Article

Evaluation of factors influencing confidence and trust in the patient-physician relationship: A survey of patient in a hand clinic

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Abstract

The purpose of this study was to identify the skills found most important to gain patient's trust from a patient's perspective. One hundred and twenty-two patients were surveyed prospectively using a questionnaire assessing professionalism, physical environment, verbal and non-verbal communication skills. Factors required to establish a trusting patient-surgeon relationship were ranked in order of importance before and after initial consultation with a surgeon in a hand surgery clinic model. No significant relationship was identified between gender, age, education or income, and answers provided by respondents. Technical ability, verbal communication skills and respect of patient's autonomy by the physician were found most important. The visit with the surgeon significantly affected the ranking of some of the skills deemed important. Patients view respect of autonomy and verbal communication skills as the most important attributes when developing trust and confidence in a surgeon, followed by technical proficiency.

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... As depicted in Figure 44, negative service users' experience and service outcomes often underly mistrust. Therefore, although media can contribute towards positive imaging of the medical profession, improving medical service treatment outcomes and enabling positive service user experience are of utmost importance in rebuilding trust (Chan, 2018;Dang et al., 2017;Gundlach & Cannon, 2010;Hamelin, Nikolis, Armano, Harris, & Brutus, 2012). Meanwhile, managing service users' expectation in the community to avoid negative perception of experience when using services is also important for fulfilling expectations and determining satisfaction (McGregor et al., 2013;Palazzo et al., 2014). ...
... Trust during the medical encounter is believed to be determined by the information, empathy, and respect patients perceived during consultation(Johansson & Winkvist, 2002;Jones, Bodie & Hughes, 2019). As evidenced in Phase 2 (Section 8.2.1), whether the doctor is perceived as competent, responsible, and caring during the medical encounter can determine patients' trust, which is consistent with empirical evidence from literature(Hamelin, Nikolis, Armano, Harris, & Brutus, 2012).As noted previously in Sections 6.4.3 and 8.2, trust, respect, and partnership are closely associated, and perceived lack of respect and not being taken seriously could result in patients' discontent(Dawson-Rose, et al., 2016;Hallowell, 2008;Hamelin et al., 2012;Jirotka et al., 2005;Jones et al., 2019). For example, the unpleasant negative experience shared by Phase 2 participants in Section 8.2.1 was directly related to a lack of respect, empathy and care by medical staff. ...
... Trust during the medical encounter is believed to be determined by the information, empathy, and respect patients perceived during consultation(Johansson & Winkvist, 2002;Jones, Bodie & Hughes, 2019). As evidenced in Phase 2 (Section 8.2.1), whether the doctor is perceived as competent, responsible, and caring during the medical encounter can determine patients' trust, which is consistent with empirical evidence from literature(Hamelin, Nikolis, Armano, Harris, & Brutus, 2012).As noted previously in Sections 6.4.3 and 8.2, trust, respect, and partnership are closely associated, and perceived lack of respect and not being taken seriously could result in patients' discontent(Dawson-Rose, et al., 2016;Hallowell, 2008;Hamelin et al., 2012;Jirotka et al., 2005;Jones et al., 2019). For example, the unpleasant negative experience shared by Phase 2 participants in Section 8.2.1 was directly related to a lack of respect, empathy and care by medical staff. ...
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In recent decades, workplace violence against medical staff in China has been reported to be widespread and has negatively impacted medical service delivery. The present study aimed to contribute to the prevention of workplace violence against medical staff in China. Guided by a socio-ecological model, the present study’s objectives included: identifying patterns and risk factors, identifying key risk factors and their interplay for workplace violence against medical staff, and developing a preliminary framework for violence prevention intervention in China. This sequential mixed-methods study took place over five years, from late 2015 to early 2021, and consisted of three phases. In Phase One, 97 publicly available Chinese healthcare violent incidents were collected and analysed. Content analysis was used to understand patterns and risk factors of violence. In Phase Two, 22 purposively sampled key stakeholders in China were interviewed to examine the violence risk factors and investigate the interplays of risk factors to inform the development of violence prevention framework. In Phase Three, findings from Phases One and Two, as well as literature, were synthesised to suggest that misunderstandings during the medical encounter could result in unpleasant communication between service users and medical staff, causing service users’ negative perception and mistrust, and at times, violence. Many of the problems identified among service users and medical staff at the individual level could be linked to problems in hospital management (organisation level) which, in turn, were rooted in community and health policies (community and societal level). Intervention strategies were then derived from triangulating findings from Phases One and Two and the literature review. The provisional framework provides an approach to highlight and address risks at the individual, organisational, and the external community and national policy levels, systematically and comprehensively, emphasising collaborating and coordinating intervention efforts. Opportunities are identified for hospital management to play a pivotal role in enabling and facilitating positive communication and positive service user experience during the medical encounter by providing the necessary resources focusing on medical staff’s wellbeing and empowerment. Hospital senior management was found to have low awareness of such a need, thereby indicating the need for policy and regulatory efforts to further guide hospitals’ senior management to implement strategic health and safety management to take care of medical staff’s wellbeing to improve medical staff’s performance. Furthermore, interplays of factors indicate that intervention at the community and policy levels is required to effectively and fundamentally address problems manifested on individual service users and medical staff, so that positive communication between service users and medical staff, and service users’ positive experience are made possible. Specifically, promoting health literacy through health education among the public, and continuing health reforms, especially reforms in human resource management of medical professionals, reforms in how medical staff are paid, and improving laws and regulations concerning protection against risks carried in medical services provision to enable trust and effective communication between service users and medical staff, are identified as necessary to address risk factors of workplace violence.
