Patient Trust Research Articles

The state of (mis) trust: Human-centered technology development & implementation in intensive mental health settings

Innovative technology-based solutions in mental healthcare promise significant improvements in care quality and clinical outcomes. However, their successful implementation is profoundly influenced by the levels of trust patients hold toward their treatment providers, organizations, and the technology itself. This paper delves into the complexities of building and assessing patient trust within the intensive mental health care context, focusing on inpatient settings. We explore the multifaceted nature of trust, including interpersonal, institutional, and technological trust. We highlight the crucial role of therapeutic trust, which comprises both interpersonal trust between patients and providers, and institutional trust in treatment organizations. The manuscript identifies potential key barriers to trust, from sociocultural background to a patient's psychopathology. Furthermore, it examines the concept of technological trust, emphasizing the influence of digital literacy, socio-economic status, and user experience on patients' acceptance of digital health innovations. By emphasizing the importance of assessing and addressing the state of trust among patients, the overarching goal is to leverage digital innovations to enhance mental healthcare outcomes within intensive mental health settings.

Privacy in Community Pharmacies in Saudi Arabia: A Cross-Sectional Study.

Privacy in healthcare is a fundamental right essential to maintain patient confidentiality and trust. Community pharmacies in Saudi Arabia (SA) play a critical role in the healthcare system by providing accessible services and serving as initial points of contact for medical advice. However, the open nature of these settings poses significant challenges in maintaining patient privacy. This cross-sectional study used electronic surveys distributed across various online platforms. The target sample included Saudi adults, with a sample size of 385 participants to achieve 80% statistical power at a 95% confidence interval. The survey comprised demographic questions and sections evaluating perceptions of privacy, the importance of privacy, and personal experiences regarding privacy in community pharmacies. Descriptive statistics and logistic regression models were used for the analysis. A total of 511 responses were obtained. The mean age was 33.5 years, with an almost equal distribution of males (49.71%) and females (50.29%). Most participants held a bachelor's degree or higher (78.67%). Privacy perceptions varied, with only 9.0% strongly agreeing that there was a private space for consultations, while 64.0% felt that the design of community pharmacies did not adequately consider patient privacy, and 86.9% reported that conversations could be overheard. Privacy concerns were notable, with almost one-half of the participants (47.6%) having concerns about privacy and 56.6% doubting the confidentiality of their health information. Moreover, 17.6% reported being asked for unnecessary personal information when buying medication, and 56.2% admitted to avoiding discussing a health problem with the pharmacist due to privacy concerns. Experiences of privacy breaches were reported by 15.7% of respondents. Logistic regression analysis revealed that the availability of private space in the pharmacy and patients feeling that the pharmacy respects their privacy were associated with a lower likelihood of avoiding discussions with pharmacists due to privacy concerns (OR = 0.758, CI = 0.599-0.0957 and OR = 0.715, CI = 0.542-0.945 respectively) Conversely, greater privacy concerns and previous privacy breaches significantly increased the likelihood of avoiding discussions with pharmacists in the community pharmacy (OR = 1.657, CI = 1.317-2.102 and OR = 4.127, CI = 1.886-9.821 respectively). This study highlights the significant concerns regarding privacy practices in community pharmacies in SA. Thus, there is a need for standards to improve privacy in community pharmacies, such as mandating the need for private consultation areas and enhanced staff training on handling privacy-related issues. Addressing the issue of privacy is crucial for maintaining patient trust, improving healthcare service quality, and ensuring effective patient-pharmacist interactions.

