Examining the Effect of Health Communication Problems on Healthcare System Distrust: A Cross-Sectional Study
Yıl 2025,
Cilt: 8 Sayı: 1, 41 - 50, 26.03.2025
Zübeyde Ağalday
,
Hülya Keskin
Öz
Objective: This study investigates the impact of communication problems between patients and healthcare professionals on distrust in the healthcare system, as inpatients perceive.
Methods: The research was conducted as a cross-sectional study, and criterion sampling was used to select participants. The study sample comprised individuals aged 18-65 who had received treatment and care services in the inpatient units of a Training and Research Hospital in Türkiye at least once in the past year. Data were collected using the “Individual Identification Information Form,” the “Health Communication Problems Scale,” and the “Healthcare System Distrust Scale.”
Results: Patients' perceptions of health communication problems were measured at an average level of X̅=2.59±0.71, while their perceptions of distrust towards the healthcare system averaged X̅=2.75±0.74. Additionally, health communication problems accounted for 19% of the variance in explaining distrust in the healthcare system (R=0.43; R2=0.19).
Conclusion: The findings indicate that inpatients experienced relatively low communication problems with healthcare professionals and held moderate levels of distrust towards the healthcare system. The research concluded that health communication problems positively impact distrust in the healthcare system.
Kaynakça
- Ağır, Z. (2022). Aşı karşıtlığında sağlık sistemine güvensizlik ve kadercilik eğiliminin değerlendirilmesi (Tıpta Uzmanlık Tezi). [Sağlık Bilimleri Üniversitesi, Gaziosmanpaşa Sağlık Uygulama ve Araştırma Merkezi].
- Armstrong, K., Rose, A., Peters, N., Long, J. A., McMurphy, S., & Shea, J. A. (2006). Distrust of the health care system and self-reported health in the United States. Journal of General Internal Medicine, 21, 292–297. https://doi.org/10.1111/j.1525-1497.2006.00396.x
- Arslanoğlu, A., & Özargun, G. (2023). Sağlık iletişimi sorunlarının tedavi sürecine etkisi. Sağlık ve Sosyal Refah Araştırmaları Dergisi, 5(2), 212-223. https://doi.org/10.55050/sarad.1296929
- Başol, E. (2018). Hasta ile sağlık çalışanları (doktor ve hemşire) arasındaki iletişim sorunları ve çözüm önerileri. International Anatolia Academic Online Journal Social Sciences Journal, 4(1), 76-93.
- Beck, R. S., Daughtridge, R., & Sloane, P. D. (2002). Physician-patient communication in the primary care office: a systematic review. The Journal of the American Board of Family Practice, 15(1), 25-38.
- Blau, P. (2017). Exchange and power in social life. Routledge.
- Blendon, R. J., & Benson, J. M. (2001). Americans’ views on health policy: a fifty-year historical perspective. Health Affairs, 20(2), 33-46.
https://doi.org/10.1377/hlthaff.20.2.33.
- Brennan, T. A., Leape, L. L., Laird, N. M., Hebert, L., Localio, A. R., Lawthers, A. G., & Hiatt, H. H. (2004). Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. BMJ Quality & Safety, 13(2), 145-151. http://dx.doi.org/10.1136/qshc.2002.003822
- Chandra, S., Mohammadnezhad, M., & Ward, P. (2018). Trust and communication in a doctor-patient relationship: a literature review. Journal of Healthcare Communications, 3(3), 1-6. http://doi.org/10.4172/2472-1654.100146
- Chant, S., Randle, J., Russell, G., & Webb, C. (2002). Communication skills training in healthcare: a review of the literature. Nurse Education Today, 22(3), 189-202. https://doi.org/10.1054/nedt.2001.0690
- Cook, K. S., Hardin, R., & Levi, M. (2005). Cooperation without trust?. Russell Sage Foundation.
