Patient Trust Research Articles

Meaningful Patient Participation in Health Care Education: A Theoretically Informed Study Exploring Boundaries and Identities

Abstract Purpose After recent policy and practice changes, health care schools are expected to involve patients as partners in the management, design, and delivery of professional curricula. However, what these partnerships mean for academic communities and the processes needed to support them are not yet understood. This study examines what involving patients as partners within an academic community means for key stakeholders. Method A qualitative case study design with a social constructivist philosophical stance was used. Communities of practice served as the theoretical framework. Semistructured interviews were conducted with patients and educators from the University of Leicester between November 2021 and May 2022. Focus groups were held with penultimate-year students. Data were analyzed using reflexive thematic analysis informed by communities of practice. Results The sample comprised 40 participants. Ten patients and 10 educators participated in 40- to 60-minute interviews. Twenty students participated in 1 of 5 focus group discussions lasting 30 to 50 minutes. Two overarching themes were reported: “boundaries as (permeable) barriers to participation” and “identity as an interpretive lens.” Boundaries among patients, educators, and students can hinder patients’ meaningful involvement in health care education. Boundaries are marked through differences in knowledge, a lack of shared vision, and a lack of trust in patients. Patients, educators, and students have separate distinct identities. They experience tensions of identity when they meet across boundaries. These tensions reveal insights into the construction of the typical patient identity in health care education. Conclusions Applying communities of practice illuminated boundary and identity issues that patients, educators, and students experience when patients are involved in health care education. Health care schools should develop comprehensive training for patients, provide faculty development regarding patient involvement, support students to trust in patient teachers, and embed a distinctive strand of patient involvement across health care curricula.

The influence of internet sources on the patient's trust in the doctor (based on a survey of doctors and patients in the Nizhny Novgorod region)

BACKGROUND: Modern society is characterized by a tendency of a sharp increase in the influence of Internet sources on the interaction of subjects of the social institute of medicine. AIM: to assess the degree of influence of Internet sources on the patient's trust in the doctor. METHODS: The study was conducted in medical organizations of the Nizhny Novgorod region by means of a questionnaire survey of patients and doctors using author's questionnaires. The study involved 521 patients and 240 doctors. RESULTS: 32.3±2.1% of respondents almost never search for and recheck a diagnosis and doctor's appointments in Internet sources, and 32.5±2.1% do this rarely, 25.9±1.9% search for a diagnosis on Internet sites and recheck doctor's appointments from time to time, and only 9.2±1.2% do it all the time. At the same time, 82.8 ± 1.6% of patients declared priority trust in the doctor, rather than recommendations received on Internet sites. 61.5±3.1% of doctors from time to time face the fact that patients have a clear opinion about their diagnosis obtained from Internet sources, 15.0±2.3% of doctors face this constantly, 17.5±2.5% of doctors rarely, and only 6.0±1.5% of doctors never face it. 51.7±3.2% of the surveyed doctors do not feel well about the fact that patients double-check the criteria for diagnosis and doctor's appointment on Internet sites, 24.9±2.3% support the activity of patients and the study of information about their disease, and 23.4±2.7% are indifferent to such a phenomenon. According to 87.8±2.1% of doctors, patients trust information received from a doctor more than online sources. CONCLUSION: According to the results of the study, 67.6±2.1% of patients access Internet sites in order to verify the correctness of medical opinions, but at the same time, according to 82.8± 1.6% of patients and 87.8±2.1% of doctors, information received from a doctor is of priority importance for patients, compared with the Internet sources.

Misdiagnosis in breast imaging: a statement paper from European Society Breast Imaging (EUSOBI)-Part 1: The role of common errors in radiology in missed breast cancer and implications of misdiagnosis.