Patient and Caregiver Perspectives on Gender Disparity in Chronic Kidney Disease: Questionnaire Survey, Based on an Interview Study

Introduction: Chronic kidney disease (CKD) in stages 3–5 without albuminuria occurs more often in women than in men; however, most patients initiating and receiving kidney replacement therapy are men. Sex-determined biological factors and gender-related aspects both likely account for this discrepancy. Patient opinions on gender-related discrepancies in kidney care have not been investigated. Methods: Building upon the findings of semi-structured interviews previously conducted with CKD patients and their caregivers, two questionnaires were developed to investigate patient behavior and opinions relating to gender and CKD. These questionnaires containing 39 items were distributed to eight outpatient clinics in Austria. Responses were descriptively analyzed and compared between genders, as well as between age-groups and CKD stages. Results: Questionnaires from 783 patients and 98 caregivers were included in the analysis and covered health awareness and self-management of disease, the impact of gender roles and gender equality, and patient autonomy and trust in the health-care system. A total of 56.1% of men patients and 63.1% of women patients found that women were better at looking after their health compared to men (41.1%/34.3% no difference, 2.8%/2.6% men better). A total of 95.4% of men patients, 95.0% of women patients, 100% of men caregivers, and 95.5% of women caregivers stated that all patients with kidney disease were treated completely equally, irrespective of gender. Conclusion: Neither the patients nor the caregivers stated gender-determined treatment decisions in CKD care. Both men and women however agreed that women are better at maintaining their own health and excel in disease self-management.

Patient trust in nurses: exploring the relationship with care quality and communication skills in emergency departments

BackgroundPatient trust in medical staff is an important ethical issue that can influence various patient behaviors and attitudes, such as seeking healthcare, sharing confidential information, accepting treatment, and adhering to recommendations. This study aimed to assess patient trust in nurses and its relationship to the quality of care and communication skills of nurses in emergency departments.MethodsThis descriptive correlational study was conducted in 2023 in the emergency departments of medical training centers of Ardabil University of Medical Sciences, Iran. A total of 378 patients was selected using a quota sampling method. Data were collected using three valid and reliable tools: the Quality Patient Care (QUALPAC) scale, the Health Communication Feedback Questionnaire (HCFQ), and the Trust in Nurses Scale (TNS).The data were analyzed using independent t-tests, one-way analysis of variance, and Pearson's correlation coefficient tests using SPSS version 24.ResultsThe majority of patients (99.2%) rated nurses' communication skills as moderate, with none rating them as poor. The average scores were 27.59 ± 2.76 for patient trust in nurses, 72.43 ± 3.30 for nurses' communication skills, and 198.30 ± 14.60 for the quality of nursing care. A significant correlation was found between patient trust in nurses and the overall quality of nursing care (r = 0.256, P < 0.001) as well as its dimensions. However, there was no significant relationship between patient trust in nurses and patient's perception of the nurses' communication skills (r = 0.046, P = 0.369).ConclusionsThe findings indicate that patient trust in nurses is positively and significantly associated with the perceived quality of nursing care. As the quality of care improves, patient trust in nurses also increases. Therefore, nurses should focus on providing high-quality care to enhance patient trust.

A cross-sectional study on Chinese senior nurses’ knowledge and attitudes toward nurse practitioners

BackgroundNurses represent China’s largest healthcare workforce. Nurse practitioners (NPs) play an essential role in providing cost-effective quality healthcare and bridging the healthcare gaps. However, NPs are relatively new in China, and limited evidence exists on senior nurses’ knowledge of and attitudes toward NPs.AimsThis study aimed to describe senior nurses’ knowledge, attitudes, and perceived facilitators and barriers of NPs in China using a self-designed, culturally adaptive questionnaire.MethodsA cross-sectional online survey was conducted among 412 senior nurses in Hunan Province from December 2021 to January 2022. The Knowledge and Attitudes towards Nurse Practitioners Questionnaire (KANPQ) was developed based on the Delphi method, which included 30 items under three dimensions: knowledge (22 items), attitude (2 items), and perceived facilitators and barriers (6 items). Multivariate linear regression was conducted to explore factors associated with senior nurses’ attitudes toward NPs.ResultsThe average KANPQ knowledge score was 68.56 ± 22.69, with 55.09%,10.20%, and 34.71% of participants showing good, moderate, and poor levels of knowledge, respectively. The average KANPQ attitude score was 7.79 ± 1.72, with 65.3% thinking NPs were necessary and 69.9% expressing willingness to become NPs. Nurses with higher professional titles and better knowledge of NPs had more positive attitudes toward NPs. The three most frequently mentioned barriers to NP implementation were patient trust, laws, and education.ConclusionsApproximately one-third of senior nurses have poor knowledge and negative attitudes toward NPs, indicating much room for improvement. Strengthening the education and training of NPs, especially among those with lower professional titles and lower knowledge of NPs, may help improve their knowledge and attitudes toward NPs. In addition, continuous political, social, economic, and individual efforts are needed to facilitate the successful development of NPs in China.

