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1 – 10 of over 21000Using data from the General Social Survey (2002), structural equation modeling is employed to examine the intersections and relationships between various socio-demographic and…
Abstract
Using data from the General Social Survey (2002), structural equation modeling is employed to examine the intersections and relationships between various socio-demographic and contextual variables, patient trust, and patient preference for behaviors that indicate a desire to be an active health care participant. In so doing, a gap in the literature is addressed by uniting previous research on patient trust with research on patient participation. Findings reveal that patient trust in doctors and various socio-demographic and contextual variables are associated with people wanting to participate in the health care process by learning about medical issues on their own and by contributing to medical decisions. Results also shed new light on past research, which finds a relationship between various socio-demographic variables and patient trust. Specifically, they highlight the importance of distinguishing between patient trust in doctors and patient trust in the broader health care institution and the economic pressures it exerts on doctors. A discussion of what these findings might mean for our understanding of the doctor-patient relationship and the delivery of health care concludes the chapter.
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Mais Al-hilou and Taghrid Suifan
The prime aim of this research is to examine the mediating effect of patient trust on the relationship between service quality and patient satisfaction in Amman, Jordan.
Abstract
Purpose
The prime aim of this research is to examine the mediating effect of patient trust on the relationship between service quality and patient satisfaction in Amman, Jordan.
Design/methodology/approach
A convenience sample of patients visiting seven out of the 44 private hospitals in Amman was selected. In total, 385 questionnaires were distributed among patients, with a response rate of 91%. Of these, 35 were disregarded, and the data from the remaining 350 questionnaires were analyzed using SPSS.
Findings
The results showed that service quality has a statistically significant effect on patient satisfaction. Furthermore, service quality has a statistically significant effect on patient trust, while there is also a statistically significant effect of patient trust on patient satisfaction. The findings also revealed that patient satisfaction partially mediates the relationship between service quality and patient satisfaction.
Originality/value
Generating more insights in the areas of service quality, patient trust and patient satisfaction while also extending the findings of earlier studies. The prior studies in the literature that focus on customers are given a more advantageous perspective by using Jordanian hospitals as a population to test the model of this research. The majority of past research on service quality, patient satisfaction and patient trust in the healthcare sector has been conducted in western nations.
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Vikki Ann Entwistle and Oliver Quick
This paper considers some implications of recent developments relating to patient safety for understandings of trust in health care contexts.
Abstract
Purpose
This paper considers some implications of recent developments relating to patient safety for understandings of trust in health care contexts.
Design/methodology/approach
Conceptual analysis focusing on patients' trust in health care providers and health care providers' trust in patients.
Findings
Growing awareness of the scale of the problem of iatrogenic harm has prompted concerns that patients' trust in health care providers may be threatened and/or become inappropriate or dysfunctional. In principle, however, patients' trust may be both well placed and compatible with current understandings of safety problems and efforts to address these. Contemporary understandings of patient safety suggest that, to be deemed trustworthy, health care providers should make vigorous efforts to improve patient safety, be honest about safety issues, enable patients to contribute effectively to their own safety, and provide appropriate care and support after safety incidents. Patients who trust health care providers need not be ignorant of patient safety problems and may be vigilant in the course of their care. Iatrogenic harms do not necessarily reflect breeches of trust (not all such harms are yet preventable), and patients who are harmed might in some circumstances appropriately forgive and resume trusting. Health care providers may feel vulnerable to patients in several respects. From their perspective, trustworthy patients will act competently to optimise the outcomes of their health care efforts and to preserve health care providers' good reputations where those are justified. Providers' trust in patients may strengthen patients' trust in them and facilitate safety improvement work.
Originality/value
Shows how, in principle, trust can be compatible with current understandings of patient safety issues and may enhance efforts to improve patient safety.
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Eva Söderström, Nomie Eriksson and Rose-Mharie Åhlfeldt
– The purpose of this paper is to analyze two case studies with a trust matrix tool, to identify trust issues related to electronic health records.
Abstract
Purpose
The purpose of this paper is to analyze two case studies with a trust matrix tool, to identify trust issues related to electronic health records.
Design/methodology/approach
A qualitative research approach is applied using two case studies. The data analysis of these studies generated a problem list, which was mapped to a trust matrix.
Findings
Results demonstrate flaws in current practices and point to achieving balance between organizational, person and technology trust perspectives. The analysis revealed three challenge areas, to: achieve higher trust in patient-focussed healthcare; improve communication between patients and healthcare professionals; and establish clear terminology. By taking trust into account, a more holistic perspective on healthcare can be achieved, where trust can be obtained and optimized.
Research limitations/implications
A trust matrix is tested and shown to identify trust problems on different levels and relating to trusting beliefs. Future research should elaborate and more fully address issues within three identified challenge areas.
Practical implications
The trust matrix’s usefulness as a tool for organizations to analyze trust problems and issues is demonstrated.