Misdiagnosis in breast imaging can have significant implications for patients, healthcare providers, and the healthcare system as a whole. Some of the potential implications of misdiagnosis in breast imaging include delayed diagnosis or false reassurance, which can result in a delay in treatment and potentially a worse prognosis. Misdiagnosis can also lead to unnecessary procedures, which can cause physical discomfort, anxiety, and emotional distress for patients, as well as increased healthcare costs. All these events can erode patient trust in the healthcare system and in individual healthcare providers. This can have negative implications for patient compliance with screening and treatment recommendations, as well as overall health outcomes. Moreover, misdiagnosis can also result in legal consequences for healthcare providers, including medical malpractice lawsuits and disciplinary action by licensing boards. To minimize the risk of misdiagnosis in breast imaging, it is important for healthcare providers to use appropriate imaging techniques and interpret images accurately and consistently. This requires ongoing training and education for radiologists and other healthcare providers, as well as collaboration and communication among healthcare providers to ensure that patients receive appropriate and timely care. If a misdiagnosis does occur, it is important for healthcare providers to communicate with patients and provide appropriate follow-up care to minimize the potential implications of the misdiagnosis. This may include repeat imaging, additional biopsies or other procedures, and referral to specialists for further evaluation and management. Question What factors most contribute to and what implications stem from misdiagnosis in breast imaging? Findings Ongoing training and education for radiologists and other healthcare providers, as well as interdisciplinary collaboration and communication, is paramount. Clinical relevance Misdiagnosis in breast imaging can have significant implications for patients, healthcare providers, and the entire healthcare system.

Association between discontinuity of care and patient trust in the usual rheumatologist among patients with systemic lupus erythematosus: a cross-sectional study.

Patient trust plays a central role in the patient-physician relationship. This study aimed to determine whether the number of outpatient visits with a covering rheumatologist is associated with patient trust in their usual rheumatologist. Japanese adults with systemic lupus erythematosus (SLE) who met the 1997 revised classification criteria of the American College of Rheumatology and had outpatient visits with a covering rheumatologist in the past year were included. We used the 11-item Japanese version of the modified Trust in Physician Scale (range 0-100) to assess patient trust. A general linear model with cluster-robust variance estimation was used to evaluate the association between the number of outpatient visits with covering rheumatologists and the patient's trust in their usual rheumatologist. Of the 515 enrolled participants, 421 patients with SLE were included in our analyses. Patients were divided into groups according to the number of outpatient visits with a covering rheumatologist in the past year as follows: no visits (59.9%; reference group), one to three visits (24.2%; low-frequency group), and four or more visits (15.9%; high-frequency group). The median Trust in Physician Scale score was 81.8 (interquartile range: 72.7-93.2). Both the low-frequency group (mean difference: -3.03; 95% confidence interval [CI] -5.93 to -0.80) and high-frequency group (mean difference: -4.17; 95% CI -7.77 to -0.58) exhibited lower trust in their usual rheumatologist. This study revealed that the number of outpatient visits with a covering rheumatologist was associated with lower trust in a patient's usual rheumatologist.

Unravelling ChatGPT's potential in summarising qualitative in-depth interviews.

Qualitative research can be laborious and time consuming, presenting a challenge for practitioners and policymakers seeking rapid, actionable results. Data collection, transcription and analysis are the main contributors to the resource-intensive nature. OpenAI's Chat Generative Pre-trained Transformer (ChatGPT), have demonstrated potential to aid in data analysis. Our study aimed to compare themes generated by ChatGPT (3.5 and 4.0) with traditional human analysis from in-depth interviews. Three transcripts from an evaluation study to understand patients' experiences at a community eye clinic were used. Transcripts were first analysed by an independent researcher. Next, specific aims, instructions and de-identified transcripts were uploaded to ChatGPT 3.5 and ChatGPT 4.0. Concordance in the themes was calculated as the number of themes generated by ChatGPT divided by the number of themes generated by the researcher. The number of unrelated subthemes and time taken by both ChatGPT were also described. The average time taken per transcript was 11.5 min, 11.9 min and 240 min for ChatGPT 3.5, ChatGPT 4.0 and researcher respectively. Six themes were identified by the researcher: (i) clinic's accessibility, (ii) patients' awareness, (iii) trust and satisfaction, (iv) patients' expectations, (v) willingness to return and (vi) explanation of the clinic by referral source. Concordance for ChatGPT 3.5 and 4.0 ranged from 66 to 100%. Preliminary results showed that ChatGPT significantly reduced analysis time with moderate to good concordance compared with current practice. This highlighted the potential adoption of ChatGPT to facilitate rapid preliminary analysis. However, regrouping of subthemes will still need to be conducted by a researcher.

