School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada.
Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands.
Int J Equity Health. 2024 May 8;23(1):94. doi: 10.1186/s12939-024-02162-y.
The COVID-19 pandemic has reignited a commitment from the health policy and health services research communities to rebuilding trust in healthcare and created a renewed appetite for measures of trust for system monitoring and evaluation. The aim of the present paper was to develop a multidimensional measure of trust in healthcare that: (1) Is responsive to the conceptual and methodological limitations of existing measures; (2) Can be used to identify systemic explanations for lower levels of trust in equity-deserving populations; (3) Can be used to design and evaluate interventions aiming to (re)build trust.
We conducted a 2021 review of existing measures of trust in healthcare, 72 qualitative interviews (Aug-Dec 2021; oversampling for equity-deserving populations), an expert review consensus process (Oct 2021), and factor analyses and validation testing based on two waves of survey data (Nov 2021, n = 694; Jan-Feb 2022, n = 740 respectively).
We present the Trust in Multidimensional Healthcare Systems Scale (TIMHSS); a 38-item correlated three-factor measure of trust in doctors, policies, and the system. Measurement of invariance tests suggest that the TIMHSS can also be reliably administered to diverse populations.
This global measure of trust in healthcare can be used to measure trust over time at a population level, or used within specific subpopulations, to inform interventions to (re)build trust. It can also be used within a clinical setting to provide a stronger evidence base for associations between trust and therapeutic outcomes.
COVID-19 大流行重新激发了卫生政策和卫生服务研究界对重建医疗保健信任的承诺，并为系统监测和评估的信任措施创造了新的需求。本文旨在开发一种多维医疗保健信任度衡量工具，其：(1) 针对现有衡量工具的概念和方法局限性做出回应；(2) 可用于识别导致公平权益人群信任度较低的系统解释；(3) 可用于设计和评估旨在（重新）建立信任的干预措施。
我们对现有的医疗保健信任度衡量工具进行了 2021 年的回顾，进行了 72 次定性访谈（2021 年 8 月至 12 月；对公平权益人群进行了过度采样）、专家审查共识流程（2021 年 10 月）以及基于两轮调查数据的因子分析和验证测试（分别为 2021 年 11 月，n=694；2022 年 1 月至 2 月，n=740）。
我们提出了多维医疗保健系统信任度衡量工具（TIMHSS）；这是一种 38 项相关的三因素医生、政策和系统信任度衡量工具。不变性测试的测量结果表明，TIMHSS 也可以可靠地用于不同人群。
这种全球医疗保健信任度衡量工具可用于在人群层面上衡量随时间推移的信任度，或在特定亚人群中使用，为（重新）建立信任的干预措施提供信息。它也可在临床环境中使用，为信任与治疗效果之间的关联提供更强的证据基础。
