of Croatia (N = 1230), stratified by regions. Of respondents, 58.7% displayed a high or very high level of trust in the healthcare system, 65.6% in physicians, and 78.3% in their family physician. Respondents’ views regarding patients’ roles in the discussion of treatment options, confidence in physicians’ expertise, and underlying motives of physicians were mixed. Respondents with a lower level of education, those with low monthly incomes, and those from smaller settlements had lower levels of trust in physicians and the healthcare system. Trust in other institutions, religiosity and religious beliefs, tolerance of personal choice, and experience of caring for the seriously ill and dying were predictors of trust in healthcare and physicians. Our findings suggest that levels of healthcare-related trust in Croatia are increasing in comparison with previous research, but need improvement. Levels of trust are lowest in populations that are most vulnerable and most in need of care and protection.

Trust in medical professionals and its influence on the stress experience of parents of premature infants.

To examine parents' perceptions of stress and their trust in physicians and nursing staff and to investigate whether trust influences the parental perceptions of potential stressors resulting from their infant's hospitalisation in a neonatal intensive care unit. Parents of very and extremely low birth weight infants were surveyed in a nationwide retrospective cross-sectional study 6-18months after their child's birth. Parental stress was measured utilising the PSS:NICU_German/2-scales, and trust was measured by the scales Trust in Physicians and Trust in Nursing Staff. In addition to descriptive analyses, multiple linear regression models were conducted. The change in parents' anticipated roles was assessed as more stressful than their infant's appearance and behaviour. Trust in nursing staff significantly influenced the parental stress level. Although the level of trust in physicians was rated higher than trust in nursing staff, trust in physicians did not yield a significant effect on the parental stress experience. Efforts to foster parental trust in nursing staff may reduce the parental stress level and hence enable parents to better cope with the situation. The parental resources unleashed in this way can be employed to enhance parenting.

Does higher health literacy lead to higher trust in public hospitals?

BackgroundDoes higher health literacy lead to higher trust in public hospitals? Existing literature suggests that this is the case since a positive association between the level of health literacy and the level of trust in physicians and the health care system has been shown. This study aims to challenge this assumption.MethodsBased on theoretical arguments from game theory and analysis of empirical data, we argue that the association is better described as an inversely u-shaped curve, suggesting that low and high levels of health literacy lead to a lower level of trust than a medium level of health literacy does. The empirical analysis is based on a study of the Danes’ relationship to the overall health care system. More than 6000 Danes have been asked about their overall expectations of the health service, their concrete experiences and their attitudes to a number of change initiatives.ResultsGame theory analysis show that the combined perceived cooperation and benefit effects can explain an inversely u-shaped relationship between social groups and trust in the health care system. Based on quantitative, binary regression analyses of empirical data, the lowest degree of trust is found among patients from the lowest and highest social groups, while the highest degree of trust is found in the middle group. The main driver for this result is that while patients having low health literacy perceive that the health care system is not cooperative, patients with a high level of health literacy have high expectations about the quality, which the health care system might not be able to provide. This reduces the perceived benefit from their encounter with the health care system.ConclusionIt is important that health care professionals understand that some patient groups have a higher chance of cooperation (e.g., agreeing on the choice of treatment) or defection (e.g. passing a complaint) than others. In perspective, future research should undertake further qualitative examinations of possible patient types and their demands in relation to different health care sectors, focusing specifically on the opportunities to improve the handling of different patient types.

The Credibility of Health Information Sources as Predictors of Attitudes toward Vaccination-The Results from a Longitudinal Study in Poland.

Background: The research focused on the relationships between attitudes towards vaccination and the trust placed in different sources of information (science, experts and the information available on the Internet) before and during COVID-19. Method: A longitudinal design was applied with the first measurement in February 2018 (N = 1039). The second measurement (N = 400) was carried out in December 2020 to test if the pandemic influenced the trust in different sources of information. Results: The final analyses carried out on final sample of 400 participants showed that there has been no change in trust in the Internet as a source of knowledge about health during the pandemic. However, the trust in science, physicians, subjective health knowledge, as well as the attitude towards the vaccination has declined. Regression analysis also showed that changes in the level of trust in physicians and science were associated with analogous (in the same direction) changes in attitudes toward vaccination. The study was also focused on the trust in different sources of health knowledge as possible predictors of willingness to be vaccinated against SARS-nCoV-2. However, it appeared that the selected predictors explained a small part of the variance. This suggests that attitudes toward the new COVID vaccines may have different sources than attitudes toward vaccines that have been known to the public for a long time.