Reasons for Declining Participation in Inpatient Research Among Historically Minoritized Racial and Ethnic Communities: A Scoping Review

BackgroundTo promote equitable recruitment for studies conducted in the inpatient hospital setting, we sought to characterize reasons why individuals, both from historically minoritized racial and ethnic groups and the broader patient population, refuse participation in clinical trials within inpatient settings. MethodsAn exhaustive search of the literature was conducted in Cochrane Library, Google Scholar, Embase, MEDLINE, PubMed, Scopus, and Web of Science databases to find relevant articles published from the inception of each database to April 30, 2023. Studies recruiting patients during their inpatient stay and reporting reasons for refusing participation in clinical trials met the inclusion criteria. ResultsThe search resulted in 2264 citations, of which 22 were included. 14 did not report data related to race, while 19 reported no ethnicity data. Reasons for refusal across trials included study burden and inconvenience (n=16), transportation and logistical issues (n=13), lack of interest in research (n=12), and refusal to be randomized (n=10). Prominent concepts included the importance of incorporating social support systems in consenting processes, lack of efforts to include data or recruitment efforts for individuals from minoritized groups, and physician involvement in recruitment. DiscussionTo enhance participation among historically minoritized communities in clinical trials, greater efforts must be made to collect demographic information and document refusal reasons to inform future recruitment methods. Strategies include proactively accounting for culture and language differences in study design and recruitment and intentionally engaging social support networks. Limiting study burden and logistics and optimizing collaborations between clinical and research teams would promote accessibility and foster patient trust.

Study of mathematical models of type 2 diabetes mellitus and its complications

The rapid increase in type 2 diabetes mellitus (DM) cases in Indonesia, driven by hereditary factors and unhealthy lifestyles, poses significant health challenges. This study develops a compartmental model to analyze the progression of type 2 DM and the onset of complications, classifying individuals into susceptible, patients without complications, patients with complications, and those disabled due to complications. The model examines the influence of two key factors on the recovery from complications: habitual factors, including medication adherence, physical activity, dietary habits, smoking history, and environmental factors, such as stress levels, environmental support, patient trust, and compliance. The results indicate that habitual factors have a more substantial impact on mitigating complications compared to environmental factors, suggesting that lifestyle interventions are crucial in improving patient outcomes. The model also shows that an increase in behavioral interactions leading to disease progression results in instability, emphasizing the need for early and consistent behavioral interventions. This research offers valuable insights for healthcare providers and policymakers. By identifying the most influential factors in managing complications, the model can guide the development of targeted interventions that prioritize habitual changes, such as medication adherence and physical activity. Public health strategies can be tailored to emphasize the importance of these habitual factors, potentially reducing the burden of type 2 DM complications. Overall, this study highlights the critical role of personalized, behavior-focused interventions in the management and prevention of complications in patients with type 2 DM, offering a practical framework for improving patient care.

The Growing Cybersecurity Crisis in Healthcare: A Call to Action

Electronic healthcare technology is pervasive throughout the globe, and it affords vast opportunities to enhance clinical outcomes, as well as for the transformation of models of care. Concerns are, however, growing, related to healthcare data and device security. Increased connectivity to legacy computer networks brought cybersecurity vulnerabilities for medical devices. Healthcare represents an attractive target for cybercrime because healthcare data is precious. This sector in present times is full of unique cybersecurity challenges, especially for susceptible kinds of patient information at stake. Second, many legacy systems will be prevalent—not adding more to that—with the changing face of cyber threats. Cybersecurity breaches have comprised stealing health information and focused ransomware attacks on hospitals; this could mean as vivid an attack as on implanted medical devices. This only points to the fact that ransomware attacks and other kinds of cyber-attacks against hospitals and other medical facilities are gaining ground; there is every reason to get alarmed and put in place stricter cybersecurity measures. An excellent healthcare cybersecurity strategy, therefore, has to consider access control, intrusion detection systems, encryption techniques, and periodic security testing. Data breaches and cyber-attacks are forcing any healthcare provider to invest in new state-of-the-art technologies related to keeping pace with trends regarding cybersecurity. The dangers that can be caused by cyber-attack include a considerable diminution in patient trust, potential health system collapse, human life threats, etc. On the whole, cybersecurity is strenuously linked with the question of patient safety.