... In a recent survey, surgical patients listed respect of autonomy and verbal communication as most important when developing trust and confidence in a surgeon, followed by technical proficiency. 37 In the same study, surgical patients had the greatest confidence in surgeons who could clearly explain their medical condition, treatment options, and answered all their concerns. 37 The authors of the study concluded, "The old perception that being a technically gifted surgeon was sufficient to meet patients' requirements no longer stands. ...
... 37 In the same study, surgical patients had the greatest confidence in surgeons who could clearly explain their medical condition, treatment options, and answered all their concerns. 37 The authors of the study concluded, "The old perception that being a technically gifted surgeon was sufficient to meet patients' requirements no longer stands. Patients now expect to be treated by a physician with excellent communication skills in addition to his or her technical abilities . . . ...
... The relationship between the patient and his surgeon has evolved from the traditional paternalizing surgeon-passive patient model to a relationship that is more similar to the interaction between a service provider surgeon and a client-patient." 37 A similar study done in India also found that communication skills, mannerisms, and word of mouth recommendations were most influential in patient confidence and satisfaction. 38 These results suggest that "Most people are not demanding more information before choosing a doctor because the information available is not what patients wish to know. ...
Article
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The Myers-Briggs Type Indicator (MBTI) is a reliable and valid screening test for describing the natural personality of an individual, especially in the medical field. The indicator gives an individual a four-letter abbreviation summarizing his/her personality characteristics. The categories include: extraverted (E) / introverted (I), sensing (S) / intuition (N), feeling (F) / thinking (T), and perception (P) / judgment (J). The personality types of physicians vary considerably across the medical field. Specific personality types indicated by the Myers-Briggs fit better with certain medical specialties than others. The alignment of physician-patient personalities and its effect on patient confidence and compliance have potential importance in the management of some disorders, such as, for example, substance abuse. This review will examine the alignment of physician-patient personalities and its effect on patient confidence and treatment outcomes.
... Physician competency, including the perceived competence of the physician by the patient [41,44,51,55,[68][69][70], the physician being up-to-date in their specialization [71], and having more years of experience [71] helped to build a trusting relationship with patients. Communication skills, including general communication skills [29,38,44,52,70,72,73], compassion, listening to the patient [41,44,52], as well as nonverbal behavior such as good eye contact, providing undivided attention, open body language, and smiling [41,44,52,73] also enhanced the trust relationship as did patient-centered [63,74,75], comprehensive care [30]. ...
... We did identify physician reputation [71] and the reputation of their medical specialty [28,34,39] as contributing to a trusting relationship. Moreover, different aspects of professionalism [71,73], such as honesty [51,55,69] and availability [41], contributed to a trusting patientphysician relationship, while being disrespectful, arrogant, or cynical were negatively associated with trust [41,73,75]. These results are summarized in Table 2. ...
Article
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Background The lack of trust between patients and physicians has a variety of negative consequences. There are several theories concerning how interpersonal trust is built, and different studies have investigated trust between patients and physicians that have identified single factors as contributors to trust. However, all possible contributors to a trusting patient-physician relationship remain unclear. This review synthesizes current knowledge regarding patient-physician trust and integrates contributors to trust into a model. Methods A systematic search was conducted using the databases MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), and Eric (Ovid). We ran simultaneous searches for a combination of the phrases: patient-physician relationship (or synonyms) and trust or psychological safety. Six-hundred and twenty-five abstracts were identified and screened using pre-defined criteria and later underwent full-text article screening. We identified contributors to trust in the eligible articles and critically assessed whether they were modifiable. Results Forty-five articles were included in the review. Patient-centered factors that contributed modifiable promoters of trust included psychological factors, levels of health education and literacy, and the social environment. Physician-centered factors that added to a trusting patient-physician relationship included competence, communication, interest in the patient, caring, the provisioning of health education, and professionalism. The patient-physician alliance, time spent together, and shared decision-making also contributed to trusting relationships between patients and physicians. External contributors included institutional factors, how payments are made, and additional healthcare services. Discussion Our model summarized modifiable contributors to a trusting patient-physician relationship. We found that providing sufficient time during patient-physician encounters, ensuring continuity of care, and fostering health education are promising starting points for improving trust between patients and physicians. Future research should evaluate the effectiveness of interventions that address multiple modifiable contributors to a trusting patient-physician relationship.
... While there is limited evidence for interventions to improve patient trust [21], several factors have been identi ed, such as perceived kindness and compassion from the surgeon, as well as having good bedside manner. These interpersonal skills are even valued higher than technical ability of the surgeon [22,23]. Patients also trust clinicians more when they feel the clinician listens carefully to the patient and is thorough [22,23]. ...
