Trust In Medical Staff Research Articles

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.

Surgery-related anxiety regarding arthroscopic meniscectomy under general anesthesia: a retrospective observational study

BackgroundThe prevalence of anxiety among patients undergoing arthroscopic surgery and its association with postoperative function has been well documented; however, the level of anxiety and anxiety-related characteristics remain unclear. As such, the present study investigated the characteristics of state anxiety in patients undergoing arthroscopic meniscectomy.MethodsData from 75 patients, who underwent arthroscopic partial meniscectomy under general anesthesia and completed an anxiety status questionnaire between April 2021 and March 2022, were retrospectively collected and reviewed. The State-Trait Anxiety Inventory (STAI)-X was used to measure state anxiety; a total score ≥ 52 was defined as clinically meaningful state anxiety. STAI score, main cause of preoperative anxiety, most anxious period, and most helpful factors for reducing perioperative anxiety were investigated. Patients were divided into 2 groups according to the main cause of preoperative anxiety; surgery or anesthesia (group I [n = 47]); and postoperative pain or rehabilitation (group II [n = 28]) Characteristics of state-anxiety between the two groups were compared using independent t-tests.ResultsThe mean STAI score of the total population was 39.1 points (range, 20–60 points). The mean STAI score was significantly higher in group I than in group II (41.9 vs. 34.4 points, respectively; P < 0.001). The proportion of patients with clinically meaningful state anxiety was significantly higher in group I than in group II (23.4% vs. 3.6%, respectively, P = 0.02). Most patients (66.0% in group I and 50.0% in group II) responded that trust in medical staff was the most helpful factor in overcoming preoperative anxiety. In group I, 63.8% reported that the surgeon’s explanation was the most helpful factor in reducing postoperative anxiety, whereas in group II, 71.4% reported that the natural course after surgery was the most helpful factor.ConclusionsSurgeons should be aware that anxiety related to arthroscopic meniscectomy differs according to patient characteristics, and a preoperative explanation of the postoperative process with the surgeon is important for patients who experience preoperative anxiety regarding anesthesia or the surgery itself.

Temporal changes in factors associated with COVID-19 vaccine hesitancy among Chinese adults: Repeated nationally representative survey

BackgroundCOVID-19 vaccine hesitancy has been cited as one of the main obstacles impacting vaccine coverage. However, factors that affect hesitancy may change over time. Understanding these evolving concerns and adapting strategies accordingly are crucial for effectively addressing vaccine hesitancy effectively and promoting public health. We aimed to explore the temporal changes in factors associated with COVID-19 VH during the COVID-19 pandemic and assess the dynamic evolution of VH. MethodsIn August 2022 and February 2023, repeated online surveys were undertaken to collect information from 5378 adults across four regions of China. Multiple linear regression models assessed the influencing factors of COVID-19 VH. The association between protective motive theory (PMT) (perceived severity, susceptibility, benefits, barriers, and self-efficacy) and VH was evaluated by structural equation modeling (SEM). ResultsRepeated measures showed that 573 (10.7%) and 1598 (29.7%) of the 5378 participants reported COVID-19 VH in the baseline and follow-up surveys, respectively. Educational levels, chronic disease, history of allergy, COVID-19 infection, and trust in medical staff and vaccine developers were positively associated with COVID-19 VH (P＜0.05). The application of SEM revealed that perceived severity, susceptibility, vaccination barriers, and self-efficacy in the PMT directly impacted on VH (P＜0.05). In addition, severity, susceptibility, benefits, and barriers had a significant direct effect on self-efficacy as β = 0.113, β = 0.070, β = 0.722, β = −0.516 respectively with P < 0.001. ConclusionThe prevalence of COVID-19 VH was relatively low in the baseline survey and much higher in the follow-up survey, with a significant increase in hesitancy rates among mainland Chinese residents. Acknowledging the substantial impact on the shaping of COVID-19 VH, one must consider factors including perceived severity, susceptibility, vaccination barriers, and self-efficacy.