Patients’ experiences of racism in German inpatient healthcare

Abstract Background Racism is recognised as a social determinant of health. An evolving concern in research and policymaking has been the impact of racism in the healthcare system, particularly regarding the quality of healthcare and barriers for healthcare. Little is known about patients’ experiences of racism in hospitals and rehabilitation facilities in Germany and their coping strategies in dealing with racism. Methods As part of a joint project on racism in healthcare (RiGeV) funded by the Federal Ministry of Education and Research, twenty qualitative interviews and two group discussions with patients and their next of kin about their experiences in hospitals and rehabilitation facilities were conducted and analysed using the documentary method. Ethical approval for this study was obtained from the Ethics Committee of Fulda University of Applied Sciences. Results Interviews with patients and their next of kin revealed that the most significant experiences of racism in hospitals are attributions of dramatisation and exaggeration of pain, embedded in a general perception of not being taken seriously and/or being ignored. Patients try to avoid such experiences that compromise their trust and sense of security, as well as the quality of treatment they receive. Healthcare for refugees is impacted by structural barriers (AsylBLg) which jeopardise the healing process and represent a considerable psychosocial burden. Conclusions Recommendations for policies and practice include a mission statement for non-discriminatory treatment and the sanctioning of racism within healthcare institutions. A complaints office should manage implementation and offer support for affected patients. The topic of racism must be addressed in the training and further education of doctors and healthcare professionals. Patient trust in a safe and high-quality form of healthcare should be strengthened by addressing their complaints. Health care for refugees has to be improved. Key messages • Racism in German inpatient healthcare represents a considerable psychosocial burden for patients and impairs the quality of treatment they receive. • Policies for reducing racism inpatient healthcare have to be implemented.

Trustworthiness of EHRs: Key Factors from a User-Centered Study in Germany

Abstract Background The integration of digital technologies, particularly Electronic Health Records (EHRs), promises substantial improvements in patient care and cost reductions. However, the success of EHRs depends heavily on patient trust and usage, which are influenced by their control over data visibility, storage, and sharing. Identifying the factors that enhance the perceived trustworthiness of EHRs is essential for increasing their reliability and acceptance in healthcare settings. Methods Participants (N = 30) first interacted with an interactive EHR prototype, then evaluated its trustworthiness and suggested improvements during semi-structured interviews. These interviews were transcribed and analyzed using thematic analysis to identify key themes affecting perceptions of the EHR’s trustworthiness. Results Through thematic analysis, we developed a categorical system encompassing five principal themes: provider reputation, information quality, system characteristics, user control, and user feedback. The analysis revealed that deficiencies in design and usability indirectly affect perceptions of privacy and data security. Conclusions Our study underscores the critical role of contextual factors-including provider reputation, strategic IT partnerships, and user feedback-in cultivating trust in Electronic Health Record (EHR) systems. Addressing privacy concerns and bolstering user trust necessitates not only a professional approach to design and usability but also clear communication about adherence to rigorous data privacy and security standards. In Germany’s tightly regulated environment, clearly communicating EHR security standards is crucial. Enhancing trust also involves robust customer support, user control over their data, and leveraging social proof like high download rates or positive reviews. These approaches could significantly improve EHR acceptance and trust in digital health across the country. Key messages • The perceived trustworthiness of EHRs is essential for increasing their reliability and acceptance in healthcare settings. • Effective communication and design are critical for building trust in digital health technologies. Trust in EHRs grows with transparent data policies and empowering user controls.

