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Published in: Journal of General Internal Medicine 6/2008

01-06-2008 | Original Article

Development and Testing of the Multidimensional Trust in Health Care Systems Scale

Authors: Leonard E. Egede, MD MS, Charles Ellis, PhD

Published in: Journal of General Internal Medicine | Issue 6/2008

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Abstract

Objective

To describe the development and psychometric testing of the Multidimensional Trust in Health Care Systems Scale (MTHCSS).

Methods

Scale development occurred in 2 phases. In phase 1, a pilot instrument with 70 items was generated from the review of the trust literature, focus groups, and expert opinion. The 70 items were pilot tested in a sample of 256 students. Exploratory factor analysis was used to derive an orthogonal set of correlated factors. In phase 2, the final scale was administered to 301 primary care patients to assess reliability and validity. Phase 2 participants also completed validated measures of patient-centered care, health locus of control, medication nonadherence, social support, and patient satisfaction.

Results

In phase 1, a 17-item scale (MTHCSS) was developed with 10 items measuring trust in health care providers, 4 items measuring trust in health care payers, and 3 items measuring trust in health care institutions. In phase 2, the 17-item MTHCSS had a mean score of 63.0 (SD 8.8); the provider subscale had a mean of 40.0 (SD 6.2); the payers subscale had a mean of 12.8 (SD 3.0); and the institutions subscale had a mean of 10.3 (SD 2.1). Cronbach’s α for the MTHCSS was 0.89 and 0.92, 0.74, and 0.64 for the 3 subscales. The MTHCSS was significantly correlated with patient-centered care (r = .22 to .62), locus of control—chance (r = .42), medication nonadherence (r = −.22), social support (r = .25), and patient satisfaction (r = .67).

Conclusions

The MTHCSS is a valid and reliable instrument for measuring the 3 objects of trust in health care and is correlated with patient-level health outcomes.
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Metadata
Title
Development and Testing of the Multidimensional Trust in Health Care Systems Scale
Authors
Leonard E. Egede, MD MS
Charles Ellis, PhD
Publication date
01-06-2008
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue 6/2008
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-008-0613-1

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