Understanding workplace violence against medical staff in China: a retrospective review of publicly available reports

BackgroundWorkplace violence against medical staff in China is a widespread problem that has negative impacts on medical service delivery. The study aimed to contribute to the prevention of workplace violence against medical staff in China by identifying patterns of workplace violence, key risk factors, and the interplay of risk factors that result in workplace violence.MethodsNinety-seven publicly reported Chinese healthcare violent incidents from late 2013 to 2017 were retrospectively collected from the internet and analysed using content analysis. A modified socio-ecological model guided analysis of the violent incidents focusing on risk.ResultsPhysical violence, yinao, or a combination of physical and verbal violence were the typical forms of violence reported. The findings identified risk at all levels. Individual level risk factors included service users’ unreasonable expectations, limited health literacy, mistrust towards medical staff, and inadequacy of medical staff’s communication during the medical encounter. Organisational level risk factors under the purview of hospital management included problems with job design and service provision system, inadequacies with environmental design, security measures, and violence response mechanisms within hospitals. Societal level risk factors included lack of established medical dispute-handling mechanisms, problems in legislation, lack of trust and basic health literacy among service users. Situational level risks were contingent on risk factors on the other levels: individual, organisational, and societal.ConclusionsInterventions at individual, situational, organisational, and societal levels are needed to systematically address workplace violence against medical staff in China. Specifically, improving health literacy can empower patients, increase trust in medical staff and lead to more positive user experiences. Organizational-level interventions include improving human resource management and service delivery systems, as well as providing training on de-escalation and violence response for medical staff. Addressing risks at the societal level through legislative changes and health reforms is also necessary to ensure medical staff safety and improve medical care in China.

"We really are seeing racism in the hospitals": Racial identity, racism, and doula care for diverse populations in Georgia.

Poor birth outcomes are more prevalent for Black communities, but strong evidence shows that doula care can improve those outcomes. More evidence is needed to understand racial differences, discrimination, and equity in doula care. The current study's objective was to describe the experiences of Black doulas as well as the challenges and facilitators of providing doula care to communities of color in Georgia. From Fall 2020-Fall 2021, 20 surveys and in-depth interviews were conducted with doulas as part of a community-based participatory study co-led by Healthy Mothers, Healthy Babies Coalition of Georgia and academic researchers. Doula participants were diverse in age (5% under 25, 40% 25-35, 35% 36-45, and 20% 46+) and race/ethnicity (45% white, 50% Black, 5% Latinx). Most (70%) Black doulas reported that more than 75% of their clientele is Black, while most (78%) white doulas reported that less than 25% of their clientele is Black. Doulas noted the alarming Black maternal mortality rate and how mistreatment causes Black clients to lose trust in medical staff, leaving them in need of advocates. Black doulas were passionate about serving and advocating with Black clients. Participants also described how language and cultural barriers, particularly for Asian and Latinx people, reduce clients' ability to self-advocate, increasing the need for doulas. Doulas also discussed the ways that race influences their connections with clients and their dissatisfaction with the lack of cultural humility or sensitivity training in standard doula training. Our findings indicate that Black doulas provide essential and supportive services to Black birthing people, and those services are more urgently needed than ever following the overturn of Roe v. Wade. Doula training must be improved to address the cultural needs of diverse clients. Increasing access to doula care for Asian and Latinx communities could also address language and cultural barriers that can negatively impact their maternal and child health outcomes.

Frequent attenders in primary health care: a mixed-methods study of patient and staff perspectives.

To understand the frequent attendance phenomenon from the perspective of patients and healthcare professionals and how it can be reduced. Frequent attenders (FAs) are characterised by the consumption of a disproportionate number of medical consultations and a high number of visits per year to primary care physicians (PCP). Although FAs constitute about 10% of all primary clinic attendees, they are responsible for ~40-50% of clinic visits, affecting the efficiency, accessibility and quality of health services provided to other patients. Mixed methods (STROBE Statement: Data S1; COREQ checklist: Data S2). Eighteen FAs were interviewed in a qualitative approach. PCPs and nurses (n = 184) completed a cross-sectional survey. FAs are driven by their personal, emotional and mental state. FAs viewed clinics as a source for information and resolving medical problems. They perceived PCPs as authoritative and knowledgeable, and nurses as treatment managers and mediators between PCPs and patients. In contrast, FAs evoked more negative emotions than positive ones among medical staff. PCPs and nurses attributed frequent visits to FAs' personal and emotional states. A model based on the findings was constructed to provide a framework for grasping frequent attendance from a sociological perspective and for planning and managing it. The accessibility and availability of health services at primary clinics, and collaboration and trust in medical staff facilitate the frequent attendance phenomenon. The frequent attendance phenomenon should be proactively prevented, even before patients become FA, using the model constructed, which serves as a foundation for introducing an intervention program to identify and prevent frequent attendance. PCPs and nurses working in primary care clinics should be made aware of the FA phenomenon and should be educated and given tools to deal with it within the clinic. The process should be facilitated by organisational support. There was no patient or public contribution to the design or conduct of the study, analysis or interpretation of the data, or in the preparation of the manuscript.