Practices and systems employed by health professionals toward protection and confidentiality of patient health records in Ghana

ObjectivesHealth information relies on a patient's sensory perceptions as well as objective assessments, diagnoses, and test findings. Ghana's current laws governing the confidentiality of patient health data seems a little pertinent in spite of ongoing conversations on the significance of patient health information and the necessity to protect patient information from improper disclosure. The study therefore investigated the extent of patient confidentiality in Ghana by looking into the guidelines, regulations, and rules that govern patient records. MethodsThe interpretive, phenomenological, and narrative methodologies used in qualitative research were employed to study the phenomenon. Twenty (20) participants were interviewed in a semi-structured manner to gather the data needed for the analysis comprising of Doctors, Nurses, Administrative staff, Record Officers, and Information Communication Technology (ICT0 Technicians of five Departments in La General Hospital. The Activity Theory was used as a theoretical foundation for the study ConclusionsThe study revealed that healthcare professionals uphold the moral standards relating to patient confidentiality and trust. Again, the findings of the study showed that medical records are safely stored through the use of Electronic Health Record system in the hospital in a manner that wouldn't compromise patient confidentiality. However, the results establishes that health care workers can potentially serve as a conduit for the leak or breach of patient information through negligence and unprofessional practices. Public interest statementThe study investigated systems and practices that are employed by health workers in Ghana to ensure that patient health records are safeguarded in order to build patients confidence in how their health records are protected. Health workers were interviewed in this study and the findings of the study show that there are practices and systems put in place to safeguard patient health records in the hospitals. Although, it was established that EHR systems help in safeguarding patient health records, the study recommends the need for users of the Health Electronic Records to be fully involved in the implementation process and strict enforcement of policies regarding the use of the EHR system to help prevent negligence and unprofessional application of the system.

Patient trust in the use of machine learning-based clinical decision support systems in psychiatric services: A randomized survey experiment.

Clinical decision support systems (CDSS) based on machine-learning (ML) models are emerging within psychiatry. If patients do not trust this technology, its implementation may disrupt the patient-clinician relationship. Therefore, the aim was to examine whether receiving basic information about ML-based CDSS increased trust in them. We conducted an online randomized survey experiment in the Psychiatric Services of the Central Denmark Region. The participating patients were randomized into one of three arms: Intervention=information on clinical decision-making supported by an ML model; Active control=information on a standard clinical decision process, and Blank control=no information. The participants were unaware of the experiment. Subsequently, participants were asked about different aspects of trust and distrust regarding ML-based CDSS. The effect of the intervention was assessed by comparing scores of trust and distrust between the allocation arms. Out of 5800 invitees, 992 completed the survey experiment. The intervention increased trust in ML-based CDSS when compared to the active control (mean increase in trust: 5% [95% CI: 1%; 9%], p=0.0096) and the blank control arm (mean increase in trust: 4% [1%; 8%], p=0.015). Similarly, the intervention reduced distrust in ML-based CDSS when compared to the active control (mean decrease in distrust: -3%[-1%; -5%], p=0.021) and the blank control arm (mean decrease in distrust: -4% [-1%; -8%], p=0.022).No statistically significant differences were observed between the active and the blank control arms. Receiving basic information on ML-based CDSS in hospital psychiatry may increase patient trust in such systems.

Downstream Effects of Market Changes on Inhalers: Impacts on Individuals With Chronic Lung Disease.

COPD and asthma are two of the most common chronic lung diseases, affecting over 545 million people globally and 34 million in the United States. Annual health care costs related to chronic lung disease are estimated at €380 billion in the European Union, and $24-$50 billion in the United States averaging to $4,000 in out-of-pocket costs per person in the U.S. A full-text literature search was conducted for English publications between January 1, 2005-March 18, 2024. It returned over 5,000 publications that were further narrowed using key search words, resulting in 172 peer-reviewed articles. Using their experience and subject expertise, the authors further narrowed the peer-reviewed articles to 55 that were in their opinion relevant. Also, 38 recently published industry reports and news articles specific to downstream effects of inhaler market changes and the future impact were included. The literature suggests that individuals with chronic lung disease face increased challenges with access to inhaled medication due to rising medication costs, discontinuation of branded medications, introduction of generic medications not covered by insurance, exclusionary preferred drug list tactics that force health care providers into non-medical switching of medication or devices, and ongoing medication shortages. Providers experience ongoing hurdles in prescribing appropriate inhaled medications for individuals with chronic lung disease, including increased time and costs spent on administrative tasks due to inhaler denials, a loss of patient trust, and limits on their ability to prescribe appropriate inhaled medication for individuals with chronic lung disease.

Collaborative and integrated working between general practice and community pharmacies: A realist review of what works, for whom, and in which contexts.