The Impact of Legalizing Medical Aid in Dying on Patient Trust: A Randomized Controlled Survey Study.

Background: Some commentators and several professional medical associations have expressed concern that legalizing medical aid in dying ("MAID") will undermine patient trust in the medical profession, particularly among historically disadvantaged patient populations. While this concern remains influential, it has been subject to limited empirical scrutiny. Objectives: This study aims to empirically assess whether MAID legalization undermines patient trust, with considerations of potential trust/demographic correlations in marginalized and minority patient populations. Design: We developed an RCT survey study that assessed patients' trust in the medical professional using the Abbreviated Wake Forest Scale ("AWFS"). Two versions of the survey were used, each distributed at random to half of participants. One survey version included notification that MAID had been legalized in the jurisdiction where patients were receiving care and the other version omitted this information. Setting/Population: We surveyed capacitated, English-speaking adult patients who were receiving care at a not-for-profit, 912-bed academic and research hospital in Washington, D.C. Of those invited to participate, 494 patients (63.2%) completed all AWFS questions, and 70.1% identified as Black or African American and 32.9% as having a physical or mental disability. Conclusions: Most of the participants not notified that MAID was legal in DC were not aware of this fact (92.5%). Patients who were notified that MAID was legal in DC were significantly more likely to report approval of MAID legalization (p = 0.0410), but showed no significant difference in AWFS score for trust in their physicians. The study did not substantiate concerns that legalizing medical aid in dying undermines patient trust in the medical profession.

An Efficient Image Encryption Scheme for Medical Image Security

In the contemporary landscape of digital healthcare, the confidentiality and integrity of medical images have become paramount concerns, necessitating the development of robust security measures. This research endeavors to address these concerns by proposing an innovative image encryption scheme tailored specifically for enhancing medical image security. The proposed scheme integrates a sophisticated blend of symmetric and asymmetric encryption techniques, complemented by a novel key management system, to fortify the protection of medical image data against unauthorized access and malicious tampering. The proposed DNA-based encryption algorithm leverages the unique properties of DNA encoding to securely scramble image data, providing an added layer of protection. By utilizing DNA sequences in the encryption and decryption processes, the scheme achieves a high level of data confusion and diffusion, significantly enhancing security. The efficacy of the proposed encryption scheme is validated through comprehensive experimental evaluations, which demonstrate its proficiency in ensuring data security while maintaining computational efficiency. The scheme's compatibility with existing medical imaging systems is also examined, affirming its seamless integration into contemporary healthcare infrastructures. This research contributes to the advancement of medical image security by proposing an efficient encryption scheme that strikes a balance between stringent security requirements and practical implementation considerations. The primary contributions include the development of a DNA-based encryption algorithm and a novel key management system, both of which significantly enhance the security of medical images. This research contributes to the advancement of medical image security by proposing an efficient encryption scheme that strikes a balance between stringent security requirements and practical implementation considerations. By safeguarding the confidentiality and integrity of medical images, the proposed scheme empowers healthcare providers to uphold patient privacy and trust in the digital age. Experimental results show that this approach ensures robust encryption without compromising image quality, making it suitable for sensitive medical imaging applications.