Legislative “ground” for transplant tourism in Russia

This article examines the current state of domestic legislation regarding me- dical tourism regulation. Gaps in criminal law and the absence of federal regulation for public relations in the transplantation field, delays in enacting necessary laws on organ and tissue donation contribute to a lack of trust in medical staff and the overall functioning of Russia’s healthcare system. The actual implementation of international obligations at the domestic level in this area has not yet occurred. The transformation of international legal norms into national laws and regulations has been partially implemented. Conclusions drawn from the opinions of a respected scientist-practitioner in Russian transplantology, a description of the underground reality of Moscow clinics by a “regular” therapist, and an analysis of current departmental legislation provide evidence for the existence of transplant tourism in Russia. The protection of the constitutional right to health for Russian patients should not be merely declarative. The realization of the human right to quality medical care should not infringe upon the rights and freedoms of others in the provision of medical services. The entire system of medical law should be promptly organized to prevent arbitrariness, immorality, and violations of the professional ethics of medical workers. Additionally, the author proposes a model of a criminal law norm on trafficking in human organs and tissues.

Nurses' experiences of discrimination in health care: A qualitative study in Iran.

Justice in health is one of the main concerns of health organizations, and discrimination in health care is one of the negative outcomes to achieving this goal. Hence, a full understanding of the phenomenon of discrimination in health care and adopting strategies to eliminate it is necessary. The present study was conducted to explore and describe the experiences of nurses of discrimination in health care. The present qualitative content analysis study was conducted between 2019 and 2020. Data were collected through semi-structured interviews with 18 participants (two physicians, three nursing supervisors, two head nurses, four clinical nurses, two nursing assistants, and three hospitalized patients) in one public and one private hospital in the city of Tehran. The participants were selected by purposive sampling, which continued until saturation of data. Data obtained were analyzed using the Graneheim and Lundman method. Four main categories and 14 subcategories were extracted from data analysis: 1) habitual discrimination (everyday discrimination in health centers, ignoring patient rights, low levels of trust in medical staff); 2) interpersonal relationships (expectations of associates, respect for colleagues and friends, the possibility of the occurrence of similar situations, reciprocating people's favors); 3) shortage of health-care resources (shortage of medical equipment, heavy workload, infrastructure of medical centers, lack of access to physicians); and 4) favoritism (ethnicity, favoritism as a common method, and favoritism as the ultimate solution to treatment problems). The present study revealed certain dimensions of discrimination in health care that remain hidden in many quantitative studies. It appears that health system managers will be able to move toward eliminating discrimination in health care. Thus, designing effective models to reduce discrimination in health care based on the underlying concepts of this study is recommended.

The Impact of Effective Communication on Perceptions of Patient Safety—A Prospective Study in Selected Polish Hospitals

Interpersonal communication plays a key role in the treatment process. It affects not only the patient’s satisfaction with the course of treatment, but also allows the achievement of the best outcome in the therapeutic process. The process of patient empowerment and putting them in the role of a partner in the therapeutic process makes it possible to build a relationship based on trust, kindness and empathy. The aim of the study is to show the relationship between a patient’s sense of safety and access to health information, friendly and empathetic treatment by medical staff and a relationship based on trust. The study is conducted on patients from public hospitals in Wrocław by using the author’s questionnaire. One of the five most important factors according to respondents is the sense of safety, as reported by more than half of the patients (54.4%)—this is the opinion of more than half of the patients (54.4%). The respondents assessed the quality of patient care as an average of M = 41.1/50 points. There is a strong positive correlation between the sense of security and the access to information (rho = 0.642), kind treatment (rho = 0.623), trust in medical staff (rho = 0.758) and satisfaction with hospital stay (rho = 0.758).