- Epstein, R. M., & Street Jr, R. L. (2011). The values and value of patient-centered care. Annals of Family Medicine, 9(2), 100-103. https://doi.org/10.1370/afm.1239
- Ehsan, U.,& Ashill, N. (2014). Drivers of patients' trusts in doctors: a study of private healthcare in Pakistan. International Journal of Healthcare Management, 7(4), 237-246. https://doi.org/10.1179/2047971914Y.0000000079
- Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149-1160. https://doi.org/10.3758/BRM.41.4.1149
- Gille, F., Smith, S., & Mays, N. (2021). What is public trust in the healthcare system? A new conceptual framework developed from qualitative data in England. Social Theory & Health, 19(1), 1-20. https://doi.org/10.1057/s41285-020-00129-x
- Gilson, L. (2006). Trust in health care: theoretical perspectives and research needs. Journal of Health Organization and Management, 20(5), 359-375. https://doi.org/10.1108/14777260610701768
- Gökçe, E., Atıcı, M., & Arslan, S. (2021). Hemşireler ile hastalar arasındaki iletişim sorunları ve beklentiler: Nitel bir araştırma. Sağlık ve Hemşirelik Yönetimi Dergisi, 8(2), 171-180. https://doi.org/10.5222/SHYD.2021.79206
- Gu, L., Tian, B., Xin, Y., Zhang, S., Li, J., & Sun, Z. (2022). Patient perception of doctor communication skills and patient trust in rural primary health care: the mediating role of health service quality. BMC Primary Care, 23(1), 255. https://doi.org/10.1186/s12875-022-01826-4
- Gül, N., & Dömbekci, H. A. (2023). Sağlık okuryazarlığının sağlık iletişimi sorunlarına etkisi: Manisa ili için değerlendirme. Süleyman Demirel Üniversitesi Vizyoner Dergisi, 14(38), 649-665. https://doi.org/10.21076/vizyoner.1197691
- Hall, M. A., Dugan, E., Zheng, B., & Mishra, A. K. (2001). Trust in physicians and medical institutions: what is it, can it be measured, and does it matter? The Milbank Quarterly, 79(4), 613-639. https://doi.org/10.1111/1468-0009.00223
- Hironaka, L. K., & Paasche-Orlow, M. K. (2008). The implications of health literacy on patient–provider communication. Archives of Disease in Childhood, 93(5), 428-432. http://dx.doi.org/10.1136/adc.2007.131516
- Hong, H., & Oh, H. J. (2020). The effects of patient-centered communication: exploring the mediating role of trust in healthcare providers. Health communication, 35(4), 502-511. https://doi.org/10.1080/10410236.2019.1570427
- Kim, H. Y. (2013). Statistical notes for clinical researchers: Assessing normal distribution (2) using skewness and kurtosis. Restorative Dentistry & Endodontics, 38(1), 52-54. https://doi.org/10.5395/rde.2013.38.1.52
- Kreps, G. L. (2015). Health communication inquiry and urban health: implications for reducing health disparities for at-risk urban populations. New York: Urban Communication Foundation.
- Kulińska, J., Rypicz, Ł., & Zatońska, K. (2022). The impact of effective communication on perceptions of patient safety-a prospective study in selected polish hospitals. International Journal of Environmental Research and Public Health, 19(15), 9174. https://doi.org/10.3390/ijerph19159174
- LaVeist, T. A., Isaac, L. A., & Williams, K. P. (2009). Mistrust of health care organizations is associated with underutilization of health services. Health Services Research, 44(6), 2093-2105. https://doi.org/10.1111/j.1475-6773.2009.01017.x
- Ndejjo, R., Hassen, H. Y., Wanyenze, R. K., Musoke, D., Nuwaha, F., Abrams, S., & Musinguzi, G. (2021). Community-based interventions for cardiovascular disease prevention in low-and middle-income countries: a systematic review. Public Health Reviews, 42, 1604018. https://doi.org/10.3389/phrs.2021.1604018
- Park, M., & Giap, T. T. T. (2020). Patient and family engagement as a potential approach for improving patient safety: a systematic review. Journal of Advanced Nursing, 76(1), 62-80. https://doi.org/10.1111/jan.14227
- Podsakoff, P. M., MacKenzie, S. B., Lee, J. Y., & Podsakoff, N. P. (2003). Common method biases in behavioral research: A critical review of the literature and recommended remedies. Journal of Applied Psychology, 88(5), 879-903.