... These interpersonal skills are even valued higher than technical ability of the surgeon [22,23]. Patients also trust clinicians more when they feel the clinician listens carefully to the patient and is thorough [22,23]. The way clinicians interact with their clinical team is also important for developing trust; there is greater trust for teams that appear stronger and where the clinician has a strong working relationship with other members of the team [22]. ...
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Background/Objectives “Only Eye Surgery” can be a stressful experience for both surgeons and patients. Our study aimed to quantitatively explore the patient experience of having eye surgery on their remaining seeing eye. Subjects/Methods A retrospective cohort study comparing monocular and binocular patients recruited from clinics in Brisbane, Australia. 107 patients (43 monocular, 64 binocular) completed a 12-item questionnaire regarding their experience. Results Multiple linear regression analysis identified that preoperative anxiety is greater in only eye surgery, (β=-13.99, 95%CI=-25.73 to -2.26, p < 0.05) and there were more worries about losing vision from surgery (β=-18.40, 95%CI=-32.31to -4.49, p < 0.05). The perceived level of support after surgery in binocular patients is influenced by their level of support from family or friends to discuss prior to surgery (r = 0.72), whereas in monocular patients, such level of support is influenced by patients’ level of trust in the surgeon (r = 0.50) and anaesthetist (r = 0.73). Conclusions Clinicians can provide support by acknowledging their patients’ anxieties related to loss of vision and its potential impact on lifestyle. By addressing these issues and providing the opportunity to discuss other aspects of the surgery preoperatively, further trust in the surgeon can be achieved. Postoperatively, the patient will feel more supported and enhance the recovery journey. In the advent of adverse outcome, the surgeon who has gained that higher level of trust, the patient will be more likely to feel reassured that everything was performed to the highest possible standard and more likely to accept the resulting level of vision.
... Our results provide important insights for healthcare delivery and future research on measures of patient trust and its dimensions as they indicate that healthcare professionals should foster both the cognitive trust and affective trust of their hospitalized patients (see Table 3 for evidence-based strategies). [26][27][28][29][30][31] These findings also have important implications for hospitalized patients in the context of the COVID-19 pandemic. For instance, many patients are distrusting of the new COVID-19 vaccines. ...
... Future research should explore how and why patients may differentially trust members of various professions, as well as of different individuals involved in their inpatient care. 27,28 ▪ Make an effort to relate to patients (e.g., discuss mutual interests) 29 ▪ Provide reassurance 30 ▪ Ask patients about their preferences 30 ▪ Avoid judgmental language and behavior 30 ▪ Show the patient you respect them as a person 31 ▪ Respect patients' time (e.g., return when you say you will) 31 ▪ Spend time during initial visit to establish rapport (e.g., act like a guest) 31 ▪ Provide training for healthcare professionals to increase their skills in this area ▪ Develop job aids (e.g., pocket cards) with tools and phrases for healthcare professionals to use to open up an effective, trusting dialogue ...
Article
Background Trust in healthcare providers is associated with important outcomes, but has primarily been assessed in the outpatient setting. It is largely unknown how hospitalized patients conceptualize trust in their providers.Objective To examine the dimensionality of a measure of trust in the inpatient setting.DesignExploratory factor analysis (EFA) and confirmatory factor analysis (CFA).ParticipantsHospitalized patients (N = 1756; 76% response rate) across six hospitals in the midwestern USA. The sample was randomly split such that approximately one half was used in the EFA, and the other half in the CFA.Main MeasuresThe Trust in Physician Scale, adapted for inpatient care.Key ResultsBased on the Kaiser-Guttman criterion and parallel analysis, EFAs were inconclusive, indicating that trust may be comprised of either one or two factors in this sample. In follow-up CFAs, a 2-factor model fit best based on a chi-squared difference test (Δχ2 = 151.48(1), p < .001) and a Comparative Fit Index (CFI) difference test (CFI difference = .03). The overall fit for the 2-factor CFA model was good (χ2 = 293.56, df = 43, p < .01; CFI = .95; RMSEA = .081 [90% confidence interval = .072–.090]; TLI = .93; SRMR = .04). Items loaded onto two factors related to cognitive (i.e., whether patients view providers as competent) and affective (i.e., whether patients view that providers care for them) dimensions of trust.Conclusions While measures of trust in the outpatient setting have been validated as unidimensional, in the inpatient setting, trust appears to be composed of two factors: cognitive and affective trust. This provides initial evidence that inpatient providers may need to work to ensure patients see them as both competent and caring in order to gain their trust.
... Evidence from this study show that PLHIV are more likely to enrol in interventions that protect their confidentiality and that foster trust between program beneficiaries and service providers. From patients' perspectives, important skills to gain patient's trust are technical ability, verbal communication skills and respect of patient's autonomy by the physician [32]. Therefore, the quality of HCWs engaged to provide ART outreach can boost the client's confidence in KP-CBART and encourage them to access HIV care and treatment. ...