Ethnic Identity in Transition: the Potential Impact of Ethnicity on Chronic Illness\u2019 Medication Adherence in Post-Soviet Country

Previously, it has been shown that factors like ethnicity and proficiency of state’s official language not only influence self-management abilities and medication adherence but may also indicate the level of trust in physicians, medication, and healthcare system. This research aims to examine the potential impact of ethnicity on medication adherence based on the example of a post-Soviet country. The research was carried out as a quantitative survey among 303 hypertension and type 2 diabetes patients in Estonia, involving participants from ethnic majority and minority. Research was conducted in community pharmacies and data analysed statistically with SPSS. The findings were opposite to previous research. Although members of the ethnic minority used less illness-related sources, these sources relied more on evidence-based medicine compared to the ethnic majority. Because of this, medication adherence was also slightly higher for the ethnic minority compared to the majority. Therefore, these findings indicate trust in medical authorities, their decisions, and recommendations. There was a statistically significant relationship between general and illness-related information-seeking activity; however, medication adherence was not related to information-seeking activity. The research outlines that in addition to ethnolinguistic aspect, also potential cultural influence might determine the trust in medicine and medication adherence.

Patient Satisfaction and Trust in Telemedicine During the COVID-19 Pandemic: Retrospective Observational Study.

BackgroundLos Angeles County is a hub for COVID-19 cases in the United States. Academic health centers rapidly deployed and leveraged telemedicine to permit uninterrupted care of patients. Telemedicine enjoys high patient satisfaction, yet little is known about the level of satisfaction during a crisis and to what extent patient- or visit-related factors and trust play when in-person visits are eliminated.ObjectiveThe aim of this study is to examine correlates of patients’ satisfaction with a telemedicine visit.MethodsIn this retrospective observational study conducted in our single-institution, urban, academic medical center in Los Angeles, internal medicine patients aged ≥18 years who completed a telemedicine visit between March 10th and April 17th, 2020, were invited for a survey (n=1624). Measures included patient demographics, degree of interpersonal trust in patient-physician relationships (using the Trust in Physician Scale), and visit-related concerns. Statistical analysis used descriptive statistics, Spearman rank-order correlation, and linear and ordinal logistic regression.ResultsOf 1624 telemedicine visits conducted during this period, 368 (22.7%) patients participated in the survey. Across the study, respondents were very satisfied (173/365, 47.4%) or satisfied (n=129, 35.3%) with their telemedicine visit. Higher physician trust was associated with higher patient satisfaction (Spearman correlation r=0.51, P<.001). Visit-related factors with statistically significant correlation with Trust in Physician score were technical issues with the telemedicine visit (r=–0.16), concerns about privacy (r=–0.19), concerns about cost (r=–0.23), satisfaction with telemedicine convenience (r=0.41), and amount of time spent (r=0.47; all P<.01). Visit-related factors associated with patients’ satisfaction included fewer technical issues (P<.001), less concern about privacy (P<.001) or cost (P=.02), and successful face-to-face video (P<.001). The only patient variable with a significant positive association was income and level of trust in physician (r=0.18, P<.001). Younger age was associated with higher satisfaction with the telemedicine visit (P=.005).ConclusionsThere have been calls for redesigning primary care after the COVID-19 pandemic and for the widespread adoption of telemedicine. Patients’ satisfaction with telemedicine during the COVID-19 pandemic is high. Their satisfaction is shaped by the degree of trust in physician and visit-related factors more so than patient factors. This has widespread implications for outpatient practices and further research into visit-related factors and the patient-provider connection over telemedicine is needed.

RELATIONSHIPS BETWEEN THE SOURCE OF HEALTH INFORMATION AND THE BEHAVIOR OF MOTHERS OF CHILDREN UNDER 5 YEARS OLD: CROSS-SECTIONAL STUDY ANALYSIS

The aim: Is to investigate relationships between trusted sources of health information and people's behavior, including their attitudes toward vaccination and their willingness to seek medical care. Materials and methods: The responses of 4,354 mothers of children under 5 years of age from all regions of Ukraine, who participated in the Multi-Indicator Cluster Household Survey (MICS-2012) were analyzed. The respondents were divided into separate groups using two-step cluster analysis. Results: 6 clusters of respondents were identified, depending on the trusted source of health information identified by them, including those who trust only physicians (50.0%), friends (15.3%), all information channels (15.2%) or do not trust anyone (6.0%). The most important statistically significant differences in the level of vaccination coverage and willingness to seek medical care were found for a group of people who do not trust any source of information about health or trust only information from the Internet. People who trust information from physicians or pharmacy workers were the most active in vaccinating and seeking medical care. Conclusions: Communication with patients who do not trust anyone through social networks seems to be a promising way to raise awareness of this group of people about health and increase the level of trust in physicians or certain medical services.

