A Scale Development Study To Measure The Trust Communication In The Patient-Physicians Relationship From A Patient Perspective

Öz

The physician-patient relationship plays an important role in health care processes. Trust in physicians has several benefits such as increasing satisfaction, compliance with treatment, continuity of patient care. The physician gives confidence to the patient; applying additional tests, eliminating inefficiencies caused by incomplete information disclosure by the patient and ıts provide effective clinical care. In this study, the issue of trust in the physician-patient relationship was discussed in three dimensions (the patient's trust in the health care behavior of the physician, physician decisions and the patient's behavior regarding the payment status). The study aims to develop a scale of trust communication in the patient-physician relationship. As a result of the analyses, a valid and reliable three-dimensional scale consisting of 19 items, which explained 56,505% of the total variance, was developed.

Anahtar Kelimeler

• Patient-Physician Relationship
• Trust Communication
• Scale Development

Hasta-Hekim İlişkisinde Güven İletişimi: Hastaların Bakış Açısıyla Ölçmeye Yönelik Bir Ölçek Geliştirme Çalışması

Öz

Hekim-hasta ilişkisi, sağlık bakım süreçlerinde önemli bir rol oynamaktadır. Hekime duyulan güven; artan memnuniyet, tedaviye uyum, bakımın sürekliliği de dahil olmak üzere çeşitli faydalar sağlamaktadır. Hekimin hastaya güven vermesi; ek testlere başvurma, hasta tarafından eksik bilgi verilmesinden kaynaklanan verimsizlikleri gidermekte ve etkili klinik bakım sağlamaktadır. Bu çalışmada, hekim-hasta ilişkisindeki güven konusu üç boyutta (hastanın; hekimin sağlık bakım davranışına, hekim kararlarına ve hekimin hastanın ödeme durumuna ilişkin davranışlarına duyduğu güven ile) ele alınmıştır. Çalışmanın amacı, hasta-hekim ilişkisinde güven iletişimine ilişkin bir ölçeğin geliştirilmesidir. Yapılan analizler sonucunda toplam varyansın %56,505’ini açıklayan, 19 maddeden oluşan üç boyutlu geçerli ve güvenilir bir ölçek geliştirilmiştir.

Anahtar Kelimeler

• Hasta-Hekim İlişkisi
• Güven İletişimi
• Ölçek Geliştirme
• Geçerlik-Güvenirlik

Kaynakça

1. Anderson, L. A., & Dedrick, R. F. (1990). Development of the trust in physician scale: A measure to assess interpersonal trust in patient-physician relationships. Psychological Reports, 67(3_suppl), 1091-1100.
2. Balkrishnan, R., Dugan, E., Camacho, F. T., & Hall, M. A. (2003). Trust and satisfaction with physicians, insurers, and the medical profession. Medical Care, 1058-1064.
3. Caterinicchio, R. P. (1979). Testing plausible path models of interpersonal trust in patient-physician treatment relationships. Social Science & Medicine. Part A: Medical Psychology & Medical Sociology, 13, 81-99.
4. Crawshaw, R., Rogers, D. E., Pellegrino, E. D., Bulger, R. J., Lundberg, G. D., Bristow, L. R., ... & Barondess, J. A. (1995). Patient-physician covenant. Jama, 273(19), 1553-1553.
5. Elk, R., & Landrine, H. (2012). Cancer disaparities: Causes and evidence-based solution. New York.: Springer Pub.
6. Epstein, R. M., Franks, P., Fiscella, K., Shields, C. G., Meldrum, S. C., Kravitz, R. L., & Duberstein, P. R. (2005). Measuring patient-centered communication in patient–physician consultations: Theoretical and practical ıssues. Social Science & Medicine, 61(7), 1516-1528.
7. Fiscella, K., Meldrum, S., Franks, P., Shields, C. G., Duberstein, P., McDaniel, S. H., & Epstein, R. M. (2004). Patient trust: Is it related to patient-centered behavior of primary care physicians?. Medical care, 1049-1055.
8. Fuertes, J. N., Mislowack, A., Bennett, J., Paul, L., Gilbert, T. C., Fontan, G., & Boylan, L. S. (2007). The physician–patient working alliance. Patient Education and Counseling, 66(1), 29-36.