The impact of trust, comfortability, usability and technophobia factors on acceptance of health information technology

In the contemporary landscape of healthcare, the rapid integration of digital technologies is reshaping traditional practices. As healthcare systems increasingly embrace digitalization, there arises a critical need to comprehend the dynamic and ever-evolving role played by Information and Communication Technologies (ICTs). Amidst the rapid digitization of healthcare systems, understanding the evolving role of Information and Communication Technologies (ICTs) is paramount. This study explores the impact of Information and Communication Technologies (ICTs) on healthcare, with a focus on Health Information Technology (HIT) and its role in enhancing patient-centered care. Specifically, the research centers on Personal Health Records (PHRs), which empower patients to control their health information securely. The study aims to identify key features influencing patients’ behavioral intention to adopt HIT, utilizing a structured questionnaire and a conceptual framework based on the Technology Acceptance Model (TAM). Feature selection analysis, conducted using the Weka tool, employed various classifiers to predict users’ perceptions and behavioral intentions towards HIT adoption. Results highlight the significance of trust, comfort, usefulness, and technophobia in shaping patients’ acceptance of HIT, with Random Forest and Bayes Net classifiers emerging as key predictors. This research provides valuable insights into the critical factors driving patients’ acceptance of HIT, contributing to the ongoing discourse on the adoption of healthcare technologies.

Innovation and challenges of artificial intelligence technology in personalized healthcare

As the burgeoning field of Artificial Intelligence (AI) continues to permeate the fabric of healthcare, particularly in the realms of patient surveillance and telemedicine, a transformative era beckons. This manuscript endeavors to unravel the intricacies of recent AI advancements and their profound implications for reconceptualizing the delivery of medical care. Through the introduction of innovative instruments such as virtual assistant chatbots, wearable monitoring devices, predictive analytic models, personalized treatment regimens, and automated appointment systems, AI is not only amplifying the quality of care but also empowering patients and fostering a more interactive dynamic between the patient and the healthcare provider. Yet, this progressive infiltration of AI into the healthcare sphere grapples with a plethora of challenges hitherto unseen. The exigent issues of data security and privacy, the specter of algorithmic bias, the requisite adaptability of regulatory frameworks, and the matter of patient acceptance and trust in AI solutions demand immediate and thoughtful resolution .The importance of establishing stringent and far-reaching policies, ensuring technological impartiality, and cultivating patient confidence is paramount to ensure that AI-driven enhancements in healthcare service provision remain both ethically sound and efficient. In conclusion, we advocate for an expansion of research efforts aimed at navigating the ethical complexities inherent to a technology-evolving landscape, catalyzing policy innovation, and devising AI applications that are not only clinically effective but also earn the trust of the patient populace. By melding expertise across disciplines, we stand at the threshold of an era wherein AI's role in healthcare is both ethically unimpeachable and conducive to elevating the global health quotient.

Shared patient information and trust: a qualitative study of a national eHealth system

BackgroundIn Norway, as in other countries, national eHealth systems, such as the Summary Care Record (SCR), have been implemented to improve the collaboration around patients by sharing patient information between health professionals across healthcare institutions and administrative levels. Although widely implemented across the health and care services in Norway, evaluations of the SCR indicate less use than expected. There is a need for analysis that lays out the visions and expectations of the SCR and contrasts these with detailed observations of use in everyday health professional work. This study adds to the eHealth research field by exploring this reality.MethodThis paper has a qualitative design with an ethnographic approach, including participant observation, qualitative interviews, and a document review. Qualitative individual interviews with 22 health professionals and six weeks of participant observation were conducted, and eight documents were reviewed. The field notes and the interview-transcriptions were analyzed following a stepwise-deductive induction analysis.ResultsThe document review identified the expectations and visions of the SCR, including an underlying assumption of trust in shared patient information. However, this assumption is implicit and not recognized as a crucial element for success in the documents. In our observation and interview data, we found that health professionals do not necessarily trust information in the SCR. In fact, several procedures and routines to assess the trustworthiness of SCR information were identified that complicate and disturb the expected use. In our analysis, two main themes characterize the health professionals' handling of the SCR: adapting to workflow and dealing with uncertainty.ConclusionOur study illustrates that unconditional trust in shared patient information is an implicit assumption in SCR policy documents, but in their everyday work health professionals do not necessarily unconditionally trust shared patient information. Rather, sharing patient information through technology, such as the SCR, requires of health professionals to critically assess the digital information. The information in the SCR, as all sources of information presented to health professionals, becomes an item for their constant trust-work. Our study is of value to policymakers, health information systems developers, and the field of practice both nationally and internationally.