Perception of clinical research among patients and healthy volunteers of clinical trials

PurposeClinical research relies on data from patients and volunteers, yet the target sample size is often not achieved. Here, we assessed the perception of clinical research among clinical trial participants to improve the recruitment process for future studies.MethodsWe conducted a single-center descriptive and exploratory study of 300 current or former participants in various phase I–III clinical trials. Questionnaires were either distributed to current clinical trial participants or emailed to former subjects.ResultsSubjects strongly agreed or agreed that contributing to improving medical care (> 81%), contributing to scientific research (> 79%), and trusting their treating physicians (> 77%) were motives for study participation. Among healthy volunteers, financial motives positively correlated with the number of clinical trials they had participated in (p < 0.05). Higher age positively correlated with expectation of best available treatment during study participation among patients (p < 0.05). Less than 8% of all subjects expressed “great concern” about the potential risks of sharing their personal information as part of the study. Subjects displayed “great trust” or “trust” in medical staff (86.6%) and in government research institutions (76.4%), and “very little trust” or “little trust” in pharmaceutical companies (35.4%) and health insurance companies (16.9%).ConclusionAltruistic motives and trust in treating physicians were predominant motives for clinical trial participation. Older patients expected to receive the best available treatment during participation. Healthy volunteers who reported financial motives had participated in more clinical trials. Consistent with great trust in medical staff and government research institutions, little concern was expressed about the misuse of personal data during the trial.

The Impact of Critical Care Transition Programs (CCTPs) on Relocation Stress in Patients and Patient Families in the Intensive Care Unit

The intensive care unit (ICU) is designed to care for patients with high disease severity who require critical care and close monitoring. Patients in the ICU may be transferred to the general ward for further treatment following recovery from the acute phase. Transferring from the ICU to the general ward after acute phase recovery is a stressful event that may stress both the patient and their family, potentially resulting in relocation stress syndrome (RSS). RSS has been found to be closely related to unplanned ICU readmissions, prolonged hospitalization, and adverse events, affecting recovery to health and family peace of mind. Furthermore, RSS may result in ineffective disease coping, feelings of uncertainty, and poor treatment response, leading to prolonged hospitalization, reduced trust in medical staff, and decreased happiness and quality of life. In recent years, the nursing profession has attached increasing importance to holistic health care. This has encouraged critical care teams to map out customized relocation plans for patients who are about to be transferred from the ICU that use standardized evaluation tools for transfers and elicit the situation and needs from patients or their family. Through the setting of care goals, shared decision making, and cross-unit support, enhanced communications among the medical team facilitate transition preparation and improve the quality and effect of intensive care.

Investigating the Extent of Coronaphobia and some Related Psycho-Social Variables in Iran

Investigating the Extent of Coronaphobia and some Related Psycho-Social Variables in Iran

Parents' Perspectives on Counseling for Fetal Heart Disease: What Matters Most?

After diagnosis of congenital heart disease (CHD) in the fetus, effective counseling is considered mandatory. We sought to investigate which factors, including parental social variables, significantly affect counseling outcome. A total of n = 226 parents were recruited prospectively from four national tertiary medical care centers. A validated questionnaire was used to measure counseling success and the effects of modifiers. Multiple linear regression was used to assess the data. Parental perception of interpersonal support by the physician (β = 0.616 ***, p = 0.000), counseling in easy-to-understand terms (β = 0.249 ***, p = 0.000), and a short period of time between suspicion of fetal CHD, seeing a specialist and subsequent counseling (β = 0.135 **, p = 0.006) significantly improve “overall counseling success”. Additional modifiers (e.g., parental native language and age) influence certain subdimensions of counseling such as “trust in medical staff” (language effect: β = 0.131 *, p = 0.011) or “perceived situational control” (age effect: β = 0.166 *, p = 0.010). This study identifies independent factors that significantly affect counseling outcome overall and its subdimensions. In combination with existing recommendations our findings may contribute to more effective parental counseling. We further conclude that implementing communication skills training for specialists should be considered essential.

Perception of Own Illness and Trust in Medical Personnel among Chronically Ill People

Appropriate perceptions of own disease by chronically ill person significantly affects the success of the diagnostic and therapeutic process. It depends on the existential situation of the patient, the adopted strategy of coping with the disease, received social support, as well as on the way the patient is treated by medical personnel. The aim of the conducted research was to assess the relationship between the perception of the disease by chronically ill people and their trust in medical staff.&#x0D; &#x0D; The study involved 511 people receiving treatment for chronic diseases. The diagnostic survey method was used in the study, the research tools were: the Imagination and Perception of Illness Scale (IPIS), the Brief Illness Perception Questionnaire (Brief IPQ), the Trust in Physician scale by L.A. Anderson and R.F. Dedrick, and a self-authorship questionnaire.&#x0D; &#x0D; Among the studied population, statistically significant relationships were observed between the perception of own disease by the patient, measured with the IPIS scale, and the trust in medical personnel calculated with the Trust in Physician. In the study group, there are statistically significant differences between the belief of the respondents in the effectiveness of treating their own disease and the overall result of trust in medical personnel.&#x0D; &#x0D; The perception of own disease by chronically ill people affects the level of trust in medical staff. The way the patients will perceive their illness depends, among other things, on the relationship between them and the doctor.

