Department of Communication, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
Patient Educ Couns. 2018 Oct;101(10):1786-1794. doi: 10.1016/j.pec.2018.05.007. Epub 2018 May 17.
Medical mistrust is seen as a barrier to health promotion and addressing health disparities among marginalized populations. This study seeks to examine how medical mistrust has been measured as a step towards informing related health promotion efforts.
A systematic review of medical mistrust scales was conducted using four major databases: PubMed, PsycINFO, ERIC, and Communication & Mass Media Complete. Databases were searched using the terms "medical mistrust scale" "medical mistrust" and "medical distrust."
The search returned 1595 non-duplicate citations; after inclusion and exclusion criteria were applied, 185 articles were retained and coded. Almost a quarter of studies used a single-item or a few items. Among validated scales, the Group-Based Medical Mistrust Scale, Medical Mistrust Index, and Health Care System Distrust Scale were most frequently used. There were important differences among these scales such as the object of mistrust (e.g., system, individual physician) and referent specificity (e.g., group). The measurement of medical mistrust varied by health topic and sample population.
These differences in scales and measurement should be considered in the context of intervention goals.
Researchers should be aware of differences in measures and choose appropriate measures for a given research question or intervention.
医疗不信任被视为促进健康和解决边缘化人群健康差距的障碍。本研究旨在探讨如何衡量医疗不信任,以推动相关的健康促进工作。
使用四个主要数据库(PubMed、PsycINFO、ERIC 和 Communication & Mass Media Complete)对医疗不信任量表进行了系统回顾。使用术语“医疗不信任量表”“医疗不信任”和“医疗怀疑”在数据库中进行搜索。
搜索返回了 1595 条非重复引文;在应用纳入和排除标准后,保留了 185 篇文章并进行了编码。近四分之一的研究使用了一个或几个项目。在经过验证的量表中,最常使用的是基于群体的医疗不信任量表、医疗不信任指数和医疗保健系统不信任量表。这些量表之间存在重要差异,例如不信任的对象(例如,系统、个别医生)和参考特异性(例如,群体)。医疗不信任的测量因健康主题和样本人群而异。
在干预目标的背景下,应考虑这些量表和测量的差异。
研究人员应注意测量方法的差异,并根据特定的研究问题或干预选择适当的测量方法。