Departments of Radiation Oncology.
Health Services Research.
Am J Clin Oncol. 2021 Apr 1;44(4):150-157. doi: 10.1097/COC.0000000000000771.
Levels of medical mistrust have historically been higher among racial/ethnic minority patients compared with whites, largely owing to societal and health system inequities and history of discrimination or experimentation. However, recently trust in physicians has declined in the United States in general. We investigated trust in physicians among a large cohort of cancer patients residing in Texas.
A sample of recently diagnosed cancer patients in Texas were identified from the Texas Cancer Registry with 1344 patients returning surveys between March 2017 and March 2020. The multiscale inventory was mailed to each individual and included the Trust in the Medical Profession Scale which assesses levels of agreement with 11 trust-related statements. Multivariable linear regression models were constructed to assess the adjusted relationship between trust in the medical profession aggregate score and sociodemographic and clinical factors.
A total of 1250 surveys were evaluable for trust in the medical profession. The mean aggregate trust score for all patients was 37.3 (95% confidence interval: 36.8-37.7). Unadjusted trust scores were higher for Hispanic (40.5) and black (38.2) respondents compared with white (36.4) (P<0.001). Multivariable analyses showed white, younger, more-educated, or those with lower levels of self-reported health estimated toward lower adjusted scores for trust in the medical profession.
We observed relatively higher levels of medical mistrust among white, younger, more-educated individuals with cancer or those with poorer health. While the relatively higher trust among minority individuals is encouraging, these findings raise the possibility that recent societal trends toward mistrust in science may have implications for cancer care.
历史上，与白人相比，少数族裔患者对医疗的信任度一直较低，这主要是由于社会和医疗体系的不平等以及历史上的歧视或实验。然而，最近美国整体对医生的信任度有所下降。我们调查了居住在德克萨斯州的大量癌症患者对医生的信任度。
从德克萨斯州癌症登记处确定了德克萨斯州的一组最近被诊断出患有癌症的患者，其中有 1344 名患者在 2017 年 3 月至 2020 年 3 月期间返回了调查。多尺度清单被邮寄给每个个体，其中包括评估对 11 个与信任相关的陈述的同意程度的信任医疗行业量表。构建多变量线性回归模型来评估信任医疗行业总体评分与社会人口统计学和临床因素之间的调整关系。
共有 1250 份调查问卷可用于评估对医疗行业的信任。所有患者的平均总体信任评分均为 37.3（95%置信区间：36.8-37.7）。未调整的信任评分，西班牙裔（40.5）和黑人（38.2）受访者高于白人（36.4）（P<0.001）。多变量分析显示，白人、年龄较小、受教育程度较高或自我报告健康状况较差的人，对信任医疗行业的调整后评分较低。
我们观察到，患有癌症的白人、年轻、受教育程度较高或健康状况较差的人对医疗的不信任程度相对较高。虽然少数族裔人群相对较高的信任度令人鼓舞，但这些发现表明，最近对科学的不信任趋势可能对癌症护理产生影响。