9. Gezergün, A., Şahin, B., Tengilimoğlu, D., Demir, C., & Bayer, E. (2006). Hastaların bakış açısıyla hekim-hasta ilişkisi ve iletişimi; bir eğitim hastanesi örneği, Sosyal Bilimler Dergisi, 1: 129-144.
10. Gulbrandsen, P., Lindstrøm, J. C., Finset, A., & Hall, J. A. (2020). Patient affect, physician liking for the patient, physician behavior, and patient reported outcomes: A modeling approach. Patient Education and Counseling.
11. Hair JF, Black WC, Babin BJ, Anderson, RE. (2014). Multivariate data analysis (Pearson new internat. ed). Harlow: Pearson.
12. Hall, M. A., Camacho, F., Dugan, E., & Balkrishnan, R. (2002). Trust in the medical profession: conceptual and measurement issues. Health Services Research, 37(5), 1419-1439.
13. Hatcher L. (1994). A step-by-step approach to using the SAS system for factor analysis and structural equation modeling. Cary, NC: The SAS Institute.
14. Heybet, M., Tekin, O., Kahveci, R., Heybet, E. R., Yarloğlueş, G., Şencan, İ., ... & Özkara, A. (2016). Hastalarda hekim algısına yönelik bir ölçek geliştirme çalışması: hekim ilişkili sağlık hizmeti algılama. Konuralp Tıp Dergisi, 8 (2), 104-113.
15. Hillman, A. L. (1990). Health maintenance organizations, financial incentives, and physicians' judgments. Annals of Internal Medicine, 112(12), 891-893.
16. Hillman, A. L., Pauly, M. V., & Kerstein, J. J. (1989). How do financial incentives affect physicians' clinical decisions and the financial performance of health maintenance organizations?. New England Journal of Medicine, 321(2), 86-92.
17. Huang, C. C., Wang, Y. M., Wu, T. W., & Wang, P. A. (2013). An empirical analysis of the antecedents and performance consequences of using the moodle platform. International Journal of Information and Education Technology, 3(2), 217.
18. Kao, A. C., Green, D. C., Davis, N. A., Koplan, J. P., & Cleary, P. D. (1998). Patients’ trust in their physicians: Effects of choice, continuity, and payment method. Journal of General Internal Medicine, 13(10), 681-686.
19. Katz, J. (1984) The silent world of doctor and patient. New York: Free Press.
20. Kim, S. S., Kaplowitz, S., & Johnston, M. V. (2004). The effects of physician empathy on patient satisfaction and compliance. Evaluation & The Health Professions, 27(3), 237-251.
21. Lang, E. V (2012). A better patient experience through better communication. J Radiol Nur. 31, 114–119.
22. Martin, K. D., Roter, D. L., Beach, M. C., Carson, K. A., & Cooper, L. A. (2013). Physician Communication Behaviors and Trust Among Black and White Patients With Hypertension. Medical Care, 51(2), 151–157. doi:10.1097/mlr.0b013e31827632a2
23. Mechanic, D., & Meyer, S. (2000). Concepts of trust among patients with serious illness. Social Science & Medicine, 51(5), 657-668.
24. Nie, J. B., Tucker, J. D., Zhu, W., Cheng, Y., Wong, B., & Kleinman, A. M. (2017). Rebuilding patient-physician trust in China, developing a trust-oriented bioethics. Developing World Bioethics.
25. Parchman, M. L., & Burge, S. K. (2004). The patient-physician relationship, primary care attributes, and preventive services. Famıly Medıcıne-Kansas Cıty, 36(1), 22-27.
26. Pellegrini, C. A. (2017). Trust: the keystone of the patient-physician relationship. Journal of the American College of Surgeons, 224(2), 95-102.
