Lu Laura Y, Sheikholeslami Nicole, Alokozai Aaron, Eppler Sara L, Kamal Robin N
VOICES Center for Health Policy, Department of Orthopaedic Surgery, Stanford University, Redwood City, CA.
VOICES Center for Health Policy, Department of Orthopaedic Surgery, Stanford University, Redwood City, CA.
J Hand Surg Am. 2019 Jul;44(7):617.e1-617.e9. doi: 10.1016/j.jhsa.2018.09.007. Epub 2018 Oct 23.
Trust is foundational to the patient-physician relationship. However, there is limited information on the patient characteristics and behaviors that are related to patient trust. We investigated whether the time patients spend researching their physician and/or symptoms before a clinic visit was correlated with patient trust in their hand surgeon.
We conducted a prospective study of new patients (n = 134) who presented to a hand surgery clinic. We tested the null hypothesis that time spent researching the physician or symptom does not correlate with physician trust. Secondarily, we tested the association of a maximizing personality (a decision-making personality type defined as one who exhaustively searches for the "best option" as opposed to a "satisficer" who settles for the "good enough" decision) with time spent researching the hand surgeon and patient symptoms, general self-efficacy (one's ability to manage adversity), and patient trust. Patients completed a questionnaire assessing demographics, patient researching behavior, general self-efficacy (GSE-6), maximizing personality (Maximization Short Form), and physician trust (Trust in Physician Form).
The average age of our cohort was 50 ± 17 years, and men and women were equally represented. Patients spent more time researching their symptoms (median, 60 min; range, 5-1,201 min) than they did researching their physician (median, 20 min; range, 1-1,201 min). There was no correlation between time spent by patients seeking information on their hand surgeon and/or symptoms with patient trust in their physician. However, female patients were significantly more trusting of their physician than male patients.
Most patients research their symptoms before clinic, whereas about half research their physicians before meeting them. Time spent seeking information before clinic was not correlated with patient trust in their physician. However, in our study, female patients were more likely to trust their hand surgeon than male patients. Thus, modifying physician behavior rather than patient characteristics may be a stronger driver of patient trust.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.
信任是医患关系的基础。然而，关于与患者信任相关的患者特征和行为的信息有限。我们调查了患者在门诊就诊前花在研究医生和/或症状上的时间是否与患者对手外科医生的信任相关。
我们对一家手外科诊所的新患者（n = 134）进行了一项前瞻性研究。我们检验了零假设，即花在研究医生或症状上的时间与对医生的信任无关。其次，我们检验了最大化人格（一种决策人格类型，定义为详尽搜索“最佳选项”的人，与满足于“足够好”决策的“满意者”相对）与花在研究手外科医生和患者症状上的时间、一般自我效能感（一个人应对逆境的能力）以及患者信任之间的关联。患者完成了一份问卷，评估人口统计学特征、患者研究行为、一般自我效能感（GSE - 6）、最大化人格（最大化简表）和对医生的信任（对医生的信任量表）。
我们队列的平均年龄为50±17岁，男女比例均衡。患者花在研究症状上的时间（中位数，60分钟；范围，5 - 1201分钟）比花在研究医生上的时间（中位数，20分钟；范围，1 - 1201分钟）更多。患者在寻求手外科医生和/或症状信息上花费的时间与患者对医生的信任之间没有相关性。然而，女性患者对医生的信任明显高于男性患者。
大多数患者在门诊前会研究他们的症状，而约一半患者在见到医生之前会研究医生。门诊前寻求信息所花费的时间与患者对医生的信任无关。然而，在我们的研究中，女性患者比男性患者更有可能信任他们的手外科医生。因此，改变医生的行为而非患者的特征可能是患者信任的更强驱动因素。
研究类型/证据水平：预后IV级。
