Trust In Healthcare System Research Articles

A Trusted Ubiquitous Healthcare Monitoring System for Hospital Environment

Wireless Body Sensor Network with wearable and implantable body sensors have been grabbing lot of interests among the researchers and healthcare service providers. These sensors forward physiological data to the personnel at the hospital, doctor or caretaker anytime, anywhere; hence the name of the network is Ubiquitous health monitoring system. The technology has brought Internet of Things into this system making it to get connected to the cloud based internet. This has made the retrieval of information to the expert and thus improving the happiness of elderly people and patients suffering from chronic diseases. This paper focuses on creating an android based application for monitoring patients in hospital environment. The necessity of sharing hospital data to the experts around the globe has brought the necessity of trust in Health care systems. The data sharing in the IOT environment is secured. The environment is tested in real-time cloud environment. The proposed android application serves to be better architecture for hospital monitoring.

International strategies in fighting against medicaments fraud and other similar offences. The MEDICRIME Convention

The Council of Europe has passed a convention which constitutes, for the first time in world history, a binding international treaty in the criminal law field “On counterfeiting of medical products and similar crimes involving threats to public health” (MEDICRIME Convention). Safeguarding of public health through penal measures against criminal behaviours, protection of victims, promotion of cooperation at national and international levels and preventive measures are the overarching aims of the above convention. Counterfeiting medical products and similar crimes threaten the right to life enshrined in the European Convention on Human Rights and Fundamental Freedoms (thereafter ECHR). Incidences of counterfeit medical products and similar crimes undermine public trust in healthcare systems and authorities’ surveillance thereof. Counterfeiting of medical products and similar crimes have a global spread, no country is spared. The present paper brings to light the added value of the MEDICRIME Convention in order to protect public health at the international level and analyses the substantive criminal law aspects of the Convention.

A Community-Engaged Assessment of Barriers and Facilitators to Rapid Stroke Treatment.

Treatment for acute ischemic stroke must be initiated within hours of stroke symptom onset, and the sooner it is administered, the better. In South Carolina, 76% of the population can access expert stroke care, and rural hospitals may provide specialized treatment using telemedicine, but many stroke sufferers seek care too late to achieve full benefit. Using a community-engaged approach in a southern rural community, we explored barriers and facilitators to early stroke care and implications for improvement. The Community-Engaged Assessment to facilitate Stroke Elimination (CEASE) study was guided by a community advisory group to ensure community centeredness and local relevance. In a qualitative descriptive study, eight focus groups were conducted including 52 individuals: recent stroke survivors, family members, emergency medical personnel, hospital emergency department staff, primary care providers, and community leaders. From analysis of focus group transcripts came six themes: lack of trust in healthcare system and providers; weak relationships fueled by poor communication; low health literacy; financial limitations related to health care; community-based education; and faith as a message of hope. A hierarchy model for improving early community-based stroke care was developed through consensus dialogue by community representatives and the research team. This model can be used to inform a community-partnered, stakeholder-informed intervention to improve stroke care in a rural southern community with the goal of improving stroke education, care, and outcome. © 2016 Wiley Periodicals, Inc.

The influence of trust in health care systems on postabortion contraceptive choice

ObjectivesThis study investigates whether trust in the health care system or other patient-level characteristics are associated with interest in immediate initiation of long-acting reversible contraception (LARC) after abortion. Study designA structured, self-administered survey was provided to English-speaking women 18years or older presenting to a reproductive health center in the Southeastern United States for first-trimester surgical abortion. The survey collected information about patient characteristics, choice of postabortion contraception, health literacy and trust in the health care system. Trust was measured using a 17-item, previously validated survey and was treated as the primary independent variable. Our primary outcome variable is interest in immediate LARC placement postabortion. Statistical analysis was performed using Chi-square tests, Student’s t tests and logistic regression with SAS® 9.2. ResultsOf 162 respondents who completed the survey, 24% planned to use LARC postabortion, which increased to 37% if LARC placement was available on the day of their abortion. The mean trust score was 59±8 (possible score of 17–85) and did not differ significantly between women who indicated an interest in immediate LARC placement postabortion and those who did not (p=.9). Women with a history of a prior birth were 3.4 times more likely to indicate interest in immediate postabortion LARC than others (adjusted odds ratio 3.42, 95% confidence interval 1.63, 7.18). ConclusionDesire to accept LARC immediately postabortion is associated with history of a prior birth but not with trust in the health care system or other demographic variables. Participant interest in postabortion LARC varied based on immediate device availability. ImplicationsThis research underscores the importance of policies and clinical practices that promote access to LARC methods on the day of an abortion. Further research is needed to elucidate factors that correlate with choice of LARC postabortion.