Originality/value
Healthcare trust issues are captured to a greater extent and from previously unchartered perspectives.
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Po-Chien Chang, Ting Wu and Juan Du
The purpose of this study is to examine the dual effects of the violation of psychological contract on patient’s antisocial behaviour via the mediator of patient trust and the…
Abstract
Purpose
The purpose of this study is to examine the dual effects of the violation of psychological contract on patient’s antisocial behaviour via the mediator of patient trust and the role of doctor-patient communication as a critical contingent variable in the psychological contract violation of patient’s antisocial behaviour relationship.
Design/methodology/approach
The data were collected from 483 hospitalized patients distributed in Shanxi province, China by using a self-administered survey.
Findings
The results indicated that psychological contract violation is positively associated with patient antisocial behaviour via patient trust. Moreover, the study found that doctor-patient communication moderates the mediated effects of psychological contract violation on patient’s antisocial behaviour through patient trust; that is, the mediated effect on antisocial behaviour is weaker when both doctor and patients have more communication.
Research limitations/implications
Due to a cross-sectional design in nature, the causal relationship cannot be developed based on the results. Despite the limitation, the present study provides insights for improving doctor-patient relationship by emphasizing the importance of increasing patient trust and doctor-patient communication.
Practical implications
To improve the quality of doctor-patient relationship, this study addresses the significance of properly showing understandings and care to regain mutual trust and reducing the likelihood of patient’s antisocial behaviour.
Social implications
The research findings have implications for both the health system and medical schools in China to reinforce the professional ethics and improve their medical humanities as the main concerns to generate a more sustainable doctor–patient relationship.
Originality/value
This study includes patient trust as a mediator and doctor-patient communication as a moderator to investigate the moderated mediation relationship among patients and medical professionals. By further examining the doctor-patient relationship, the results may not only help improve the efficient implementation of medical practices but also support the institutes and develop medical professionals for more positive doctor-patient relationships.
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Nadia Robb and Trisha Greenhalgh
This article explores issues of trust in narratives of interpreted consultations in primary health care.
Abstract
Purpose
This article explores issues of trust in narratives of interpreted consultations in primary health care.
Design/methodology/approach
The paper is based on empirical data from a qualitative study of accounts of interpreted consultations in UK primary care, undertaken in three north London boroughs. In a total of 69 individual interviews and two focus groups, narratives of interpreted consultations were sought from 18 service users, 17 professional interpreters, nine family member interpreters, 13 general practitioners, 15 nurses, eight receptionists, and three practice managers. The study collected and analysed these using a grounded theory approach and taking the story as the main unit of analysis. It applies a theoretical model that draws on three key concepts: Greener's taxonomy of trust based on the different “faces” of power in medical consultations; Weber's notion of bureaucratic vs traditional social roles; and Habermas' distinction between communicative and strategic action.
Findings
Trust was a prominent theme in almost all the narratives. The triadic nature of interpreted consultations creates six linked trust relationships (patient‐interpreter, patient‐clinician, interpreter‐patient, interpreter‐clinician, clinician‐patient and clinician‐interpreter). Three different types of trust are evident in these different relationships – voluntary trust (based on either kinship‐like bonds and continuity of the interpersonal relationship over time, or on confidence in the institution and professional role that the individual represents), coercive trust (where one person effectively has no choice but to trust the other, as when a health problem requires expert knowledge that the patient does not have and cannot get) and hegemonic trust (where a person's propensity to trust, and awareness of alternatives, is shaped and constrained by the system so that people trust without knowing there is an alternative). These different types of trust had important implications for the nature of communication in the consultation and on patients' subsequent action.
Research limitations/implications
The methodological and analytic approach, potentially, has wider applications in the study of other trust relationships in health and social care.
Practical implications
Quality in the interpreted consultation cannot be judged purely in terms of accuracy of translation. The critical importance of voluntary trust for open and effective communication, and the dependence of the latter on a positive interpersonal relationship and continuity of care, should be acknowledged in the design and funding of interpreting services and in the training of both clinicians, interpreters and administrative staff.
Originality/value
This is the first study in which interpreted consultations have been analysed from a perspective of critical sociology with a particular focus on trust and power relations.
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Yan Wan, Yifan Zhang and Mengling Yan
Online trust is a key factor for successful online transactions. To some extent, online health consultation can be considered an online transaction. Owing to the unique physician…
Abstract
Purpose
Online trust is a key factor for successful online transactions. To some extent, online health consultation can be considered an online transaction. Owing to the unique physician–patient relationship, patients' choice of physicians within an online health consultation setting may not only be based on rational judgments but also considerably affected by their feelings. Hence, the purpose of this study was to explore which physicians' attributes affect patients' cognitive and affective trust in physicians, as well as how these two variables and their association affect patients' willingness to choose.
Design/methodology/approach
Based on the broad conceptual framework of online trust, this paper proposed a set of hypotheses that were tested through analyzing survey data using structural equation modeling techniques.