Article
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Background World Health Organization recommended community-based ART (CBART) approaches to improve access to antiretroviral treatment (ART) and treatment outcomes among key populations living with (KPLHIV). Key populations (KP) are female sex workers, men who have sex with men, persons who inject drugs, and transgender people. How CBART for KP (KP-CBART) worked and why, for whom and in what circumstances it worked within KP communities or at community sites, are yet to be described. The aim of this study is to describe the different KP-CBART approaches or models in Nigeria, identifying the context conditions and mechanisms that are likely to produce the desired outcomes. Method Building on our previous study eliciting an initial programme theory for KP-CBART, we used a multiple case design and cross-case analysis to evaluate 3 KP-CBART approaches, namely: One Stop Shop clinic; community drop-in centre; and outreach venue. Between 2021 and 2023, we conducted a retrospective cohort study, 99 indepth interviews and 5 focused group discussions with various actors. Using realist evaluation, we synthesised context-mechanism-outcome configurations (CMOCs) and developed programme theory for each of the cases and an overall theory. Result The analysis showed the central importance of decentralizing ART service delivery to a safe place within the community for KPLHIV. The provision of ART in a KP friendly environment triggered a feeling of safety and trust in the healthcare workers among KPLHIV, resulting in KP-CBART acceptance and improved ART uptake, medication adherence and retention on ART. KP community engagement in ART delivery, peer support through support group meetings, and linkages with KP-led organizations improved self-efficacy, fostered solidarity and a sense of belonging among KP. These resources encouraged and motivated clients to engage with the KP-CBART model. However, fear of disclosure of HIV and KP status, and lack of trust between KP groups, demotivated and discouraged KPLHIV from initiating ART and continuing their treatment in KP-CBART. Conclusion To optimise access to ART and treatment outcomes for KPLHIV, policy makers and health practitioners should ensure the provision of a safe place for ART service delivery that can be trusted by the clients and the KP communities.
... as a result, doctors rarely have enough time to fully communicate with patients about their condition and treatment options [54]. On the other hand, many doctors put more emphasis on providing excellent treatments than on communicating with patients [55]. this may lead to doctors ignoring the emotional needs of their patients and lacking the necessary humanistic care for them, which ultimately leads to doctor-patient conflicts and workplace violence [56]. ...
Article
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Background Workplace violence in healthcare settings is a significant public concern that profoundly impacts healthcare workers. However, there is a dearth of knowledge regarding the prevalence of workplace violence and its correlation with suicidal ideation among undergraduate medical students in China during their clinical training. The objective of this study was to evaluate the prevalence of workplace violence inflicted by patients or their family members/visitors and to assess its association with suicidal ideation among undergraduate medical students. Method The snowballing sampling technique was used to recruit Chinese medical students. A question designed by the research team was used to ask medical students about their encounters with workplace violence. Students’ basic demographic information and mental distresses (learning burnout, depression symptoms, anxiety symptoms, alcohol abuse/dependence, excessive daytime sleepiness and history of mental disorders) were also assessed. As appropriate, the data were analysed using descriptive statistics, chi-square tests, independent-sample t-tests and multiple logistic regression. Results Out of the 1402 undergraduate medical students who participated, 493 (35.2%) reported having experienced workplace violence inflicted by patients or their family members/visitors, of which 394 (28.1%) were verbal abuse, 14 (1.0%) were physical aggression, and 85 (6.1%) were suffered from both verbal abuse and physical aggression. Furthermore, students exposed to workplace violence were more likely to report suicidal ideation and had a higher prevalence of learning burnout, depression symptoms, anxiety symptoms, alcohol abuse/dependence and excessive daytime sleepiness. Depression symptoms, history of mental disorders, learning burnout and having a partner were significantly associated with suicidal ideation in this population. Conclusion The prevalence of workplace violence inflicted by patients or their family members/visitors was high among undergraduate medical students in China. This may be associated with their mental distress and suicidal ideation. Consequently, it is crucial to strengthen workplace safety measures and promptly implement interventions to mitigate the potentially serious consequences.
... This may require supporting medical staff to gain additional skills for effective communication [56][57][58][59][60]. Effective communication can facilitate humanistic care, contribute to quality care, and accordingly positive service user experience [61][62][63][64][65]. It would be difficult to expect a positive experience if medical staff only exhibited technical skills in the absence of effective communication during the medical encounter [66,67]. Providing effective training to medical staff is therefore a necessary intervention strategy to address such a concern [68,69]. ...
Article
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Background Workplace violence against medical staff in China is a widespread problem that has negative impacts on medical service delivery. The study aimed to contribute to the prevention of workplace violence against medical staff in China by identifying patterns of workplace violence, key risk factors, and the interplay of risk factors that result in workplace violence. Methods Ninety-seven publicly reported Chinese healthcare violent incidents from late 2013 to 2017 were retrospectively collected from the internet and analysed using content analysis. A modified socio-ecological model guided analysis of the violent incidents focusing on risk. Results Physical violence, yinao, or a combination of physical and verbal violence were the typical forms of violence reported. The findings identified risk at all levels. Individual level risk factors included service users’ unreasonable expectations, limited health literacy, mistrust towards medical staff, and inadequacy of medical staff’s communication during the medical encounter. Organisational level risk factors under the purview of hospital management included problems with job design and service provision system, inadequacies with environmental design, security measures, and violence response mechanisms within hospitals. Societal level risk factors included lack of established medical dispute-handling mechanisms, problems in legislation, lack of trust and basic health literacy among service users. Situational level risks were contingent on risk factors on the other levels: individual, organisational, and societal. Conclusions Interventions at individual, situational, organisational, and societal levels are needed to systematically address workplace violence against medical staff in China. Specifically, improving health literacy can empower patients, increase trust in medical staff and lead to more positive user experiences. Organizational-level interventions include improving human resource management and service delivery systems, as well as providing training on de-escalation and violence response for medical staff. Addressing risks at the societal level through legislative changes and health reforms is also necessary to ensure medical staff safety and improve medical care in China.