- Rose, A., Peters, N., Shea, J. A., & Armstrong, K. (2004). Development and testing of the health care system distrust scale. J Gen Intern Med, 19(1), 57-63. https://doi.org/10.1111/j.1525-1497.2004.21146.x
- Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education Monographs, 2(4), 328-335. https://doi.org/10.1177/109019817400200403
- Saha, S., Beach, M. C., & Cooper, L. A. (2008). Patient centeredness, cultural competence and healthcare quality. Journal of the National Medical Association, 100(11), 1275-1285. https://doi.org/10.1016/S0027-9684(15)31505-4
- Schermelleh-Engel, K., Moosbrugger, H. & Müller, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures. Methods of Psychological Research Online, 8(2), 23-74.
- Setia, M. S. (2016). Methodology series module 3: Cross-sectional studies. Indian Journal of Dermatology, 61(3), 261-264. https://doi.org/10.4103/0019-5154.182410
- Skirbekk, H., Magelssen, M., & Conradsen, S. (2023). Trust in healthcare before and during the COVID-19 pandemic. BMC Public Health, 23(1), 863. https://doi.org/10.1186/s12889-023-15716-6
- Solmaz, B., & Duğan, Ö. (2018). Sağlık çalışanı ile hasta ve yakınları arasında yaşanan şiddetin nedenlerinden iletişim üzerine bir inceleme. Bolu Abant İzzet Baysal Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 18(2), 185-206.
- Souvatzi, E., Katsikidou, M., Arvaniti, A., Plakias, S., Tsiakiri, A., & Samakouri, M. (2024). Trust in Healthcare, Medical Mistrust, and Health Outcomes in Times of Health Crisis: A Narrative Review. Societies, 14(12), 269. https://doi.org/10.3390/soc14120269
- Stewart, M.A., Brown, J. B., Weston, W., McWhinney, I. R., McWilliam, C. L., & Freeman, T. (2013). Patient-centered medicine: transforming the clinical method. CRC Press.
- Street Jr, R. L., Makoul, G., Arora, N. K., & Epstein, R. M. (2009). How does communication heal? Pathways linking clinician-patient communication to health outcomes. Patient Education and Counseling, 74(3), 295-301. https://doi.org/10.1016/j.pec.2008.11.015
- Thompson, T. L., Parrott, R., & Nussbaum, J. F. (2011). The routledge handbook of health communication. Routledge.
- Uludağ, A. (2011). Hastane hasta hakları kurullarının iletişim sorunu içerikli başvurulara bakışı, Konya hastaneleri örneği. Türkiye Klinikleri Journal of Medical Sciences, 31(3), 653-663. https://doi.org/10.5336/medsci.2009-16481
- Uslu, D. (2023). Sağlık sistemlerine güvensizlik ile dijital sağlık ortamında veri yönetimi arasındaki ilişkinin incelenmesi. İşletme Akademisi Dergisi, 4(3), 355-366. http://dx.doi.org/10.29228/javs.57441
- Wei, D., Xu, A., & Wu, X. (2020). The mediating effect of trust on the relationship between doctor–patient communication and patients' risk perception during treatment. PsyCh Journal, 9(3), 383-391. https://doi.org/10.1002/pchj.327
- Yang, F., & Huang, Z. (2021). Health communication and trust in institutions during the COVID-19 lockdown in China's urban communities. Urban Governance, 1(1), 17-22. https://doi.org/10.1016/j.ugj.2021.10.001
- Yeşildal, M., Dömbekci, H. A., & Öztürk, Y. E. (2021). Sağlık iletişimi sorunları: Bir ölçek geliştirme çalışması. Türkiye Sosyal Hizmet Araştırmaları Dergisi, 5(2), 108-119.
- Yeşildal, M., Erişen, M., & Kıraç, R. (2020). Sağlık sistemlerine güvensizlik: bir geçerlilik ve güvenilirlik çalışması. Uluslararası Sağlık Yönetimi ve Stratejileri Araştırma Dergisi, 6(2), 251-259.