A Research on Determining the Level of Trust in Physicians

Amaç: Güven kavramı, hasta-hekim ilişkisinin temelini oluşturmaktadır. Bu araştırma ile toplumun hekimlere güven düzeyinin belirlenmesi ve hekimlere güven düzeyinin demografik değişkenlere göre istatistiksel olarak farklılaşıp farklılaşmadığının ortaya konulması amaçlanmıştır.&#x0D; Yöntem: Tanımlayıcı ve kesitsel tipte planlanan araştırma, Ekim 2019’da İstanbul’da gerçekleştirilmiştir. Araştırma evrenini İstanbul’da ikamet eden ve 18 yaşını doldurmuş bireyler oluşturmuştur. Araştırmada veri toplamak için anket yöntemi kullanılmıştır.&#x0D; Bulgular: Araştırma ile elde edilen bulgulara göre katılımcıların hekime güven düzeyinin yüksek olduğu belirlenmiştir (3,82±0,60). Ayrıca katılımcıların cinsiyetine, yaşına ve çalışma durumuna göre hekime güven düzeylerinin istatistiksel olarak farklılık göstermediği belirlenmiştir. Katılımcıların eğitim ve medeni durumuna göre hekime güven düzeylerinin istatistiksel olarak farklılık gösterdiği belirlenmiştir.&#x0D; Sonuç: Araştırma sonucunda hekime güven düzeyinin yüksek olduğu belirlenmiş ve bu sonuç çerçevesinde bireylerin hekime güven düzeyinin sürdürülebilir ve arttırılmasına yönelik bazı önerilerde bulunulmuştur.

Healthcare bricolage in Europe\u2019s superdiverse neighbourhoods: a mixed methods study

BackgroundStudies of the relationship between diverse populations, healthcare access and health outcomes have been dominated by approaches focusing on ethno-national groups or specific healthcare sectors. Healthcare bricolage conceptualises the processes by which individuals use multiple resources to address health concerns. It is relevant in superdiverse neighbourhoods with complex populations. This paper is original in its application of mixed methods to examine the extent to which, and the reasons why, individuals engage in healthcare bricolage.MethodsThe study utilized a parallel sequential methodology. Eight superdiverse neighbourhoods were selected, two in each of Bremen, Birmingham, Lisbon and Uppsala. Ethnographic research scoping the nature of each healthcare ecosystem was followed by 160 interviews (20 each neighbourhood) with a maximum variation sample of residents undertaken October 2015 to December 2016. Interviewees were asked to recall a health concern and describe actions taken to attempt resolution. Data was coded with a MAXQDA codebook checked for inter-coder reliability. Interview findings enabled identification of five types of bricolage, the nature of healthcare resources utilised and the factors which influenced residents’ tactics. Results were used to design a household survey using new questions and validated epidemiological instruments implemented January to October 2017. Respondents were identified using random address files and interviewed in person or by telephone. Multinomal logistic regressions were used to estimate the effect of changing the values of determinants on the probability of observing an outcome.ResultsAge, gender, level of education, migration background and extent of functional limitation were associated with bricolage tactics. Individuals demonstrating high levels of agency were more likely than those with low levels to engage in bricolage. Residents with high levels of trust in physicians were less likely to bricolage than those with lower levels of trust. Levels of health literacy showed no significant effects.ConclusionsThe nature and severity of health concern, trust in physicians and agency shaped residents’ bricolage tactics. The concept of bricolage enabled us to make visible the actions and resources utilised around public healthcare systems that would otherwise remain outwith healthcare access research. Actions were frequently undertaken via networks offering insights into healthcare-seeking behaviour.

Evaluating the expected effects of disclosure of patient safety incidents using hypothetical cases in Korea.