Collaborative and integrated (C + I) working between general practice and community pharmacies has the potential to increase accessibility to services, improve service efficiency and quality of care, and reduce health care expenditures. Many existing studies report challenges and complexities inherent in establishing effective C + I ways of working. The aim of our review is to understand how, when and why working arrangements between General Practitioners (GP) and Community Pharmacists (CP) can provide the conditions necessary for effective communication, decision-making, and C + I working. We conducted a realist review to explore the key contextual factors and mechanisms through which GP-CP C + I working may be achieved. MEDLINE, Embase, CINAHL, PsycINFO, HMIC, Web of Science, IBSS, ASSIA, Sociological Abstracts, Sociology Database and the King's Fund Library Database were searched for articles and grey literature published between January 2000 and April 2022. A total of 136 documents were included in the final synthesis. Our findings highlight the importance of mutually beneficial remuneration models to support effective integration of services; supportive organisational cultures and values; flexible and agile IT systems/technologies; adequate physical infrastructure and space design to support multidisciplinary teamworking; the importance of establishing patient's trust in collaborative processes between GP-CP; and the need to acknowledge, support and utilise effective triadic relationships. Our research generates new insights regarding how, why and in which contexts C + I working can be achieved between GPs and CPs. The findings of our review can be used to inform future policy, research and clinical practice guidelines for designing and delivering C + I care.

Exploring Patient Empowerment in Major Depressive Disorder: Correlations of Trust, Active Role in Shared Decision-Making, and Symptomatology in a Sample of Italian Patients.

Background/Objectives: Empowerment in medicine and psychiatry involves patients gaining control over health-related decisions, improving treatment adherence, outcomes, and satisfaction. This concept is especially significant in psychiatric care due to the complex challenges of mental health conditions, including stigma and impairment of emotional and cognitive functioning. We aim to investigate the correlations between patient trust, decision-making involvement, symptom severity, and perceived empowerment among individuals with Major Depression. Methods: Patients with Major Depressive Disorder were recruited in the "Policlinico G. Rodolico" psychiatry outpatient clinic from November 2022 to June 2023. Inclusion criteria: ages 18-65, ability to consent, stable condition, psychiatric medication history, and recent consultation. Exclusion criteria: psychotic features, bipolar disorder, substance abuse, high suicide risk, and severe comorbidities. Measures included the User Scale for Measuring Empowerment in Mental Health Services (SESM), Trust in Oncologist Scale (TiOS), Clinical Decision-Making Style for Patients (CDMS-P), and Hamilton Depression Rating Scale (HAM-D). Analysis used Kendall's Tau correlation and Two-One-Sided Tests procedure. Results: Seventy-three patients completed the study. No relationship was found between decision-making involvement and perceived empowerment (τ = -0.0625; p = 0.448), or between trust in psychiatrists and empowerment (τ = 0.0747; p = 0.364). An inverse correlation existed between patient involvement in therapy management and trust (τ = -0.2505; p = 0.002). Depression severity inversely correlated with empowerment (τ = -0.2762; p = <.001), but not with trust or decision-making involvement. Conclusions: The lack of significant correlations suggests that decision-making involvement and trust alone may not suffice to enhance empowerment. Trust may encourage patient passivity, while skepticism might drive active involvement. Higher empowerment is associated with less depressive symptoms, highlighting its potential connection with patient outcomes.

Shaping the future: perspectives on the Integration of Artificial Intelligence in health profession education: a multi-country survey

