Università della Svizzera Italiana, Institute of Communication & Health, Via Buffi 6, 6900 Lugano, Switzerland; Università del Salento, Lab of Applied Psychology and Intervention, Italy.
Università Cattolica del Sacro Cuore, Department of Psychology, Largo Gemelli, 1, 20123 Milano, Italy.
Soc Sci Med. 2019 Aug;235:112391. doi: 10.1016/j.socscimed.2019.112391. Epub 2019 Jul 4.
Although they form a dyadic relationship, doctor's and patient's levels of trust in the other have usually been investigated separately. As members of dyadic relationships, they influence each other's behaviors and are interdependent because they share a past history and eventually a common future.
The aim of this paper was to examine the composition of trust in doctor-patients relationship and estimate its association with quality of doctor's communication. One-With-Many analyses (OWM) were used to examine the composition of trust variance into "doctor and patient effects", "relationship effects", and "reciprocity effects," taking into account the interdependence of the data.
Twelve General Practitioners (GPs; Mage = 54.16, SD = 12.28, 8 men) and 189 of their patients (Mage = 47.48, SD = 9.88, 62% women) took part in the study. GPs and their patients completed postconsultation questionnaires on trust and quality of communication.
The findings revealed that "doctor" and "patient" effects were significant. However, the most important part of the variance was attributable to the relationship and reciprocity effects, meaning that if a doctor reported high trust in a particular patient, then the patient reported a similarly high level of trust. Higher quality of communication was positively associated to those relationship effects of trust.
Our study stresses the importance to investigate trust in doctor-patients relationship as a dyadic and interdependent phenomenon applying appropriate methodological design and analysis. Convergence between doctor's and patients' perceptions of their relationship may enhance trust more than conventional intervention and may ultimately contribute to better health outcomes.
尽管医生和患者构成了医患关系，但通常分别调查他们对彼此的信任水平。作为二元关系的成员，他们相互影响，相互依存，因为他们共享过去的历史，并最终拥有共同的未来。
本文旨在研究医患信任关系的构成，并评估其与医生沟通质量的关系。采用“One-With-Many”分析（OWM），考虑到数据的相互依存性，将信任方差分解为“医生效应”、“关系效应”和“互惠效应”。
12 名全科医生（GPs；平均年龄 54.16 岁，标准差 12.28 岁，8 名男性）和 189 名患者（平均年龄 47.48 岁，标准差 9.88 岁，62%为女性）参与了研究。GP 和他们的患者在咨询后完成了关于信任和沟通质量的问卷。
研究结果表明，“医生”和“患者”效应显著。然而，方差的最重要部分归因于关系和互惠效应，这意味着如果医生对特定患者报告了高度的信任，那么患者也会报告类似的高度信任。更高的沟通质量与信任的关系效应呈正相关。
我们的研究强调了将医患信任关系作为一个二元和相互依存的现象进行调查的重要性，需要采用适当的方法设计和分析。医生和患者对他们关系的看法趋同可能比传统干预更能增强信任，并最终有助于改善健康结果。