Trust matters: A narrative literature review of the role of trust in health care systems in sub-Saharan Africa

This article makes a contribution to the debate about health service utilisation and the role of trust in fostering demand for health services in sub-Saharan Africa. It is framed as a narrative literature review based on a thematic analysis of nine empirical, qualitative studies. For the purposes of this article trust is defined as a voluntary course of action, which involves the optimistic expectation that the trustee will do no harm to the trustor and is increasingly perceived as an important influence on health system functioning. The article looks at trust issues in interpersonal, intergroup and institutional situations. The findings of the review point to four elements that are important for trust to develop in health sector relationships: the sensitive use of discretionary power by health workers, perceived empathy by patients of the health workers, the quality of medical care and workplace collegiality. When trust works in health sector encounters, it reduces the social complexity and inherent uneven distribution of power between clients and providers. The article concludes that understanding and supporting trust processes between patients and providers, as well as between co-workers and managers, will improve health sector collaboration and stimulate demand for health care services.

Why public trust in health care systems matters and deserves greater research attention.

Considering the underlying importance of trust, there is too little research into the understanding, protection and recovery of trust in health care systems, not only for the effective functioning of health care systems but also for society in general. Several researchers have pointed towards a contemporary crisis of trust in health care systems and there have been many examples that show the severe effects of mistrust. More research into public trust in health care systems could contribute to improving efficiency while protecting the health of the public.

The Influence of Trust in Health Care Systems on Postabortion Contraceptive Choice

INTRODUCTION: After recent abortion women are at high risk for unintended pregnancy and repeat abortion. Use of highly effective contraception postabortion may mitigate this risk. Women cannot discontinue long-acting reversible contraception (LARC) without visiting a health care provider. This study investigates whether a womens trust in the health care system is associated with a willingness to consider LARC placement immediately postabortion. METHODS: A structured self-administered survey was provided to English-speaking women older than 18 years old presenting to a reproductive health center in the United States for first-trimester pregnancy termination. The survey collected information about demographics and reproductive history. We measured trust in the health care system with a validated scale. Statistical analysis was performed using chi tests Students t tests and logistic regression with SAS 9.2. RESULTS: One hundred sixty-two respondents completed surveys. Twenty-four percent indicated a plan to use LARC postabortion whereas 37% indicated they would accept LARC if available on the day of their abortion. The mean trust score was 59 (standard deviation 8 range 38-78) and did not differ significantly between women who indicated a willingness to use LARC immediately postabortion and others (P=.9). Demographic variables including education marital status income and prior pregnancy met criteria for inclusion in our multivariable model but none was ultimately predictive of LARC use postabortion. CONCLUSION: More than one third of participants reported that they would accept LARC immediately postabortion if available. In our study neither trust in the health care system nor demographic variables predicted willingness to accept LARC immediately postabortion.

Self-rated health among women and their assessment of the health care system / Samoocena zdravja med ženskami in njihov odnos do zdravstvenega sistema v sloveniji

Abstract Background: This article researches gender inequality in health based on subjective assessments of health, the accessibility of health care services and trust in the health care system between different social categories of women in Slovenia. Methods: The study is based on the Slovenian Public Opinion survey (ISSP Health Module) carried out in 2011 on representative samples of the adult Slovenian population. In the data, we investigated the gender differences and difference between different socio-economic categories within the female sub-sample in self-assessed health, and some other related topics such as: trust in doctors, trust in health care system, access to health care services and attitude to the health care policy in Slovenia. Results: The data shows significant inequalities in self-assessed health between different social strata. Self-assessed health is significantly lower among women at the bottom of the educational and income scale. The data also reveals strong support for the preservation of the available public health. Conclusion: Neoliberal economic reforms (of health care) affect vulnerable social categories the most, and women are particularly exposed. The use of women’s unpaid work in the family belongs among the basic (neo)liberal saving strategies. These want to take more care and health work within families from the shoulders of the state and place it onto the shoulders of family members, which mainly means women. In these circumstances, it is understandable that women subjectively assess their health as being worse than men’s. Moreover, conditions are being established that de facto could lead to worse health in the female population in Slovenia.