Examining the Effect of Health Communication Problems on Healthcare System Distrust: A Cross-Sectional Study
Yıl 2025,
Cilt: 8 Sayı: 1, 41 - 50, 26.03.2025
Zübeyde Ağalday
,
Hülya Keskin
Öz
Objective: This study investigates the impact of communication problems between patients and healthcare professionals on distrust in the healthcare system, as inpatients perceive.
Methods: The research was conducted as a cross-sectional study, and criterion sampling was used to select participants. The study sample comprised individuals aged 18-65 who had received treatment and care services in the inpatient units of a Training and Research Hospital in Türkiye at least once in the past year. Data were collected using the “Individual Identification Information Form,” the “Health Communication Problems Scale,” and the “Healthcare System Distrust Scale.”
Results: Patients' perceptions of health communication problems were measured at an average level of X̅=2.59±0.71, while their perceptions of distrust towards the healthcare system averaged X̅=2.75±0.74. Additionally, health communication problems accounted for 19% of the variance in explaining distrust in the healthcare system (R=0.43; R2=0.19).
Conclusion: The findings indicate that inpatients experienced relatively low communication problems with healthcare professionals and held moderate levels of distrust towards the healthcare system. The research concluded that health communication problems positively impact distrust in the healthcare system.
Kaynakça
- Ağır, Z. (2022). Aşı karşıtlığında sağlık sistemine güvensizlik ve kadercilik eğiliminin değerlendirilmesi (Tıpta Uzmanlık Tezi). [Sağlık Bilimleri Üniversitesi, Gaziosmanpaşa Sağlık Uygulama ve Araştırma Merkezi].
- Armstrong, K., Rose, A., Peters, N., Long, J. A., McMurphy, S., & Shea, J. A. (2006). Distrust of the health care system and self-reported health in the United States. Journal of General Internal Medicine, 21, 292–297. https://doi.org/10.1111/j.1525-1497.2006.00396.x
- Arslanoğlu, A., & Özargun, G. (2023). Sağlık iletişimi sorunlarının tedavi sürecine etkisi. Sağlık ve Sosyal Refah Araştırmaları Dergisi, 5(2), 212-223. https://doi.org/10.55050/sarad.1296929
- Başol, E. (2018). Hasta ile sağlık çalışanları (doktor ve hemşire) arasındaki iletişim sorunları ve çözüm önerileri. International Anatolia Academic Online Journal Social Sciences Journal, 4(1), 76-93.
- Beck, R. S., Daughtridge, R., & Sloane, P. D. (2002). Physician-patient communication in the primary care office: a systematic review. The Journal of the American Board of Family Practice, 15(1), 25-38.
- Blau, P. (2017). Exchange and power in social life. Routledge.
- Blendon, R. J., & Benson, J. M. (2001). Americans’ views on health policy: a fifty-year historical perspective. Health Affairs, 20(2), 33-46.
https://doi.org/10.1377/hlthaff.20.2.33.
- Brennan, T. A., Leape, L. L., Laird, N. M., Hebert, L., Localio, A. R., Lawthers, A. G., & Hiatt, H. H. (2004). Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. BMJ Quality & Safety, 13(2), 145-151. http://dx.doi.org/10.1136/qshc.2002.003822
- Chandra, S., Mohammadnezhad, M., & Ward, P. (2018). Trust and communication in a doctor-patient relationship: a literature review. Journal of Healthcare Communications, 3(3), 1-6. http://doi.org/10.4172/2472-1654.100146
- Chant, S., Randle, J., Russell, G., & Webb, C. (2002). Communication skills training in healthcare: a review of the literature. Nurse Education Today, 22(3), 189-202. https://doi.org/10.1054/nedt.2001.0690
- Cook, K. S., Hardin, R., & Levi, M. (2005). Cooperation without trust?. Russell Sage Foundation.