... Have found that cultural identity will affect the patient's trust in doctors [13] .The factors of medical service providers mainly involve doctors. Research by Hamelin et al. reveals that doctors' medical level, oral communication skills and compliance with patient autonomy all have a significant impact on doctor-patient trust [14] .The survey results of patients by omme and others reveal that information support, emotional support, joint decision-making and other factors will affect the trust level of patients in doctors [15] . Environmental factors mainly involve the system and the interaction environment between doctors and patients. ...
Article
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With the outbreak of COVID-19, Internet plus Healthcare has developed rapidly with a number of Internet plus Healthcare platforms emerging. The problem of doctor-patient trust is a key issue restricting the development of the Internet plus Healthcare, which has aroused extensive attention of scholars. The patient's perceived trust on the Internet plus Healthcare platform has the characteristics of subjectivity, ambiguity, and high perceived risk. Therefore, existing trust calculation method becomes inapplicable because these characteristics have not been considered. In order to solve this problem, this study extracts influencing factors of patient trust on the Internet plus Healthcare platform, gives a trust calculation method based on intuitionistic fuzzy set theory, and added a risk preference coefficient in order to integrate the characteristics of patients' high perceived risk into the proposed method. This method is conducive to the platform to provide patients with more accurate doctor recommendations
... Our study did not compare the relative impacts of physician attire with these and other factors known to influence the patient-physician relationship such as health literacy, 63 communication skills 64 65 and respect for patient autonomy. 64 Finally, the data from several of the individual country-specific studies have been previously published. However, this study is the first instance in which all data are compiled to allow for crossnational comparisons. ...
Article
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Objective The patient–physician relationship impacts patients’ experiences and health outcomes. Physician attire is a form of nonverbal communication that influences this relationship. Prior studies examining attire preferences suffered from heterogeneous measurement and limited context. We thus performed a multicentre, cross-sectional study using a standardised survey instrument to compare patient preferences for physician dress in international settings. Setting 20 hospitals and healthcare practices in Italy, Japan, Switzerland and the USA. Participants Convenience sample of 9171 adult patients receiving care in academic hospitals, general medicine clinics, specialty clinics and ophthalmology practices. Primary and secondary outcome measures The survey was randomised and included photographs of a male or female physician dressed in assorted forms of attire. The primary outcome measure was attire preference, comprised of composite ratings across five domains: how knowledgeable, trustworthy, caring and approachable the physician appeared, and how comfortable the respondent felt. Secondary outcome measures included variation in preferences by country, physician type and respondent characteristics. Results The highest rated forms of attire differed by country, although each most preferred attire with white coat. Low ratings were conferred on attire extremes (casual and business suit). Preferences were more uniform for certain physician types. For example, among all respondents, scrubs garnered the highest rating for emergency department physicians (44.2%) and surgeons (42.4%). However, attire preferences diverged for primary care and hospital physicians. All types of formal attire were more strongly preferred in the USA than elsewhere. Respondent age influenced preferences in Japan and the USA only. Conclusions Patients across a myriad of geographies, settings and demographics harbour specific preferences for physician attire. Some preferences are nearly universal, whereas others vary substantially. As a one-size-fits-all dress policy is unlikely to reflect patient desires and expectations, a tailored approach should be sought that attempts to match attire to clinical context.
... focused on why trust may or may not exist, the majority of which is explored through normative or quantitative methodologies [3,5,7,8]. To better capture this complex relational experience, we used a qualitative approach to elucidate the mechanisms and components of how trust forms between otolaryngologists and their surgical patients. ...
Article
Objective Trust is crucial to the success of any personal or professional relationship. Literature on trust in the surgeon-patient relationship has been largely explored through quantitative methodologies, primarily examining why trust may or may not exist. We aimed to qualitatively elucidate the mechanisms of how trust develops between otolaryngologists and their patients. Methods Patients were recruited by surgery scheduling staff following an outpatient visit where a decision had been made to proceed with surgery at a tertiary academic medical center. We used qualitative realist thematic analysis of phone interviews to explore participants’ (n = 17) perceptions and conceptualization of trust formation within the surgeon-patient relationship. Results Thematic analysis revealed three themes regarding trust formation in the surgeon-patient relationship: 1) Trust Across Various Contexts; 2) Impact of Prior Knowledge; and 3) Interpersonal Connection during the Clinical Encounter. Conclusion An interpersonal surgeon-patient connection is crucial to the formation of trust. Trust is also influenced by surgeon and institutional reputation and witnessed surgeon interactions with the healthcare team. Practice Implications Patients perceive trust in a surgeon as carrying unique importance. To optimize conditions for trust development in this context, surgical care paradigms should promote meaningful preoperative interpersonal surgeon-patient relationships and positive surgeon and institutional reputations.
