Parents' trust in their child's physician: using an adapted Trust in Physician Scale.
ABSTRACT To assess the performance of the Pediatric Trust in Physician Scale (Pedi-TiPS) that refers to a child's physician and is a modified version of the Trust in Physician Scale (TiPS), and to explore the association of trust to demographic variables.
We performed a cross-sectional survey of parents in pediatric specialty and primary care sites. Parents completed an anonymous questionnaire that included the Pedi-TiPS. Our main outcome variable was total Pedi-TiPS score (higher scores = higher trust). Reliability was determined by Cronbach's alpha. Bivariate comparisons and linear regression modeling explored potential associations between demographic variables and total score.
Five hundred twenty-six parents completed surveys (73% response rate). The mean total score was 45.4 (SD 6), with good internal consistency (alpha = .84). In bivariate analysis, lower scores were associated with being a father (P = 0.03), older parent age (P = 0.02), private insurance status (P < 0.01), parent education greater than high school (P = 0.04), and not having a child age <3 years (P = 0.03). In a regression model adjusted for other factors, parents who were either African American (P = 0.05), or "other" race (P < 0.01), parents with private insurance (P = 0.02), and parents who had no children <3 years of age (P = 0.04) had lower trust.
The Pedi-TiPS has properties similar to the original instrument. We found associations between trust and demographic factors that should be confirmed with further studies.
SourceAvailable from: Sachiko Ozawa[Show abstract] [Hide abstract]
ABSTRACT: People's trust in the health system plays a role in explaining one's access to and utilization of medical care, adherence to medications, continuity of care, and even self-reported health status. Yet it is not easy to find trust measures and understand what they are measuring. A systematic review of scales and indices identified 45 measures of trust within the health system with an average of 12 questions each, which quantified levels of trust among various relationships across the health system. Existing evidence was narrow in scope, where half examined the relationship between doctors/nurses and patients, and the majority were designed, tested and validated in the United States. We developed a health systems trust content area framework, where we identified that honesty, communication, confidence and competence were captured frequently in these measures, with less focus on concepts such as fidelity, system trust, confidentiality and fairness. Half of the measures employed a qualitative method in the design of these measures and 33% were pilot tested. Reporting of test-retest reliability and inter-rater reliability were less common. This review identifies a need to develop measurements of trust beyond doctor-patient relationships and outside of U.S. contexts, and strengthen the rigor of existing trust measures. Greater development and use of trust measures in the health system could improve monitoring and evaluation efforts, which may in turn result in better health outcomes.Social Science [?] Medicine 08/2013; 91C:10-14. DOI:10.1016/j.socscimed.2013.05.005 · 2.56 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Urban adolescents face many barriers to health care that contribute to health disparities in rates of sexually transmitted infections (STIs) and unintended pregnancy. Designing interventions to increase access to health care is a complex process that requires understanding the perspectives of adolescents. We conducted six focus groups to explore the attitudes and beliefs about general and sexual health care access as well as barriers to care among urban, economically disadvantaged adolescents. Participants first completed a written survey assessing health behaviors, health care utilization, and demographics. The discussion guide was based on the Theory of Planned Behavior and its constructs: attitudes, subjective norms, and perceived behavioral control. Transcripts of group discussions were analyzed using directed content analysis with triangulation and consensus to resolve differences. Fifty youth participated (mean age 15.5 years; 64% female; 90% African American). Many (23%) reported missed health care in the previous year. About half (53%) reported previous sexual intercourse; of these, 35% reported no previous sexual health care. Youth valued adults as important referents for accessing care as well as multiple factors that increased comfort such as good communication skills, and an established relationship. However, many reported mistrust of physicians and identified barriers to accessing care including fear and lack of time. Most felt that accessing sexual health care was more difficult than general care. These findings could inform future interventions to improve access to care and care-seeking behaviors among disadvantaged youth.Vulnerable Children and Youth Studies 07/2014; 9(3):279-290. DOI:10.1080/17450128.2014.925170
[Show abstract] [Hide abstract]
ABSTRACT: The quality of Pediatric communication directly influences the treatment success, by promoting satisfactory adherence levels, information retention, and the inclusion of biopsychosocial demands. The main aim of this study was to perform a systematic literature review concerning pediatric communication, with papers published between 2000 and 2010. The selected studies were included in the following databases: PubMed/MedLine, Bireme/BVS and ScienceDirect, Capes Papers Online site, and SciELO. The 61 selected papers indicate the prevalence of descriptive designs and qualitative or quantitative analysis techniques, over experimental studies and the use of mixed data analysis techniques. The literature indicated the need to include the pediatric patient in the communication process and to consider psychosocial demands, highlighting the good results achieved by programs related to better communication patterns. The need is highlighted for systematic studies that can comprehend the factors involved in pediatric communication, and the inclusion of efficient psychosocial programs.Estudos de Psicologia (Campinas) 12/2013; 30(4):539-552. DOI:10.1590/S0103-166X2013000400007