BackgroundArtificial intelligence (AI) is transforming health profession education (HPE) through personalized learning technologies. HPE students must also learn about AI to understand its impact on healthcare delivery. We examined HPE students’ AI-related knowledge and attitudes, and perceived challenges in integrating AI in HPE.MethodsThis cross-sectional included medical, nursing, physiotherapy, and clinical nutrition students from four public universities in Jordan, the Kingdom of Saudi Arabia (KSA), the United Arab Emirates (UAE), and Egypt. Data were collected between February and October 2023 via an online survey that covered five main domains: benefits of AI in healthcare, negative impact on patient trust, negative impact on the future of healthcare professionals, inclusion of AI in HPE curricula, and challenges hindering integration of AI in HPE.ResultsOf 642 participants, 66.4% reported low AI knowledge levels. The UAE had the largest proportion of students with low knowledge (72.7%). The majority (54.4%) of participants had learned about AI outside their curriculum, mainly through social media (66%). Overall, 51.2% expressed positive attitudes toward AI, with Egypt showing the largest proportion of positive attitudes (59.1%). Although most participants viewed AI in healthcare positively (91%), significant variations were observed in other domains. The majority (77.6%) supported integrating AI in HPE, especially in Egypt (82.3%). A perceived negative impact of AI on patient trust was expressed by 43.5% of participants, particularly in Egypt (54.7%). Only 18.1% of participants were concerned about the impact of AI on future healthcare professionals, with the largest proportion from Egypt (33.0%). Some participants (34.4%) perceived AI integration as challenging, notably in the UAE (47.6%). Common barriers included lack of expert training (53%), awareness (50%), and interest in AI (41%).ConclusionThis study clarified key considerations when integrating AI in HPE. Enhancing students’ awareness and fostering innovation in an AI-driven medical landscape are crucial for effectively incorporating AI in HPE curricula.

THE MEDIATING ROLE OF EMOTIONAL SATISFACTION AND PATIENT TRUST IN THE RELATIONSHIP BETWEEN SERVICE QUALITY AND REVISIT INTENTION

Revisit intention is an interesting issue in the field of marketing and is important in the service industry because maintaining customer loyalty in the long term is the success key of a business. Measuring and predicting revisit intention is considered as one of the important indicators of the achievement of service companies. This study aims to investigate the effects of service quality on the revisit intention of patients to hospitals, as well as the mediating role of emotional satisfaction and patient trust on the relationship between service quality and revisit intention. The sample used in this study amounted to 200 respondents who were patients with non BPJS Health insurance who visited at least three times in 2021-2023. The sampling technique in this study used non probability sampling technique (purposive sampling). The method used in this study is Structural Equation Modeling (SEM) and using smart PLS 3.2.9 software. The findings of this study shows that service quality does not have a direct impact on revisit intention of non-BPJS Health patients, but rather an indirect impact through emotional satisfaction and patient trust. Emotional satisfaction mediates the relationship between service quality and revisit intention, while patient trust also plays a role. Based on the analysis of mediation influence, emotional satisfaction and patient trust play a role in full mediation (indirect-only).

Cultural Competency in Dental Practice: Navigating the Experiences and Perspectives of Dentists in South Punjab, Pakistan.

Introduction Cultural competence in healthcare embraces the principles of equal access and nondiscriminatory services in healthcare delivery. Dentists as significant healthcare professionals should definitely have the skills needed to diagnose and treat patients' conditions, but it is crucial to also address nontechnical skills such as cross-cultural communication, the ability to empathize, and inclusive-mindedness. Globally, cultural competency training has been included in healthcare educational programs; however, national practices reportedly have revolved around patients' clinical competencies and thus entailed overlooking the cultural dimensions of dental education that include diverse sociocultural factors that influence how dental practices are taught, learned, and delivered. These dimensions encompass elements such as language, communication styles, attitudes toward healthcare, and culturally specific oral health beliefs and behaviors. Therefore, the aim of this study is to explore the experiences and perspectives of dentists practicing in South Punjab regarding cultural competency. Methodology The study employed a qualitative phenomenological approach. Data was collected through purposive sampling techniques utilizing semistructured interview guides. The participants recruited were licensed dentists practicing in dental institutions in South Punjab, Pakistan. A total of 18 dentists were recruited in the study. The interviews were focused on the different aspects of cultural competency by exploring the perspectives of dentists. Thematic analysis was carried out utilizing the Bran and Clarkes framework to categorize data into key themes and subthemes utilizing inductive coding. Results The study revealed that dentists lack awareness and understanding of cultural competency; they also faced significant problems due to limited cultural proficiency while dealing with diverse patients. Major challenges included inadequate training, communication barriers, and cultural bias in dentists while dealing with such diverse populations. Patients recognized the benefits of cultural competency and highlighted facilitators like institution support, peer support, mentorship support, and patient trust.Participants suggested incorporating cultural competency in dentistry curricula, continuous professional development, and community outreach programs for the development of cultural competency among dentists. Conclusions The study highlighted perspectives and experiences of dentists regarding cultural competency. The findings demonstrated key problems due to limited or lack of cultural proficiency that included communication and language barriers and unconscious cultural bias among dentists. The study also highlighted facilitators of cultural competency like institutional facilitation, mentoring opportunities from peers and seniors, and patient trust. Facilitating cultural competency among dentists may result in improved patient satisfaction, enhanced patient care, and an increase in compliance, hence overall enhancing the quality of care.

