Hall Michael J, Park Cindy Y, Ruth Karen J, Kelly Patrick J A, Singley Katie, Luck Caseem C, Chertock Yana, Bauerle Bass Sarah
Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA 19111, USA.
Lewis Katz School of Medicine, Temple University Health System, Philadelphia, PA 19140, USA.
Cancers (Basel). 2025 Feb 14;17(4):649. doi: 10.3390/cancers17040649.
: Medical mistrust (MM) is associated with adverse health outcomes, but few studies have assessed MM in cancer patients. MM is frequently measured using the Medical Mistrust Inventory (MMI), measuring institutional MM (e.g., government), or the Group-Based Medical Mistrust Scale (GBMMS), measuring race-based MM. We sought to assess the prevalence of MM among cancer patients diverse by age, sex, race/ethnicity, and socioeconomic status (SES), recruited from an urban safety net hospital and a suburban comprehensive cancer center. : Patients completed a one-time survey. The primary outcome was MM as measured by the GBMMS and MMI tools. Covariates included demographics, treatment campus (urban vs. suburban), and psychosocial measures relevant to MM. : Purposeful sampling recruitment resulted in 200 participants (survey completion: 74.6%). The median age was 60 years, with 62% female, 45% African-American, 15% Hispanic, 47.5% education ≤ HS diploma, and 51.5% income ≤ USD 50,000/yr. Elevated MMI and GBMMS scores (moderate-to-high) were seen, respectively, in Hispanic (20.7% and 33.4%) and African-American (AA) patients (31.8% and 48.9%), compared with White patients (14.3% and 9.9%). The MMI and GBMMS tools captured complimentary aspects of MM in cancer patients (Spearman's 0.531, < 0.0001). MMI was associated with lower education (0.034) and race ( = 0.04), while GBMMS was strongly associated with race ( < 0.001), urban campus ( = 0.035), and mistrust of government/health organization information (both < 0.05). Higher MMI/GBMMS scores were both associated with research mistrust and mistrust of information from physicians. : Institutional and race-based MM are prevalent among cancer patients diverse by age, sex, race/ethnicity, and SES. Lower education was associated with institutional MM but not race-based MM.
医疗不信任(MM)与不良健康结果相关,但很少有研究评估癌症患者中的医疗不信任情况。医疗不信任通常使用医疗不信任量表(MMI)来衡量机构性医疗不信任(例如对政府的不信任),或使用基于群体的医疗不信任量表(GBMMS)来衡量基于种族的医疗不信任。我们试图评估从城市安全网医院和郊区综合癌症中心招募的、年龄、性别、种族/族裔和社会经济地位(SES)各异的癌症患者中医疗不信任的患病率。
患者完成了一项一次性调查。主要结果是通过GBMMS和MMI工具测量的医疗不信任情况。协变量包括人口统计学特征、治疗地点(城市与郊区)以及与医疗不信任相关的心理社会指标。
有目的的抽样招募产生了200名参与者(调查完成率:74.6%)。中位年龄为60岁,女性占62%,非裔美国人占45%,西班牙裔占15%,47.5%的人教育程度≤高中文凭,51.5%的人年收入≤50,000美元。与白人患者(分别为14.3%和9.9%)相比,西班牙裔患者(分别为20.7%和33.4%)和非裔美国(AA)患者(分别为31.8%和48.9%)的MMI和GBMMS得分升高(中度至高)。MMI和GBMMS工具捕捉到了癌症患者医疗不信任的互补方面(斯皮尔曼相关系数为0.531,P<0.0001)。MMI与较低的教育程度(P = 0.034)和种族(P = 0.04)相关,而GBMMS与种族(P<0.001)、城市治疗地点(P = 0.035)以及对政府/卫生组织信息的不信任(两者P<0.05)密切相关。较高的MMI/GBMMS得分均与对研究的不信任以及对医生信息的不信任相关。
机构性和基于种族的医疗不信任在年龄、性别、种族/族裔和社会经济地位各异的癌症患者中普遍存在。较低的教育程度与机构性医疗不信任相关,但与基于种族的医疗不信任无关。