27. Peng, Y., Yin, P., Deng, Z., & Wang, R. (2020). Patient–Physician Interaction and Trust in Online Health Community: The Role of Perceived Usefulness of Health Information and Services. International Journal of Environmental Research and Public Health, 17(1), 139.
28. Rolfe, A., Cash‐Gibson, L., Car, J., Sheikh, A., & McKinstry, B. (2014). Interventions for improving patients' trust in doctors and groups of doctors. Cochrane Database of Systematic Reviews, (3).
29. Sackett, D. L., Rosenberg, W. M., Gray, J. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence Based Medicine: What it is and what it isn't. Clin Orthop Relat Res, 455, 3-5.
30. Sherwood, A., Brinkmann, J., & Fatone, S. (2018). Review of benefits to practitioners of using good patient-practitioner communication. JPO: Journal of Prosthetics and Orthotics, 30 (1), 5-12.
31. Song, H., Zuo, X., Cui, C., & Meng, K. (2019). The willingness of patients to make the first visit to primary care institutions and its influencing factors in Beijing medical alliances: a comparative study of Beijing’s medical resource-rich and scarce regions. BMC Health Services Research, 19(1), 361.
32. Sulmasy, D. P. (1992). Physicians, cost control, and ethics. Annals of Internal Medicine, 116(11), 920-926.
33. Thom, D. H. (2001). Physician behaviors that predict patient trust. Journal of Family Practice, 50(4), 323-323.
34. Thom, D. H., & Campbell, B. (1997). Patient-Physician Trust: An Exploratory Study. The Journal of Family Practice, 44(2), 169.
35. Thom, D. H., Kravitz, R. L., Bell, R. A., Krupat, E., & Azari, R. (2002). Patient trust in the physician: relationship to patient requests. Family Practice, 19(5), 476-483.
36. Thom, D. H., Ribisl, K. M., Stewart, A. L., Luke, D. A., & The Stanford Trust Study Physicians. (1999). Further validation and reliability testing of the Trust in Physician Scale. Medical Care, 510-517.
37. Thom, D. H., Wong, S. T., Guzman, D., Wu, A., Penko, J., Miaskowski, C., & Kushel, M. (2011). Physician trust in the patient: development and validation of a new measure. The Annals of Family Medicine, 9(2), 148-154.
38. Thom, H. D. (2000). Training physicians to increase patient trust. Journal of Evaluation in Clinical Practice, 6(3), 245-253.
39. Trachtenberg, F., Dugan, E., & Hall, M. A. (2005). How patients' trust relates to their involvement in medical care. Journal of Family Practice, 54(4), 344-354.
40. Urfa, O., Yıldızer, G., Aşçı, F. H., Çağlar, E., & Miçooğulları, B. O. (2019). Kendini Fiziksel Tanımlama Envanteri Kısa Formunun Ergenlerde Geçerlilik ve Güvenirliliği. Turkiye Klinikleri Spor Bilimleri, 11(3): 153-63.
41. Weng, H. C. (2008). Does the physician's emotional intelligence matter?: Impacts of the physician's emotional intelligence on the trust, patient-physician relationship, and satisfaction. Health Care Management Review, 33(4), 280-288.
42. Whitcomb, M. E (2000). Communication and professionalism. Patient Educ Couns, 41, 137–144.
43. Yıldız, M. A. (2016). Ergenler için öfke düzenleme ölçeğinin (EİÜDÖ) geliştirilmesi ve psikometrik özelliklerinin incelenmesi. Düşünen Adam. The Journal of Psychiatry and Neurological Sciences, 29:247-258.
44. Yılmaz, A. A. (2005). Hasta-Hekim İlişkisinde Güven İletişimi Akdeniz Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı Tüp Bebek Ünitesinde bir Uygulama. (Yayınlanmış Yüksek Lisans Tezi). Akdeniz Üniversitesi, Sosyal Bilimler Enstitüsü, Antalya.