A Survey of Patient Utilization and Trust of Emergency Medical Services

Little is known about patients’ decisions to come to the Emergency Department (ED) via emergency medical services (EMS) versus privately owned vehicle (POV); this is problematic as trust in EMS systems impacts patient care decisions. Furthermore, no studies exist that evaluate patients’ trust of the EMS system as it relates to a patient’s race. Patients completed a multi-method survey during their ED stay. Quantitative data included: patient demographics (age, gender, race) income, insurance status, previous medical training, highest level of education, self-reported medical and social history, number of ED visits in the past three months, and two scales assessing trust and empathy: the Group-Based Medical Mistrust Scale and the Jefferson Scale. Characteristics of patients who came to the ED via EMS versus POV were shown. A Wilcoxon signed rank test described differences in EMS trust scales by race. Logistic regression showed which factors contribute to the decision of EMS or POV. Qualitative comments described patients’ rationale for EMS versus POV. 23/72 (31.94%) patients utilized EMS transport and 49/72 (68.06%) utilized POV. 59.09% of patients self-identified as Black and 40.91% self-identified as White. The Group-Based Medical Mistrust Scale found Black patients had less trust in the EMS system (p=0.0001), while the Jefferson Scale of Patient Perception of Physician Empathy showed no significant difference in patient perceptions of EMS provider empathy (p=0.608). Logistic regression indicated that age predicted the use of EMS over POV (p&lt;0.001). Lack of access to POV, physical limitations, cost, speed, perception of emergency, and fear were identified as reasons that supportg patients’ decision to use EMS or POV. Many factors can influence patients’ transportation decisions and this study highlights trust, age, and other social and economic factors. These findings could inform policy decisions and ensure emergency care systems that are accessible for all patients.

Role of online health communities in patient compliance: a social support perspective

PurposeOnline health communities (OHC) can transform the healthcare industry, particularly in developing economies. Technology advancement and increased health literacy pave the way for these communities to become powerful tools for empowering patients. The purpose of this study was to empirically validate the linkages between social support and how it overarchingly influences patient compliance. Following social support theory, this study delineates how support from the community affects the patient–physician relationship (PERP) and consequently patient compliance regarding the treatment plan. This study also invents the role of patient trust in an OHC in moderating the relationship between PERP and engagement.Design/methodology/approachThis paper is based on social support and empowerment theories to investigate the importance of social support in improving patients’ health behaviours and health outcomes via patient empowerment, patient engagement and patient compliance. The authors surveyed users from three Facebook cancer communities in India to collect data. The authors used partial least squares structured equation modelling and necessary condition analysis (NCA) with 265 participants to support the proposed model.FindingsThe result demonstrates that PERP is a crucial factor for patient engagement in OHC, and patient engagement has a significant effect on patient compliance. The results also showed that trust was a significant moderator between PERP and engagement. The NCA analysis shows all the relationships are significant; however, emotional support is not a necessary condition for PERP.Research limitations/implicationsBy empowering cancer patients and enabling them to meet their emotional and informational needs through OHCs, the study model can aid in the development of solutions that will improve compliance with their treatment in an emerging economic context. The findings indicate the potential chain reaction of social support and PERP in online cancer health communities. This study also contributes to quantifying the social impacts of online healthcare services and how to enhance the healthcare compliance framework.Originality/valueThis study combines social support and empowerment theory with patient, physician, and technology to provide a fine-grained picture of PERP in OHC. It explains how social support in OHC promotes self-care behaviour. This linkage validation enables readers and the community at large to gain a more nuanced understanding of how social support – through PERP, engagement and trust – enables patient compliance using primary data.