Barriers to the adoption of routine surgical video recording: a mixed-methods qualitative study of a real-world implementation of a video recording platform

BackgroundRoutine surgical video recording has multiple benefits. Video acts as an objective record of the operative record, allows video-based coaching and is integral to the development of digital technologies. Despite these benefits, adoption is not widespread. To date, only questionnaire studies have explored this failure in adoption. This study aims to determine the barriers and provide recommendations for the implementation of routine surgical video recording.Materials and methodsA pre- and post-pilot questionnaire surrounding a real-world implementation of a C-SATS©, an educational recording and surgical analytics platform, was conducted in a university teaching hospital trust. Usage metrics from the pilot study and descriptive analyses of questionnaire responses were used with the non-adoption, abandonment, scale-up, spread, sustainability (NASSS) framework to create topic guides for semi-structured interviews. Transcripts of interviews were evaluated in an inductive thematic analysis.ResultsEngagement with the C-SATS© platform failed to reach consistent levels with only 57 videos uploaded. Three attending surgeons, four surgical residents, one scrub nurse, three patients, one lawyer, and one industry representative were interviewed, all of which perceived value in recording. Barriers of ‘change,’ ‘resource,’ and ‘governance,’ were identified as the main themes. Resistance was centred on patient misinterpretation of videos. Participants believed availability of infrastructure would facilitate adoption but integration into surgical workflow is required. Regulatory uncertainty was centred around anonymity and data ownership.ConclusionBarriers to the adoption of routine surgical video recording exist beyond technological barriers alone. Priorities for implementation include integration recording into the patient record, engaging all stakeholders to ensure buy-in, and formalising consent processes to establish patient trust.

Potential US Health Care Savings Based on Clinician Views of Feasible Site-of-Care Shifts

Shifting care to alternative sites when clinically appropriate may be associated with reduced US health care spending, improved access, and, in some cases, improved care outcomes. To fill 2 main gaps in the current literature on site-of-care shifts: (1) understanding the clinician perspective on appropriateness of alternative care sites, given the central role they play in referrals and patient trust and (2) considering all potential sites where care could shift and calculating net savings potential. In this survey study, physicians (MDs and DOs), nurse practitioners, physician assistants, nurse anesthetists, radiology and imaging technicians, and psychologists were surveyed from September 17 to November 22, 2021, about potential shifts of care from the hospital setting to alternative sites. Participants were selected by the survey firm Intellisurvey to provide broad representation across all specialties of interest. A minimum of 34 clinicians responded to each question. Data were analyzed from April 2022 through October 2023. More than 5000 individual diagnostic and procedural codes were reviewed and sorted into 312 distinct care activities by an expert panel of physicians. Survey respondents were then provided with the 2019 claims-based distribution across sites of care for each care activity and were asked, "based on your clinical judgment, what portion of [care activity] could safely occur in each of the following sites of care, without compromising clinical outcomes?" Based on clinician-reported distributions, the total potential shift of volume from hospital-based settings to alternative sites and the associated net savings were estimated. Survey respondents included 1069 practicing clinicians (386 female [36.1%]; mean [SD] years since residency of physicians, 21.0 [9.7] years; mean [SD] age of nonphysicians, 45.3 [9.4] years) across specialties, all of whom practiced more than 20 clinical hours per week. There were 794 physicians (74.3%), and the remaining 275 respondents were midlevel professionals, such as physician assistants. Among 312 care activities surveyed, respondents indicated that 10.3 percentage points (95% CI, 10.0-10.5 percentage points) of commercial and 10.9 percentage points (95% CI, 10.7-11.1 percentage points) of Medicare volume currently taking place in hospital-based settings could shift to alternative sites with today's technology without compromising clinical outcomes. Across the entire US health care system, these shifts could be associated with a reduction in overall health care consumption spending ($3 562 339 000 000 000) by approximately $113.8 billion ($113 767 446 087 174 [3.2%]) to $147.7 billion ($147 661 672 284 263 [4.1%]) annually. In this study, a substantial net savings opportunity was estimated. However, realizing this potential will require ongoing alignment among organizations, clinicians, and policymakers to overcome barriers to these shifts.