- Epstein, R. M., & Street Jr, R. L. (2011). The values and value of patient-centered care. Annals of Family Medicine, 9(2), 100-103. https://doi.org/10.1370/afm.1239
- Ehsan, U.,& Ashill, N. (2014). Drivers of patients' trusts in doctors: a study of private healthcare in Pakistan. International Journal of Healthcare Management, 7(4), 237-246. https://doi.org/10.1179/2047971914Y.0000000079
- Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149-1160. https://doi.org/10.3758/BRM.41.4.1149
- Gille, F., Smith, S., & Mays, N. (2021). What is public trust in the healthcare system? A new conceptual framework developed from qualitative data in England. Social Theory & Health, 19(1), 1-20. https://doi.org/10.1057/s41285-020-00129-x
- Gilson, L. (2006). Trust in health care: theoretical perspectives and research needs. Journal of Health Organization and Management, 20(5), 359-375. https://doi.org/10.1108/14777260610701768
- Gökçe, E., Atıcı, M., & Arslan, S. (2021). Hemşireler ile hastalar arasındaki iletişim sorunları ve beklentiler: Nitel bir araştırma. Sağlık ve Hemşirelik Yönetimi Dergisi, 8(2), 171-180. https://doi.org/10.5222/SHYD.2021.79206
- Gu, L., Tian, B., Xin, Y., Zhang, S., Li, J., & Sun, Z. (2022). Patient perception of doctor communication skills and patient trust in rural primary health care: the mediating role of health service quality. BMC Primary Care, 23(1), 255. https://doi.org/10.1186/s12875-022-01826-4
- Gül, N., & Dömbekci, H. A. (2023). Sağlık okuryazarlığının sağlık iletişimi sorunlarına etkisi: Manisa ili için değerlendirme. Süleyman Demirel Üniversitesi Vizyoner Dergisi, 14(38), 649-665. https://doi.org/10.21076/vizyoner.1197691
- Hall, M. A., Dugan, E., Zheng, B., & Mishra, A. K. (2001). Trust in physicians and medical institutions: what is it, can it be measured, and does it matter? The Milbank Quarterly, 79(4), 613-639. https://doi.org/10.1111/1468-0009.00223
- Hironaka, L. K., & Paasche-Orlow, M. K. (2008). The implications of health literacy on patient–provider communication. Archives of Disease in Childhood, 93(5), 428-432. http://dx.doi.org/10.1136/adc.2007.131516
- Hong, H., & Oh, H. J. (2020). The effects of patient-centered communication: exploring the mediating role of trust in healthcare providers. Health communication, 35(4), 502-511. https://doi.org/10.1080/10410236.2019.1570427
- Kim, H. Y. (2013). Statistical notes for clinical researchers: Assessing normal distribution (2) using skewness and kurtosis. Restorative Dentistry & Endodontics, 38(1), 52-54. https://doi.org/10.5395/rde.2013.38.1.52
- Kreps, G. L. (2015). Health communication inquiry and urban health: implications for reducing health disparities for at-risk urban populations. New York: Urban Communication Foundation.
- Kulińska, J., Rypicz, Ł., & Zatońska, K. (2022). The impact of effective communication on perceptions of patient safety-a prospective study in selected polish hospitals. International Journal of Environmental Research and Public Health, 19(15), 9174. https://doi.org/10.3390/ijerph19159174
- LaVeist, T. A., Isaac, L. A., & Williams, K. P. (2009). Mistrust of health care organizations is associated with underutilization of health services. Health Services Research, 44(6), 2093-2105. https://doi.org/10.1111/j.1475-6773.2009.01017.x
- Ndejjo, R., Hassen, H. Y., Wanyenze, R. K., Musoke, D., Nuwaha, F., Abrams, S., & Musinguzi, G. (2021). Community-based interventions for cardiovascular disease prevention in low-and middle-income countries: a systematic review. Public Health Reviews, 42, 1604018. https://doi.org/10.3389/phrs.2021.1604018
- Park, M., & Giap, T. T. T. (2020). Patient and family engagement as a potential approach for improving patient safety: a systematic review. Journal of Advanced Nursing, 76(1), 62-80. https://doi.org/10.1111/jan.14227
- Podsakoff, P. M., MacKenzie, S. B., Lee, J. Y., & Podsakoff, N. P. (2003). Common method biases in behavioral research: A critical review of the literature and recommended remedies. Journal of Applied Psychology, 88(5), 879-903.