... Pembelajaran tentang bagaimana membangun hubungan saling percaya antara dokter dan pasien sulit dan tidak bisa diajarkan kepada kita saat ini, walaupun menggunakan metode seperti dalam anatomi atau fisiologi (Hamelin et al., 2012). Dengan memberikan pelayanan yang berkualitas akan menciptakan persepsi yang baik dan dapat memuaskan konsumen sehingga menimbulkan kepercayaan. ...
Article
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The purpose of this study was to determine the effect of perceptions and beliefs on the interests of patient visits at Pematangsiantar Vita Medistra Clinic. Data analysis techniques used by the authors in this study are as follows in the form of quantitative descriptive analysis, Classical Assumption Test, Multiple Linear Regression Analysis, Hypothesis Test, Coefficient of determination. The object of research at the Vita Medistra Clinic which is located at Jalan Pattimura No. 11 / C Team SBC complex. City 21131, Tomuan Village, Siantar Timur District, Pematangsiantar City, North Sumatra 21139. The results of the study can be concluded as follows: The results of multiple regression repercussions and perceptions have a positive effect on the interest in patient re-visits. Hypothesis test results F-test perception and trust significantly influence the interest in return visits. The results of the t-test perception have a significant effect on interest in the visit, and trust significantly influence the interest of the patient's visit in Pematangsiantar Vita Medistra Clinic. he results of the coefficient of determination of 0.604 means The high or low interest of return visits to the Vita Medistra Clinic by 60.4% can be explained by perception and trust. The company must be a customer perception and trust given by customers about the company to increase interest in repeat visits
... Esta emergente participación yace no solo en la adquisición de conocimiento a través de tecnología, sino en la manifestación individual de autonomía propia de la actualidad. Cada vez más, las libertades individuales y la aparición de instituciones que velan por el respeto de estas estimulan la participación de los individuos en la toma de decisiones (7). La rápida transición se debe a fenómenos como internet, que facilitan el acceso a la información médica y dotan al paciente de conocimiento que le permite ser partícipe de las decisiones que se toman conforme a su salud; pero también complejiza su relación con el proveedor de salud (8,9). ...
Article
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Introducción: Actualmente, la medicina tiende a una atención centrada en el paciente. Esto se debe, no solo a la naturaleza de la profesión, sino también a que, inmersos en un sistema de salud en crisis, la satisfacción del paciente puede traducirse en mejores desenlaces en salud y, por ende, al menos a largo plazo, en ahorros importantes para los sistemas de salud. Objetivo: Llevar a cabo una revisión temática de la literatura que tratará sobre las expectativas del paciente frente al comportamiento del médico durante la atención. Métodos y materiales: Búsqueda en las bases de datos Pubmed, Lilacs y Embase con términos indexados y libres. Resultados: Se seleccionaron 46 artículos según los criterios de inclusión establecidos, y a partir de la información encontrada, se crearon 4 dimensiones relacionadas con el constructo de las expectativas: confianza, respeto (autonomía), empatía y comunicación. Finalmente, se sintetizó la información en conformidad con estas categorías. Conclusiones: Aunque pareciera existir una cantidad importante de investigaciones al respecto, también existe mucha divergencia entre los hallazgos. La mayoría de las veces, las investigaciones tratan dimensiones similares, pero las conclusiones son muy heterogéneas y resaltan las diferencias entre diferentes grupos culturales. En este orden de ideas, sugieren una aproximación local frente a las expectativas de los pacientes.
... 24,27 Hamelin refers to the non-verbal interpersonal skills of doctor as the "Art of Care" and describes it as "the communication of caring, concern, sincerity, compassion, and respect". 28 The hospitality and respectful behavior of the office staff and assistants also lead to the patients' satisfaction. 7,25,29 Thus, physicians should pay much attention to the way that their staff deal with patients. ...
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Background: The purpose of this study is to construct and validate a measurement model of women's preferences in Obstetrician and Gynecologist (OB/GYN) selection in the private sector of non-clinical parameters. Methods: This methodological study included 462 respondents in OB/GYN's offices to a researcher-made questionnaire. The patients visited 57 offices of OB/GYNs in the city of Mashhad in Iran and completed women's preferences in OB/GYN selection questionnaire over a 2-month period from January to February 2018. Exploratory Factor Analysis (EFA) was conducted to verify the instrument's construct validity. Confirmatory Factor Analysis (CFA) was used to test whether the data fit our hypothesized model obtained from EFA model. Results: The first draft of the questionnaire was prepared with 118 items based on literature review. The outcome of content validity assessment was a 51-item questionnaire. Scale-Content Validity Index (S-CVI) turned out to be 0.80. The results of EFA yielded an instrument with 33 items in six domains, which explained 52.657% of the total variance of the questionnaire. With performing CFA, the 6-factor model with 29 items demonstrated a good fit with the data (CFI=0.952, CMIN/DF=1.613, RMSEA=0.036). Availability and Accessibility, Communicational Skills, Office Environment, Recommendation by Others, Special Services, and Cost and Insurance were found to define the women's preferences in OB/GYN selection in private sector, Iran. Conclusion: The developed measurement model considers the patient's preferences that influence decision-making process on OB/GYN selection. It can provide useful knowledge for OB/GYNs and policymakers to design appropriate and efficient marketing strategies according to the consumer preferences priority.