To introduce disclosure of patient safety incidents (DPSI) into a specific country, evidence of the effectiveness of DPSI is essential. Since such a disclosure policy has not been adopted in South Korea, hypothetical cases can be used to measure the effectiveness of DPSI. We evaluated the effectiveness of DPSI using hypothetical cases in a survey with a sample of the Korean general public. We used 8 hypothetical cases reflecting 3 conditions: the clarity of medical errors, the severity of harm, and conducting DPSI. Face-to-face interviews with 700 people using structured questionnaires were conducted. Participants were asked to read each hypothetical case and give remarks on the following: their judgment of a situation as a medical error and of the requirement for an apology, the willingness to revisit or recommend physicians, the intention to file a medical lawsuit and commence criminal proceedings against physicians, the level of trust in physicians, and the expected amount of compensation. The results indicated favorable findings in support of DPSI; DPSI reduced the likelihood of perceiving a situation as a medical error, promoted willingness to revisit and recommend physicians, and discouraged the intention to file a medical lawsuit and take commence criminal proceedings against physicians. Furthermore, DPSI increased patients’ trust scores in physicians and reduced the expected amount of compensation. The general public had positive attitudes towards DPSI in South Korea. This result provides empirical evidence for reducing the psychological burden that the introduction of DPSI may have on health professionals.

Is health literacy associated with greater medical care trust?

To examine the relationship between health literacy and trust in physicians and in the healthcare system. A cross-sectional survey of a nationally representative sample of adults. Taiwan. Non-institutionalized adults (N = 2199). Trust in physicians was a composite measure assessing respondents' general trust in physicians and their perceptions of their physician's communication, medical skills, beneficence, honesty, confidentiality, respect and fairness. Trust in the healthcare system was a single-item measure. Health literacy was measured by four items. Respondents with higher health literacy had, overall, higher levels of trust in physicians (P<0.001) and in the healthcare system (P = 0.04). Health literacy remained significantly and positively associated with trust in physicians (P<0.001) and in the healthcare system (P = 0.001) after adjusting for respondents' sociodemographic characteristics. Our findings demonstrate that health literacy is positively associated with trust. Actionable plans targeting health literacy at the national and local levels to establish a health literate care environment may contribute to enhancing trust in physicians and the healthcare system.

What Do Patients Think About Their Radiation Oncologists? An Assessment of Online Patient Reviews on Healthgrades.

IntroductionAn increasing number of patients search for their physicians online. Many hospital systems utilize Press-Ganey studies as internal tools to analyze patient satisfaction, but independent third-party websites have a large presence online. Patients’ trust in these third-party sites may occur despite a low number of reviews and a lack of validity of patients’ entries. Healthgrades.com has been shown as the most popular site to appear on Google searches for radiation oncologists (ROs) in the United States (US). The aim of this study was to analyze patient satisfaction scores and the factors that influence those scores for American ROs on Healthgrades.MethodsThe physician ratings website Healthgrades was manually queried to obtain reviews from all Medicare-participating ROs with reviews (n=2,679). Patient Review Satisfaction Scores (PRSS) were recorded in response to a variety of questions. All information in the survey was scored from 1 (poor) to 5 (excellent) for the following characteristics: likelihood to recommend (LTR), office environment, ease of scheduling, trust in the physician’s decision, staff friendliness, ability of the physician to listen and answer questions, ability of the physician to explain the condition, and whether the physician spent sufficient time with the patients. Associations amongst these factors were considered by computing Spearman correlation coefficients and utilizing Mann-Whitney and Kruskal-Wallis tests.ResultsThe ROs’ mean LTR score was 4.51±0.9 (median 5.0, 66% received the highest possible score of 5; 95% received a score>2). Patient reviews per RO ranged from 1 to 242 (4.50±0.9, median 2.0). LTR scores correlated very strongly with physician-related factors, ranging from r=0.85 (with appropriate time spent with patients) to r=0.89 (with level of trust in physician). LTR scores were not statistically significantly associated with gender, wait time, ROs’ years since graduation, academic status, or geographic region.ConclusionSatisfaction scores for ROs on a leading physician ratings website are very strong, and most patients leaving reviews are likely to recommend their own ROs to their friends and family. Understanding online ratings and identifying factors associated with positive ratings are important for both patients and ROs due to the recent growth in physician-rating third-party sites. ROs should have increased awareness regarding sites like Healthgrades and their online reputation.