How is diagnostic uncertainty communicated and managed in real world primary care settings?

BackgroundManaging diagnostic uncertainty is a major challenge in primary care due to factors such as the absence of definitive tests, variable symptom presentations and disease evolution. Maintaining patient trust during a period of investigative uncertainty, whilst minimising scope for diagnostic error is a challenge. Mismanagement can lead to diagnostic errors, treatment delays, and suboptimal patient outcomes.ObjectiveOur aim was to explore how UK primary care physicians (GPs) address and communicate diagnostic uncertainty in practice.DesignThis qualitative study used video and audio-recordings. Verbatim transcripts were coded with a modified, validated tool to capture GPs’ actions and communication in primary care consultations that included diagnostic uncertainty. The tool includes items relating to advice regarding new symptoms or symptom deterioration (sometimes called ‘safety netting’). Video data was analysed to identify GP and patient body postures during and after the delivery of the management plan.ParticipantsAll patient participants had a consultation with a GP, were over the age of 50 and had (1) at least one new presenting problem or (2) one persistent problem that was undiagnosed.ApproachData collection occurred in GP-patient consultations during 2017–2018 across 7 practices in UK during 2017–2018.Key resultsGPs used various management strategies to address diagnostic uncertainty, including (1) symptom monitoring without treatment, (2) prescribed treatment with symptom monitoring, and (3) addressing risks that could arise from administrative tasks. GPs did not make management plans for potential treatment side effects. Specificity of uncertainty management plans varied among GPs, with only some offering detailed actions and timescales. The transfer of responsibility for the management plan to patients was usually delivered rather than negotiated, with most patients confirming acceptance before concluding the discussion.ConclusionsWe offer guidance to healthcare professionals, improving awareness of using and communicating management plans for diagnostic uncertainty.

Polish adaptation, psychometric properties and validation of Physician’s Trust in the Patient Scale (PTPS)

Mutual trust is considered one of the critical aspects of building a successful doctor-patient relationship. Albeit patient trust in physicians has been widely explored by researchers, physician trust in patients remains neglected, which is reflected by the lack of existing tools to assess this construct. Therefore, we aimed to validate and adapt Thom’s Physician’s Trust in the Patient Scale (PTPS) in Polish. We conducted a survey-based study among 307 medical doctors. To determine the factor structure of the scale, both exploratory (EFA) and confirmatory factor analysis (CFA) were performed. The two-factor solution was established for the scale in accordance with the original version. To determine the internal reliability and consistency of the scale, we measured Cronbach’s alpha, corrected-item total correlation, and discrimination indices—all of them obtained very good or excellent values. Estimates of convergent and discriminant validity reached all suggested thresholds. The scale also performed well in theoretical validity. Together, these findings suggest that the psychometric properties of the Polish adaptation and validation of PTPS are satisfactory and that the tool can find practical and scientific applications. We believe that the scale can substantially add to our understanding of building trust-based relationships and rapport between patients and physicians.

Stuttering Impact and Patient Trust in Indian Health Care: A Cross-Sectional Study

Purpose: This study aims to determine the relationship between (a) stuttering impact and trust in the health care system and (b) stuttering impact and trust in physicians among persons who stutter in India. Method: This quantitative study utilized cross-sectional electronic surveys to assess the experiences of 118 adults who stutter in India. The surveys queried (a) stuttering impact, (b) trust in the health care system, and (c) trust in physicians. Results: Stuttering impact is strongly negatively associated with trust in the health care system ( r = −.940, p ≤ .0001, R 2 = .885) and strongly negatively associated with trust in physicians ( r = −.941, p ≤ .0001, R 2 = .885). Controlling for age, gender, and income does not affect these relationships. Conclusions: The strongly significant associations found in this study between stuttering impact and trust call attention to how interrelated stuttering experiences are with trust in health care. Speech-language pathologists around the globe may wish to discuss how stuttering might affect health care experiences with their clients who stutter to build rapport, to advocate for people who stutter, and to better support their health professional colleagues.