Perceptions of clinical care and research among African-American patients with lymphoma

Across lymphoma subtypes, African Americans experience disparities in clinical trial enrollment and outcomes. Understanding the needs of this population can aid addressing these disparities. Semi-structured interviews were conducted with 14 self-identified Black/African-American lymphoma patients to determine their perceptions and attitudes about aspects of treatment and research. Constant-comparative methods identified themes including trust in medical staff, lack of diagnosis information, interest in research, research priorities, and potentially unaddressed emotional needs. Patients trusted their doctors and desired more diagnosis information. Participants often did not consider the emotions surrounding their diagnoses and concentrated on positive attitudes during treatment. Most participants were interested in clinical trials to help future lymphoma patients. Participants suggested a range of future research topics emphasizing lymphoma etiology. Building on trusting doctor-patient relationships, expanding clinical trials information, addressing emotional needs, and aligning research objectives with patient concerns are potential strategies for increasing clinical trial enrollment among Black lymphoma patients.

Rebuild doctor\u2013patient trust in medical service delivery in China

Doctor–patient trust is not strong in China, but studies examining this factor remain insufficient. The present study aimed to explore the effect of doctor–patient communication, medical service quality, and service satisfaction on patient trust in doctors. Five hundred sixty-four patients with tuberculosis participated in this cross-sectional study in Dalian, China. They completed questionnaires assessing socio-demographic characteristics, doctor–patient communication, medical service quality, service satisfaction and patient trust in medical staff. A structural equation model was applied to examine the hypotheses, and all the study hypotheses were supported: (1) doctor–patient communication, medical service quality and service satisfaction were positively associated with building doctor–patient trust; (2) service quality positively mediated the relationship between doctor–patient communication and trust; (3) medical service satisfaction positively mediated the relationship between doctor–patient communication and trust; (4) medical service satisfaction positively mediated the relationship between medical service quality and doctor–patient trust; and (5) medical service quality and service satisfaction were the positively sequential mediators between communication and doctor–patient trust. Based on these findings, improvements in doctor–patient communication, medical service quality, and service satisfaction are the important issues contributing to the rebuilding of doctor–patient trust in medical service delivery.

Potential research participants' use of information during the consent process: A qualitative pilot study of patients enrolled in a clinical trial.

There is increasing evidence that clinical trial participants are uninformed about the trials in which they participate, raising ethical concerns regarding informed consent. The aim of this pilot study was to explore clinical trial participants’ use of consent discussions and information sheets when considering participating in clinical trials research. A qualitative, interview-based pilot study was designed in order to elicit, through dialogue, details of the reasons for participants’ use of, and preferences regarding, different modes of information provision. Semi-structured interviews were undertaken with two different groups of patients who were participants in the Reinforcement of Closure of Stoma Site trial. The first group comprised newly-consented trial participants, who had been recruited up to 72 hours before our interview; the second group comprised patients attending a follow-up clinic 12 months after joining the trial. Thirteen participants were recruited in total: three newly-consented patients, and ten follow-up patients. The study found that participants’ use of consent discussions to gain information about clinical trials was varied, and that they only minimally used information sheets after providing initial consent for the trial. Participants demonstrated varying degrees of knowledge about the trial, with some having forgotten that they were still involved in the trial. Participants reported a high level of trust in medical staff as a reason for not seeking more information about the trial. Some participants reported dissatisfaction with the timing of information provision. Some were amenable to novel ways of receiving trial information, such as web-based methods. The pilot study demonstrated the feasibility of a larger study into the provision of information to prospective clinical trial participants. The results suggest that considering alternative ways of providing information and the appropriateness of existing information provision may be acceptable to and useful for potential trial participants.