Findings
Results showed that physicians' ability had a significant positive influence on patients' cognitive trust in the physician; physicians' integrity and benevolence had a significant positive influence on patients' affective trust in the physician; cognitive and affective trust had a significant positive impact on patients' willingness to choose and there were significant positive interactions between affective and cognitive trust.
Originality/value
This study theoretically enriches the generic model of online trust. From the practical perspective, it will provide physicians working in online health consultation platforms and relevant practitioners with baseline information on the topic and advice for decision-making toward service enhancement and clientele improvements.
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Mellina da Silva Terres and Cristiane Pizzutti dos Santos
The purpose of this paper is to address the impact of affect (as opposed to cognition) on patient trust in high‐consequence exchanges. The authors also investigate the mediator's…
Abstract
Purpose
The purpose of this paper is to address the impact of affect (as opposed to cognition) on patient trust in high‐consequence exchanges. The authors also investigate the mediator's role of trust in the relationship between affect and cognition, and behavioural intentions.
Design/methodology/approach
Using undergraduate students from a large North American university, three between‐subjects experiments were performed.
Findings
Study 1 findings demonstrate that affect and cognition elements equally influence trust in high‐consequence decisions. Also, trust is an important mediator between affect and cognition and the intention to continue the relationship and to seek a second opinion. Study 2 reinforces the importance of trust for the patient's evaluations, showing that when trust is low, the second opinion influences patient satisfaction. However, when patient trust is high, the second opinion (the same or different, compared with the first diagnosis) does not affect patient satisfaction. Study 3 shows that, in low‐consequence choices, cognition is a more relevant antecedent of trust than affect. Affect is important when cognition aspects (e.g. the competence of the doctor) are perceived as low.
Originality/value
As an original contribution, this study addresses the different impacts of affect and cognition aspects on patient trust, in high‐ and low‐consequence exchanges. Also, it highlights the importance of patient trust in the doctor when a second opinion is sought: a different diagnosis depletes patient satisfaction only for patients with low levels of trust in the doctor.
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Existing descriptions of trust in health care largely assume a straightforward association between a patient’s relationship with a regular provider and his or her trust in health…
Abstract
Purpose
Existing descriptions of trust in health care largely assume a straightforward association between a patient’s relationship with a regular provider and his or her trust in health care. I extend status characteristics theory (SCT) and social identity theory (SIT) to suggest greater variability in this association by investigating the role of social differences between patients and their regular providers. Whereas the SIT extension predicts lower trust in dissimilar than similar dyads, the predictions from the SCT extension depend on status in dissimilar dyads. Further, research examining how social differences in patient–provider dyads shape trust largely emphasizes racial differences, but the theories implicate gender differences too.
Methodology/approach
I analyze a longitudinal dataset of patient–provider dyads offering a conservative test of the extensions.
Findings
Results generally support predictions from the SCT extension. Specifically, patients’ status based on differences in either race or gender: (1) is inversely related to their trust in health care and (2) influences the resiliency of their trust, whereby the degree health care met prior expectations matters less (more) for the trust of low (high) status patients than equal status patients.
Research limitations/implications
When patients and providers differ on both race and gender, findings sometimes depart from predictions. This indicates differences in two social categories is a unique situation where the contributions of each category are distinct from that of the other.
Originality/value
This research extends SCT to explain greater variability in the connection between patient–provider dyads and trust in health care, while also showing how gender compares to race.
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Brita Gjerstad, Svein Ingve Nødland and Inger Lise Teig
Trust plays an important role in the organisation of healthcare services. In Norway, the establishment of mandatory municipal acute wards with 24 h inpatient services introduces a…
Abstract
Purpose
Trust plays an important role in the organisation of healthcare services. In Norway, the establishment of mandatory municipal acute wards with 24 h inpatient services introduces a new unit into the healthcare system. This article discusses how this new health care service succeeds in building trust with patients and among healthcare workers.
Design/methodology/approach
The article is an in-depth case study of a single, exemplary inter-municipal acute ward. The study draws on interviews with COPD patients, the leader and doctors at the ward. The study also includes observations of daily work at the municipal acute ward. Moreover, administrators and healthcare workers at related healthcare institutions have been interviewed. Data were analysed using a qualitative method.
Findings
The study reveals that trust is built in complex relations and that it has both individual and systemic factors. The practices employed in the daily treatment and care of patients and in encounters between health care personnel and patients are important trust-building processes; however, these processes depend on structures and routines that promote efficient and adequate inter-organisational communication and patient-oriented procedures.
Practical implications
The study provides insight into how trust dynamics work on multiple organisational levels and how they depend on both individual and systemic factors. Additionally, the study may provide a picture of the importance of trust in organising healthcare services in the future.
Originality/value
Lessons regarding trust building inspired by data from a case-study care institution can be applied in different care settings and countries.
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