Impact of Patient Education on Establishing Trust as the Medical Student Provider: A Student Run Free Clinic Experience

Background: Effective doctor-patient relationships are crucial for quality healthcare, and trust is central to this dynamic. Trust in healthcare comprises competence, empathy, communication, and shared decision-making. Patient education sessions offer a platform to enhance patient trust, especially amongst novice providers. This study investigates the impact of patient education sessions led by medical students on patient trust within the context of a student-run free clinic. Methods: At our student-run free clinic, we conducted a cross-sectional survey to collect patient data, including background information, trust in healthcare, and opinions on education sessions at a student-run free clinic. Results: Amongst the enrolled 24 participants, the demographics revealed a diverse racial composition, with a significant portion having not completed high school and the majority being either unemployed or on disability. Following attendance at patient education sessions, a high percentage of participants reported positive experiences, including improved rapport with medical student providers and a likelihood of returning for future services and following medication recommendations. Conclusion: This study highlights the significant role of patient education sessions in fostering trust between patients and providers, improving health behaviors, and enhancing the broader healthcare system's credibility. It demonstrates how such sessions empower patients, leading to better medication adherence and timely medical assistance seeking, while also suggesting their potential for implementation across various healthcare settings to improve patient engagement and healthcare services.

Quackery: A Major Persisting Issue in the Dental Profession of Nepal

Background: Quackery in the dental profession is a significant and persistent issue in Nepal, particularly in urban areas like Hetauda city. This practice involves the provision of dental services by individuals lacking formal education, training, or licensing, posing serious risks to patient health and safety. Objective: This study aims to assess the prevalence of quackery in Hetauda city, Nepal, and its implications for dental care quality and patient safety. It also seeks to understand the reasons behind patients’ continued use of unlicensed dental practitioners and to provide recommendations for addressing this issue. Methods: A cross-sectional study was conducted in 25 dental clinics across Hetauda city. Data collection included structured interviews with licensed dental practitioners, patient surveys, and observational assessments of clinic operations and infection control practices. Quantitative data were analyzed using descriptive statistics, while qualitative data from interviews were thematically analyzed. Results: The study found that 28% of the surveyed clinics employed unlicensed practitioners. Clinics with quacks exhibited significantly lower standards of care, including inadequate infection control and improper procedures. Only 30% of patients were aware of their dental care providers' qualifications, with many opting for quacks due to affordability and accessibility. A higher incidence of complications and adverse outcomes were reported among patients treated by unlicensed practitioners. Qualitative findings highlighted patient trust in quacks, frustrations of licensed practitioners, and regulatory gaps. Conclusion: Quackery remains a major issue in the dental profession in Hetauda city, Nepal. Addressing this problem requires a multifaceted approach, including improved regulation, increased public awareness, and stringent enforcement of licensing standards. Ensuring that all dental practitioners are properly qualified and licensed is essential for protecting patient safety and maintaining the credibility of the dental profession in Nepal.

Development of a Video Consultation Patient-Satisfaction Questionnaire (vCare-PSQ): A Cross-Sectional Explorative Study.

Since the COVID-19 pandemic, the use of video consultation (VC) in primary care has expanded considerably in many countries. VC and other telehealth formats are often touted as a solution to improved health care access, with numerous studies showing high satisfaction with this care format among health professionals and patients. However, operationalization and measurement of patient satisfaction with VC varies across studies and often lacks consideration of dynamic contextual factors (eg, convenience, ease-of-use, or privacy) and doctor-patient relational variables that may influence patient satisfaction. We aim to develop a comprehensive and evidence-based questionnaire for assessing patient satisfaction with VC in general practice. The vCare Patient-Satisfaction Questionnaire (the vCare-PSQ) was developed according to the COSMIN (Consensus-Based Standards for the Selection of Health Measurement Instruments) guidelines. To achieve our overall objective, we pursued three aims: (1) a validation analysis of an existing patient-satisfaction scale (the PS-14), (2) an assessment of extrinsic contextual factors that may impact patient satisfaction, and (3) an assessment of pertinent intrinsic and relational satisfaction correlates (eg, health anxiety, information technology literacy, trust in the general practitioner, or convenience). For validation purposes, the questionnaire was filled out by a convenience sample of 188 Danish adults who had attended at least 1 VC. Our validation analysis of the PS-14 in a Danish population produced reliable results, indicating that the PS-14 is an appropriate measure of patient satisfaction with VC in Danish patient populations. Regressing situational and doctor-patient relational factors onto patient satisfaction further suggested that patient satisfaction is contingent on several factors not measured by the PS-14. These include information technology literacy and patient trust in the general practitioner, as well as several contextual pros and cons. Supplementing the PS-14 with dynamic measures of situational and doctor-patient relational factors may provide a more comprehensive understanding of patient satisfaction with VC. The vCare-PSQ may thus contribute to an enhanced methodological approach to assessing patient satisfaction with VC. We hope that the vCare-PSQ format may be useful for future research and implementation efforts regarding VC in a general practice setting.