Identifying and explaining experiences of fear of childbirth and coping strategies: A qualitative study

Background and Objectives: Fear of childbirth is a natural response that helps women prepare for childbirth. However, if fear is increased, it can lead to physical and emotional disabilities. This study aims to explain the experiences of fear of childbirth and, consequently, present a model for reducing such fears. Methods: A phenomenological approach was used in this study. The participants were selected from among primigravida (women who were pregnant for the first time) through purposeful sampling, and the data were collected through open and unstructured interviews. Besides, the collected data were analyzed using Colaizzi’s nine-stage method. Results: Different types of fear of childbirth identified in this study were harmful to maternal and neonatal health, normal childbirth, the feeling of inability, and cesarean section. Besides, the reasons behind fear of childbirth were inadequate awareness, lack of trust in medical staff, negative experiences from information sources, and the environment of the maternity center. Finally, the most important strategies to deal with the fear of childbirth were faith in God, feeling confident, receiving support, raising awareness, and positive thinking which were used to design the model. Conclusion: The findings of the study showed that women's self-confidence plays a key role in decreasing fear of childbirth. Therefore, effective measures should be taken to increase women's sense of self-confidence to reduce their fear of childbirth.

Counseling for Prenatal Congenital Heart Disease-Recommendations Based on Empirical Assessment of Counseling Success.

Objectives: Empirical assessment of parental needs and affecting factors for counseling success after prenatal diagnosis of congenital heart disease (CHD).Methods:Counseling success after fetal diagnosis of CHD was assessed by a validated standardized questionnaire. The dependent variable “Effective Counseling” was measured in five created analytical dimensions (1. “Transfer of Medical Knowledge—ToMK”; 2. “Trust in Medical Staff—TiMS”; 3. “Transparency Regarding the Treatment Process—TrtTP”; 4. “Coping Resources—CR”; 5. “Perceived Situational Control–PSC”). Analyses were conducted with regard to influencing factors and correlations.Results: Sixty-one individuals (n = 40 females, n = 21 males) were interviewed in a tertiary medical care center. Median gestational age at first parental counseling was 28 + 6 weeks. Parental counseling was performed four times (median), mostly by pediatric cardiologists (83.6%). Overall counseling was successful in 46.3%, satisfying in 51.9%, and unsuccessful in 1.9%. Analyses of the analytical dimensions show that counseling was less successful for TOMK (38.3%) and PSC (39%); success rates were higher if additional written information or links to web sources were provided (60 and 70%, respectively). Length of consultation was positively correlated to counseling success for ToMK (r = 0.458), TrtTP (r = 0.636), PSC (r = 0.341), and TiMS (r = 0.501). Interruptions were negatively correlated to the dimensions TiMS (r = −0.263), and TrtTP (r = −0.210). In the presence of high-risk CHD (37.5%) overall counseling success was lower (26.1%). By cross table analysis and to a low degree of positive correlation in one dimension (ToMK; r = 0.202), counseling tends to be less successful for ToMK, TrtTP, and TiMS if parents have not been counseled by cardiologists. Analyses regarding premises show a parental need for a separate counseling room, which significantly impacts ToMK (r = −0,390) and overall counseling success (r = −0.333). A language barrier was associated with lower success rates for ToMK, TiMS, and CR (21.4, 42.9, and 30.8%).Conclusions: Data from this multidisciplinary study indicate that parents after fetal diagnosis of CHD need uninterrupted counseling of adequate duration and quality in a separate counseling room. Providing additional written information or links to adequate web sources after initial counseling seems necessary. High-risk CHD needs more attention for counseling. There is a trend towards more counseling success if provided by cardiologists.

The mediating effect of trust on the relationship between doctor-patient communication and patients' risk perception during treatment.

Doctor-patient communication interacts with patients' satisfaction to influence patients' risk perception. Current theories to explain this relationship have assumed particular psychological processes to explain observations of risk-sensitive behavior in an economic setting, but as of yet, they have not addressed whether it is adaptive for a decision-maker in a health-care situation. In addition, little is known about the role of interpersonal trust between doctor and patient. We surveyed 602 patients to examine the way in which trust, communication, and patients' satisfaction are related to patients' risk perception about uncertainties in medical treatment. The results showed that patients held a relatively low level of risk perception, which means that they had insufficient preparation for the possibility of uncertainties about the treatment. The association between doctor-patient communication and patients' perceived risk was mediated by doctor-patient trust. These results suggest that there is a relationship among good doctor-patient communication, patients' trust in medical staff, and perceived risk during medical treatment. Finally, theoretical and practical implications are discussed.