A Validity and Reliability Study of the Multidimensional Trust in Health-Care Systems Scale in a Turkish Patient Population

The importance of trust within health care is widely acknowledged. Measuring patients’ trust in health care systems may contribute to plans for the financing, delivery, and outcomes of health services. Although many scales are available to measure patient trust, less attention has been paid to the multidimensional nature of trust in health care systems. The purpose of this methodological study was to adapt the Multidimensional Trust in Health-Care Systems Scale into Turkish and to evaluate its psychometric properties for a Turkish patient population. The scale was adapted into Turkish through a translation and back-translation process. The content validity of the scale was assessed using expert approval. The psychometric properties of the scale were investigated by collecting data from 232 hospitalised patients in Ankara during theperiod of 1 January–30 December 2010. An exploratory factor analysis identified that the eigenvalues for the three factors of the scale were 7.30, 2.61, and 1.21; these three factors explained 65 % of the variance. A confirmatory factor analysis indicated a sufficient model fit for the construct validity of the scale. Cronbach’s α for the total scale was 0.87, as well as 0.91, 0.82, and 0.61 for the three subscales; the Spearman-Brown split half reliability coefficient was 0.67. Despite the low internal consistency of the subscale 3, evidence from this study supports the validity and reliability of the Multidimensional Trust in Health-Care Systems Scale. This instrument can be used to measure multiple aspects of trust in the health care system; however, as trust is a contextual phenomenon, further work is needed to test the psychometric properties of this scale both in Turkish and different cultures.

Factors and Outcomes of Decision Making for Cancer Clinical Trial Participation

To describe factors and outcomes related to the decision-making process regarding participation in a cancer clinical trial. Cross-sectional, descriptive. Urban, academic, National Cancer Institute-designated comprehensive cancer center in the mid-Atlantic United States. 197 patients with advanced gastrointestinal cancer. Mailed survey using one investigator-developed instrument, eight instruments used in published research, and a medical record review. disease context, sociodemographics, hope, quality of life, trust in healthcare system, trust in health professional, preference for research decision control, understanding risks, and information. decision to accept or decline research participation and satisfaction with this decision. All of the factors within the Research Decision Making Model together predicted cancer clinical trial participation and satisfaction with this decision. The most frequently preferred decision-making style for research participation was shared (collaborative) (83%). Multiple factors affect decision making for cancer clinical trial participation and satisfaction with this decision. Shared decision making previously was an unrecognized factor and requires further investigation. Enhancing the process of research decision making may facilitate an increase in cancer clinical trial enrollment rates. Oncology nurses have unique opportunities as educators and researchers to support shared decision making by those who prefer this method for deciding whether to accept or decline cancer clinical trial participation.

Factors Associated With African American and White Elders' Participation in a Brain Donation Program

This study examined factors associated with brain donation program participation among African American and White elders. By postal mail, participants were recruited from an Alzheimer's research registry (all of whom had been invited to participate in the Center's brain donation program) and asked to complete surveys assessing brain donation knowledge, trust in healthcare systems, and religiousness. African American respondents completed a cultural mistrust inventory. Demographic, brain donation status, and literacy data (as assessed by the Wide Range Achievement Test-3 Reading subtest) were compiled from the respondents' most recent registry visit. The survey response rate was 60% (n=184 White and n=49 Black respondents). Logistic regression, comparing religiousness, trust in healthcare institutions, and educational attainment, identified a single predictor (ie, religiousness) in the prediction of donation status among White respondents (P=0.008), whereas no predictors were observed for donation status among the Black respondents. Using all African American donors and nondonors from the registry (n=68), comparisons revealed Wide Range Achievement Test-3 Reading score differences for African American donors (46.8±5.9) and nondonors (42.8±8.4, P=0.02). Results suggest that increased religiousness is related to White elders' decisions not to donate, whereas lower reading ability might be related to African American participants' decisions not to donate.

Public Trust in Primary Care Doctors, the Medical Profession and the Healthcare System among Redhill Residents in Singapore

There have been few studies on public trust in doctors and healthcare systems and this is the first in Singapore. A cross-sectional survey was carried out in Redhill in January 2005. Citizens or Permanent Residents aged > or =18 years were randomly selected, one per household to avoid cluster bias, and 361 participated (response rate 68.7%). An interview administered questionnaire included 3 questionnaires measuring public trust: "Interpersonal Trust in Physicians Scale" for primary care doctors; "Trust in Physicians Generally Scale" for the medical profession; and "Trust in Healthcare System Scale" for the Healthcare System. Questions were answered on a Likert scale: 1. Strongly Disagree, 2. Disagree, 3. Neutral, 4. Agree, 5. Strongly Agree. Individual transformed scores of trust (range, 0 to 100) were equally divided into 5 categories with their average being the transformed mean. Trust in primary care doctors (mean 59.7) had proportions (prevalence rates) of: very low 0.3%, low 2.5%, neutral 40.4%, high 54.0%, and very high 2.8%. Trust in the medical profession (mean 61.8) had proportions of: very low 1.0%, low 7.7%, neutral 33.7%, high 47.0%, and very high 10.5%. Trust in the healthcare system (mean 61.5) had proportions of: very low 0.5%, low 4.1%, neutral 40.0%, high 48.7%, and very high 6.7%. For areas of the healthcare system, proportions of high/very high trust were: "Healthcare Providers' Expertise" (70.8%), "Quality of Care" (61.5%), "Patient Focus of Providers" (58.7%), "Information Supply and Communication by Care Providers" (52.3%), "Quality of Cooperation" (43.3%), and Policies of the Healthcare System" (24.6%). While low proportions had low/very low trust, the high proportions with neutral trust and the rather low level of trust in "Policies of the Healthcare System" are causes for concern.