Hope and trust in diagnostic imaging contexts – Constituting technology and liminal patients

IntroductionThis study investigates patients’ experience of selected imaging examinations and how human experiences are transformed through technological mediation. MethodA qualitative study of patients' experiences during selected imaging examinations, centering on human-technology relations, was conducted.Data was gathered in two Danish hospitals, through semi-structured interviews and participant observations. The study included fifteen diagnostic imaging examination cases, distributed over three Computed Tomography (CT)-guided lung biopsy interventions, seven conventional CT examinations, and five Positron Emission Tomography CT examinations. The participating patients were undergoing investigation for cancer within Fast Track Cancer Referral Programs (FTCRP).The study has a philosophical approach to practice grounded in Postphenomenology and draws on anthropological studies of healthcare practice as its theoretical and analytical framework. ResultsDiagnostic imaging technologies were found to have existential implications creating hope and trust in patients. Patients demonstrated technological readiness, in their willingness to comply with examination criteria and the professional's instructions. The patient's primary concern was achieving a good examination result, for which they were prepared to push themselves beyond their usual limits.Participating in diagnostic imaging examinations may be viewed as a life crisis ritual, wherein patients are constituted as liminal beings, existing between healthy and sick. ConclusionsThe existential implications of an imaging examination were clear in terms of hope and trust. Hope is related to life and death in two temporal perspectives: A future hope of surviving cancer and a present hope of being cancer-free. Hope was linked to avoiding despair and rested on trusting oneself to technology, thus, forming a circle of interrelated concepts. Implications for practiceProfessionals need to recognize the patients’ liminal passings yet, unnoticed transformative and existential implications, to perform better patient-centered care.

Perceived Penalties for Sharing Patient Beliefs with Health Care Providers.

Health care interactions may require patients to share with a physician information they believe but is incorrect. While a key piece of physicians' work is educating their patients, people's concerns of being seen as uninformed or incompetent by physicians may lead them to think that sharing incorrect health beliefs comes with a penalty. We tested people's perceptions of patients who share incorrect information and how these perceptions vary by the reasonableness of the belief and its centrality to the patient's disease. We recruited 399 United States Prolific.co workers (357 retained after exclusions), 200 Prolific.co workers who reported having diabetes (139 after exclusions), and 244 primary care physicians (207 after exclusions). Participants read vignettes describing patients with type 2 diabetes sharing health beliefs that were central or peripheral to the management of diabetes. Beliefs included true and incorrect statements that were reasonable or unreasonable to believe. Participants rated how a doctor would perceive the patient, the patient's ability to manage their disease, and the patient's trust in doctors. Participants rated patients who shared more unreasonable beliefs more negatively. There was an extra penalty for incorrect statements central to the patient's diabetes management (sample 1). These results replicated for participants with type 2 diabetes (sample 2) and physician participants (sample 3). Participants believed that patients who share incorrect information with their physicians will be penalized for their honesty. Physicians need to be educated on patients' concerns so they can help patients disclose what may be most important for education. Understanding how people think they will be perceived in a health care setting can help us understand what they may be wary to share with their physicians.People think that patients who share incorrect beliefs will be viewed negatively.Helping patients share incorrect beliefs can improve care.