Baidya M, Gopichandran V, Kosalram K
MPH Student, School of Public Health, SRM University, Medical College, Kattankulathur, Kancheepuram District, Tamil Nadu, India.
J Postgrad Med. 2014 Jan-Mar;60(1):21-6. doi: 10.4103/0022-3859.128802.
Trust is the acceptance of a vulnerable situation in which the truster believes that the trustee will act in the truster's best interests. The cornerstone of the patient-physician relationship is "trust". Despite the intensity and importance of trust relationship of patients toward their physician, the phenomenon is rarely studied in developing countries.
Our study aimed to explore the concept of patient-physician trust among adults of rural Tamil Nadu to assess the factors affecting patient-physician trust relationship and patient satisfaction.
A cross-sectional descriptive household survey was carried out on 112 individuals selected by a multistage random sampling method. Men and women aged above 40 years who have visited a health care service at least once during the last 5 years were included in the study. Thom et al's modification of the Anderson and Dedrick Physician Trust scale was used to measure patient trust in physician.
Trust is a one-dimensional construct in the surveyed population as revealed by an exploratory factor analysis which extracted one component explaining 50% of the overall variance. Trust influences patient's self-reported satisfaction (β coefficient of 0.048; P < 0.001) and remains independent of all the other factors assessed in the study such as, age, gender, education, self-reported health status, time spent with the physician, physician's gender, physician's age, and medical specialty that the physician belongs to. Physician's gender, physician's age, self-reported health status, and time spent with the physician were significantly associated with satisfaction with the physician.
Trust in physicians seems to not depend on any of the assessed factors and largely seems to be implicit in the physician-patient relationship. Trust in physician is associated with patient satisfaction. Further studies are needed to assess trust in physicians in developing country settings.
信任是对一种脆弱情形的接受,在这种情形中,信任者相信受托方会为信任者的最大利益行事。医患关系的基石是“信任”。尽管患者对医生的信任关系强烈且重要,但在发展中国家,这一现象很少得到研究。
我们的研究旨在探索泰米尔纳德邦农村成年人中患者与医生之间信任的概念,以评估影响医患信任关系和患者满意度的因素。
采用多阶段随机抽样方法对112名个体进行了横断面描述性家庭调查。纳入研究的对象为年龄在40岁以上、在过去5年中至少去过一次医疗服务机构的男性和女性。采用汤姆等人对安德森和德德里克医生信任量表的修订版来测量患者对医生的信任。
探索性因素分析显示,在所调查的人群中,信任是一个一维结构,提取出一个解释总方差50%的成分。信任影响患者自我报告的满意度(β系数为0.048;P<0.001),并且独立于研究中评估的所有其他因素,如年龄、性别、教育程度、自我报告的健康状况、与医生相处的时间、医生的性别、医生的年龄以及医生所属的医学专业。医生的性别、医生的年龄、自我报告的健康状况以及与医生相处的时间与对医生的满意度显著相关。
对医生的信任似乎不依赖于任何评估因素,在很大程度上似乎隐含在医患关系中。对医生的信任与患者满意度相关。需要进一步研究来评估发展中国家背景下对医生的信任情况。