Researching trust relations in health care

The aim of this paper is to provide a rationale for examining trust in health care. Conducts a review of the literature of trust relations in health care that highlighted that most empirical research has addressed threats to patient-provider relationships and trust in health care systems from the patient's perspective, but studies in the organisational literature suggests that trust relations in the workforce, between providers and between providers and managers, may also influence patient-provider relationships and levels of trust. Suggests that trust is not primarily dispositional or an individual attribute or psychological state, but is constructed from a set of inter-personal behaviors or from a shared identity. These behaviors are underpinned by sets of institutional rules, laws and customs. This introductory paper has presented some evidence from an international, comparative study but there is the need for further, more detailed investigation into why trust relations may vary in different health care systems. This introductory paper provides a rationale for examining trust in health care and a context for the different elements of trust.

Racial Differences in Trust and Lung Cancer Patients' Perceptions of Physician Communication

Black patients report lower trust in physicians than white patients, but this difference is poorly studied. We examined whether racial differences in patient trust are associated with physician-patient communication about lung cancer treatment. Data were obtained for 103 patients (22% black and 78% white) visiting thoracic surgery or oncology clinics in a large Southern Veterans Affairs hospital for initial treatment recommendation for suspicious pulmonary nodules or lung cancer. Questionnaires were used to determine patients' perceptions of the quality of the physicians' communication and were used to assess patients' previsit and postvisit trust in physician and trust in health care system. Patients responded on a 10-point scale. Previsit trust in physician was statistically similar in black and white patients (mean score, 8.2 v 8.3, respectively; P = .80), but black patients had lower postvisit trust in physician than white patients (8.0 v 9.3, respectively; P = .02). Black patients, compared with white patients, judged the physicians' communication as less informative (7.3 v 8.5, respectively; P = .03), less supportive (8.1 v 9.3, respectively; P = .03), and less partnering (6.4 v 8.2, respectively; P = .001). In mixed linear regression analysis, controlling for clustering of patients by physician, patients' perceptions of physicians' communication were statistically significant (P < .005) predictors of postvisit trust, although patient race, previsit trust, and patient and visit characteristics were not significant (P > .05) predictors. Perceptions that physician communication was less supportive, less partnering, and less informative accounted for black patients' lower trust in physicians. Our findings raise concern that black patients may have lower trust in their physicians in part because of poorer physician-patient communication.

A note on construction of treaps and cartesian trees

Vaccines for COVID-19 are anticipated to be available by 2021. Vaccine uptake rate is a crucial determinant for herd immunity. We examined factors associated with acceptance of vaccine based on (1). constructs of the Health Belief Model (HBM), (2). trust in the healthcare system, new vaccine platforms and manufacturers, and (3). self-reported health outcomes.A population-based, random telephone survey was performed during the peak of the third wave of COVID-19 outbreak (27/07/2020 to 27/08/2020) in Hong Kong. All adults aged ≥ 18 years were eligible. The survey included sociodemographic details; self-report health conditions; trust scales; and self-reported health outcomes. Multivariable regression analyses were applied to examine independent associations. The primary outcome is the acceptance of the COVID-19 vaccine.We conducted 1200 successful telephone interviews (response rate 55%). The overall vaccine acceptance rate after adjustment for population distribution was 37.2% (95% C.I. 34.5–39.9%). The projected acceptance rates exhibited a “J-shaped” pattern with age, with higher rates among young adults (18–24 years), then increased linearly with age. Multivariable regression analyses revealed that perceived severity, perceived benefits of the vaccine, cues to action, self-reported health outcomes, and trust in healthcare system or vaccine manufacturers were positive correlates of acceptance; whilst perceived access barriers and harm were negative correlates. Remarkably, perceived susceptibility to infection carried no significant association, whereas recommendation from Government (aOR = 10.2, 95% C.I. 6.54 to 15.9, p < 0.001) was as the strongest driving factor for acceptance. Other key obstacles of acceptance included lack of confidence on newer vaccine platforms (43.4%) and manufacturers without track record (52.2%), which are of particular relevance to the current context.Governmental recommendation is an important driver, whereas perceived susceptibility is not associated with acceptance of COVID-19 vaccine. These HBM constructs and independent predictors inform evidence-based formulation and implementation of vaccination strategies.