- Rose, A., Peters, N., Shea, J. A., & Armstrong, K. (2004). Development and testing of the health care system distrust scale. J Gen Intern Med, 19(1), 57-63. https://doi.org/10.1111/j.1525-1497.2004.21146.x
- Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education Monographs, 2(4), 328-335. https://doi.org/10.1177/109019817400200403
- Saha, S., Beach, M. C., & Cooper, L. A. (2008). Patient centeredness, cultural competence and healthcare quality. Journal of the National Medical Association, 100(11), 1275-1285. https://doi.org/10.1016/S0027-9684(15)31505-4
- Schermelleh-Engel, K., Moosbrugger, H. & Müller, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures. Methods of Psychological Research Online, 8(2), 23-74.
- Setia, M. S. (2016). Methodology series module 3: Cross-sectional studies. Indian Journal of Dermatology, 61(3), 261-264. https://doi.org/10.4103/0019-5154.182410
- Skirbekk, H., Magelssen, M., & Conradsen, S. (2023). Trust in healthcare before and during the COVID-19 pandemic. BMC Public Health, 23(1), 863. https://doi.org/10.1186/s12889-023-15716-6
- Solmaz, B., & Duğan, Ö. (2018). Sağlık çalışanı ile hasta ve yakınları arasında yaşanan şiddetin nedenlerinden iletişim üzerine bir inceleme. Bolu Abant İzzet Baysal Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 18(2), 185-206.
- Souvatzi, E., Katsikidou, M., Arvaniti, A., Plakias, S., Tsiakiri, A., & Samakouri, M. (2024). Trust in Healthcare, Medical Mistrust, and Health Outcomes in Times of Health Crisis: A Narrative Review. Societies, 14(12), 269. https://doi.org/10.3390/soc14120269
- Stewart, M.A., Brown, J. B., Weston, W., McWhinney, I. R., McWilliam, C. L., & Freeman, T. (2013). Patient-centered medicine: transforming the clinical method. CRC Press.
- Street Jr, R. L., Makoul, G., Arora, N. K., & Epstein, R. M. (2009). How does communication heal? Pathways linking clinician-patient communication to health outcomes. Patient Education and Counseling, 74(3), 295-301. https://doi.org/10.1016/j.pec.2008.11.015
- Thompson, T. L., Parrott, R., & Nussbaum, J. F. (2011). The routledge handbook of health communication. Routledge.
- Uludağ, A. (2011). Hastane hasta hakları kurullarının iletişim sorunu içerikli başvurulara bakışı, Konya hastaneleri örneği. Türkiye Klinikleri Journal of Medical Sciences, 31(3), 653-663. https://doi.org/10.5336/medsci.2009-16481
- Uslu, D. (2023). Sağlık sistemlerine güvensizlik ile dijital sağlık ortamında veri yönetimi arasındaki ilişkinin incelenmesi. İşletme Akademisi Dergisi, 4(3), 355-366. http://dx.doi.org/10.29228/javs.57441
- Wei, D., Xu, A., & Wu, X. (2020). The mediating effect of trust on the relationship between doctor–patient communication and patients' risk perception during treatment. PsyCh Journal, 9(3), 383-391. https://doi.org/10.1002/pchj.327
- Yang, F., & Huang, Z. (2021). Health communication and trust in institutions during the COVID-19 lockdown in China's urban communities. Urban Governance, 1(1), 17-22. https://doi.org/10.1016/j.ugj.2021.10.001
- Yeşildal, M., Dömbekci, H. A., & Öztürk, Y. E. (2021). Sağlık iletişimi sorunları: Bir ölçek geliştirme çalışması. Türkiye Sosyal Hizmet Araştırmaları Dergisi, 5(2), 108-119.
- Yeşildal, M., Erişen, M., & Kıraç, R. (2020). Sağlık sistemlerine güvensizlik: bir geçerlilik ve güvenilirlik çalışması. Uluslararası Sağlık Yönetimi ve Stratejileri Araştırma Dergisi, 6(2), 251-259.