... Consequently, there is a common use of terms to describe communication techniques that are not defined clearly and may vary in definitional intent between studies. For example, "attentive listening" or "active listening" is insufficiently defined in the literature, and when a definition is provided, it is often inconsistent [9][10][11][12][13][14][15][16]. The lack of consistent definitions for communication techniques described in the literature creates limitations in the development of interventions, fidelity, study replication, and translation to teaching and practice. ...
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Background Currently, there is no available standardized taxonomy of defined communication techniques and aids used by healthcare providers during patient consultations. It is challenging to identify communication techniques that contribute to effective healthcare provider and patient consultations and to replicate communication interventions in research. Objective The aim of this paper is to describe a protocol for the development and pilot of a taxonomy of communication techniques and aids used by healthcare providers during patient consultations. Methods A systematic review will be completed to identify eligible studies. Extracted techniques and aids will be organized into a preliminary taxonomy by a multidisciplinary team. The preliminary taxonomy will be piloted by two groups: research assistants trained in taxonomy application and healthcare providers and healthcare professional students not trained in taxonomy use. The pilot will use custom developed video footage of health provider and patient interactions. Interrater validity and interview feedback will be used to inform a Delphi panel of multidisciplinary healthcare providers and patient experts when they convene to finalize the preliminary taxonomy. Results This study was funded in November 2017 by the Monash University Interdisciplinary Research Seed Funding Scheme. Data collection commenced in March 2018, and data analysis is in progress. We expect the results to be published in 2021. Conclusions This is the first known attempt to develop a defined and standardized taxonomy of communication techniques and aids used by healthcare providers in patient consultations. The findings will be used to inform future research by providing a detailed taxonomy of healthcare providers’ communication techniques and standardized definitions. International Registered Report Identifier (IRRID) DERR1-10.2196/16801
... Consequently, they form deeper relations with the patient and often receive a lot of information on them, frequently quite intimate. In situations like these, gentleness, sensitivity, empathy, and, most importantly devoting time to the patient and to listening to them attentively, are indispensable [26]. ...
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Patients' trust in their physicians has recently become a focus of concern, largely owing to the rise of managed care, yet the subject remains largely unstudied. We undertook a qualitative research study of patients' self-reported experiences with trust in a physician to gain further understanding of the components of trust in the context of the patient-physician relationship. Twenty-nine patients participants, aged 26 to 72, were recruited from three diverse practice sites. Four focus groups, each lasting 1.5 to 2 hours, were conducted to explore patients' experiences with trust. Focus groups were audio-recorded, transcribed, and coded by four readers, using principles of grounded theory. The resulting consensus codes were grouped into seven categories of physician behavior, two of which related primarily to technical competence (thoroughness in evaluation and providing appropriate and effective treatment) and five of which were interpersonal (understanding patient's individual experience, expressing caring, communicating clearly and completely, building partnership/sharing power and honesty/respect for patient). Two additional categories were predisposing factors and structural/staffing factors. Each major category had multiple subcategories. Specific examples from each major category are provided. These nine categories of physician behavior encompassed the trust experiences related by the 29 patients. These categories and the specific examples provided by patients provide insights into the process of trust formation and suggest ways in which physicians could be more effective in building and maintaining trust.
Article
Although effective role models are important in medical education, little is known about the characteristics of physicians who serve as excellent clinical role models. We therefore conducted a case-control study to identify attributes that distinguish such physicians from their colleagues. We asked members of the internal-medicine house staff at four teaching hospitals to name physicians whom they considered to be excellent role models. A total of 165 physicians named by one or more house-staff members were classified as excellent role models (these served as the case physicians in our study). A questionnaire was sent to them as well as to 246 physicians who had residency-level teaching responsibilities but who were not named (controls). Of these 411 physicians, 341 (83 percent) completed questionnaires while unaware of their case-control status. Of the 341 attending physicians who responded, 144 (42 percent) had been identified as excellent role models. Having greater assigned teaching responsibilities was strongly associated with being identified as an excellent role model. In the multivariate analysis, five attributes were independently associated with being named as an excellent role model: spending more than 25 percent of one's time teaching (odds ratio, 5.12; 95 percent confidence interval, 1.81 to 14.47), spending 25 or more hours per week teaching and conducting rounds when serving as an attending physician (odds ratio, 2.48; 95 percent confidence interval, 1.15 to 5.37), stressing the importance of the doctor-patient relationship in one's teaching (odds ratio, 2.58; 95 percent confidence interval, 1.03 to 6.43), teaching the psychosocial aspects of medicine (odds ratio, 2.31; 95 percent confidence interval, 1.23 to 4.35), and having served as a chief resident (odds ratio, 2.07; 95 percent confidence interval, 1.07 to 3.98). These data suggest that many of the attributes associated with being an excellent role model are related to skills that can be acquired and to modifiable behavior.
Article
Changes in the structure of the health care system have placed unprecedented stress on the surgeon-patient relationship. The essential trust placed in the surgeon by her patients has been weakened by changes in the structure and financing of the health care system. This article considers the historical and ethical foundation of the surgeon-patient relationship and proposes that the primary moral obligation of surgeons is to strengthen and earn patient trust. By improving communication skills, enhancing ethical education, serving as consistent advocates for patients, and conducting patient-focused outcome research, the surgical community can meet its moral obligation by increasing trust in the surgeon-patient relationship.
Article
The goal for this study was to assess the relative strength of the association between physician behaviors and patient trust. STUDY DESIGN AND POPULATION: Patients (N=414) enrolled from 20 community-based family practices rated 18 physician behaviors and completed the Trust in Physician Scale immediately after their visits. Trust was also measured at 1 and 6 months after the visit. The association between physician behaviors and trust was examined in regard to patient sex, age, and length of relationship with the physician. All behaviors were significantly associated with trust (P<.0001), with Pearson correlation coefficients (r) ranging from 0.46 to 0.64. Being comforting and caring, demonstrating competency, encouraging and answering questions, and explaining were associated with trust among all groups. However, referring to a specialist if needed was strongly associated with trust only among women (r=0.61), more established patients (r=0.62), and younger patients (r=0.63). The behaviors least important for trust were gentleness during the examination, discussing options/asking opinions, looking in the eye, and treating as an equal. Caring and comfort, technical competency, and communication are the physician behaviors most strongly associated with patient trust. Further research is needed to test the hypothesis that changes in identified physician behaviors can lead to changes in the level of patient trust.
Article
Lack of time is a frequently expressed patient concern, but actual measured consultation length is often not associated with patient satisfaction. Correlational analysis of patients from nine GP practices was used to test the hypothesis that patients' perceptions of consultation length are influenced not just by actual consultation length, but by other aspects of their experience of consultations. The consultations of 160 patients were timed, and patients in subsequent interviews gave estimates of consultation duration and completed a satisfaction questionnaire. Consultations where patients were more satisfied appeared to patients to have lasted longer (partial correlation r = 0.26), but were not actually longer. Patient concerns about time may be as much about quality time as about actual time.
Article
Nearly half of all medical visits are to specialist physicians, yet little is known about patients' outpatient experiences with specialists or how patients' characteristics and experiences are related to trust in specialist physicians. We surveyed patients who had a new patient visit with a cardiologist, neurologist, nephrologist, gastroenterologist, or rheumatologist practicing in hospital-based practices (response rate, 73%; N = 417) and inquired about their experiences with care and trust in the specialist physician. We used multivariable models to assess associations of patients' characteristics and experiences with trust. Most patients reported good experiences, and 79% reported complete confidence and trust in the specialist. Black patients were less trusting than white patients (risk ratio [RR], 0.5; 95% confidence interval [CI], 0.2-0.8). Patients were more trusting if they reported that the consultant listened (RR, 1.8; 95% CI, 1.0-2.5), received as much information as they wanted (RR, 1.6; 95% CI, 1.1-1.9), were told what to do if problems or symptoms continued, got worse, or returned (RR, 1.4; 95% CI, 1.2-1.5), were involved in decisions as much as they wanted (RR, 1.5; 95% CI, 1.2-1.8), and spent as much time as they wanted with the specialist (RR, 1.8; 95% CI, 1.3-2.2). Patients reported high levels of trust in specialist physicians after an initial visit. Several specific experiences were associated with higher trust, suggesting that efforts to improve patient-physician interactions may be successful at achieving trust. Such efforts should especially aim to optimize physicians' interactions with black patients, who were less trusting of specialist physicians.
Article
To document patients' preferred dress styles of their doctors and modes of address. Descriptive survey. Inpatients and outpatients at a tertiary level hospital, New Zealand. 202 inpatients and 249 outpatients, mean age 55.9 (SD 19.3) years. Ranking of patients' opinions of photographs showing doctors wearing different dress styles. A five point Likert scale was used to measure patient comfort with particular items of appearance. Patients preferred doctors to wear semiformal attire, but the addition of a smiling face was even better. The next most preferred styles were semiformal without a smile, followed by white coat, formal suit, jeans, and casual dress. Patients were more comfortable with conservative items of clothing, such as long sleeves, covered shoes, and dress trousers or skirts than with less conservative items such as facial piercing, short tops, and earrings on men. Many less conservative items such as jeans were still acceptable to most patients. Most patients preferred to be called by their first name, to be introduced to a doctor by full name and title, and to see the doctor's name badge worn at the breast pocket. Older patients had more conservative preferences. Patients prefer doctors to wear semiformal dress and are most comfortable with conservative items; many less conservative items were, however, acceptable. A smile made a big difference.
Annual Demographic Estimates: Canada, Provinces and Territories http://www.statcan.gc.ca/cgi-bin/af-fdr.cgi?l=eng&amp;loc=http://www.statcan.gc.ca/pub/91-215-x/91-215-x2007000-eng.pdf&amp;t=Annual Demographic Estimates
  • Canada Statistics
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  • Ontario
  • Canada
  • Canada Statistics
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CanMEDS 2005 framework
  • J. Frank
  • J. Frank