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Published in: Journal of General Internal Medicine 1/2011

01-01-2011 | Original Research

The Import of Trust in Regular Providers to Trust in Cancer Physicians among White, African American, and Hispanic Breast Cancer Patients

Authors: Karen Kaiser, PhD, Garth H. Rauscher, PhD, Elizabeth A. Jacobs, MD, MPP, Teri A. Strenski, MS, Carol Estwing Ferrans, PhD, RN, FAAN, Richard B. Warnecke, PhD

Published in: Journal of General Internal Medicine | Issue 1/2011

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Abstract

BACKGROUND

Interpersonal trust is an important component of the patient-doctor relationship. Little is known about patients’ trust in the multiple providers seen when confronting serious illness.

OBJECTIVES

To characterize breast cancer patients’ trust in their regular providers, diagnosing physicians, and cancer treatment team and examine whether high trust in one’s regular provider confers high trust to cancer physicians.

DESIGN

In-person interviews.

PARTICIPANTS

704 white, black, and Hispanic breast cancer patients, age 30 to 79, with a first primary in situ or invasive breast cancer who reported having a regular provider.

MEASURES

We measure trust in: (1) regular provider, (2) diagnosing doctors, and (3) cancer treatment team. Other variables include demographic variables, preventive health care, comorbidities, time with regular provider, time since diagnosis, cancer stage, and treatment modality.

RESULTS

Sixty-five percent of patients reported high trust in their regular provider, 84% indicated high trust in their diagnosing doctors, and 83% reported high trust in their treatment team. Women who reported high trust in their regular provider were significantly more likely to be very trusting of diagnosing doctors (OR: 3.44, 95% CI: 2.27–5.21) and cancer treatment team (OR: 3.09, 95% CI: 2.02–4.72 ). Black women were significantly less likely to be very trusting of their regular doctor (OR: 0.58, 95% CI: 0.38–0.88) and cancer treatment team (OR: 0.45, 95% CI: 0.25–0.80). English-speaking Hispanic women were significantly less trusting of their diagnosing doctors (OR: 0.29, 95% CI: 0.11–0.80).

CONCLUSIONS

Our results suggest that patients are very trusting of their breast cancer providers. This is an important finding given that research with other populations has shown an association between trust and patient satisfaction and treatment adherence. Our findings also suggest that a trusting relationship with a regular provider facilitates trusting relationships with specialists. Additional work is needed to increase interpersonal trust among black women.
Literature
1.
go back to reference Calnan M, Rowe R. Researching trust relations in health care. J Organisat Manag. 2006;20(5):349–58.CrossRef Calnan M, Rowe R. Researching trust relations in health care. J Organisat Manag. 2006;20(5):349–58.CrossRef
2.
go back to reference Hall MA, et al. Trust in physicians and medical institutions: what is it, can it be measured, and does it matter? Milbank Q. 2001;79(4):613–39.CrossRefPubMed Hall MA, et al. Trust in physicians and medical institutions: what is it, can it be measured, and does it matter? Milbank Q. 2001;79(4):613–39.CrossRefPubMed
3.
go back to reference Safran, D.G., et al. Linking primary care performance to outcomes of care. J Fam Pract, 1998. v47(n3): p 213(8). Safran, D.G., et al. Linking primary care performance to outcomes of care. J Fam Pract, 1998. v47(n3): p 213(8).
4.
go back to reference Kraetschmer N, et al. How does trust affect patient preferences for participation in decision-making? Health Expect. 2004;7(4):317–26.CrossRefPubMed Kraetschmer N, et al. How does trust affect patient preferences for participation in decision-making? Health Expect. 2004;7(4):317–26.CrossRefPubMed
5.
go back to reference Piette JD, et al. The role of patient-physician trust in moderating medication nonadherence due to cost pressures. Arch Intern Med. 2005;165(15):1749–55.CrossRefPubMed Piette JD, et al. The role of patient-physician trust in moderating medication nonadherence due to cost pressures. Arch Intern Med. 2005;165(15):1749–55.CrossRefPubMed
6.
go back to reference Altice FL, Mostashari F, Friedland GH. Trust and the acceptance of and adherence to antiretroviral therapy. J Acquir Immune Defic Syndr. 2001;28(1):47–58.PubMed Altice FL, Mostashari F, Friedland GH. Trust and the acceptance of and adherence to antiretroviral therapy. J Acquir Immune Defic Syndr. 2001;28(1):47–58.PubMed
7.
go back to reference Schneider J, et al. Better physician-patient relationships are associated with higher reported adherence to antiretroviral therapy in patients with HIV infection. J Gen Intern Med. 2004;19(11):1096–103.CrossRefPubMed Schneider J, et al. Better physician-patient relationships are associated with higher reported adherence to antiretroviral therapy in patients with HIV infection. J Gen Intern Med. 2004;19(11):1096–103.CrossRefPubMed
8.
go back to reference Mostashari F, et al. Acceptance and adherence with antiretroviral therapy among HIV-infected women in a correctional facility. J Acquir Immune Defic Syndr Human Retrovirol. 1998;18:341–8. Mostashari F, et al. Acceptance and adherence with antiretroviral therapy among HIV-infected women in a correctional facility. J Acquir Immune Defic Syndr Human Retrovirol. 1998;18:341–8.
9.
go back to reference Safran DG, et al. Switching doctors: predictors of voluntary disenrollment from a primary physician’s practice. J Fam Pract. 2001;50(2):130–6.PubMed Safran DG, et al. Switching doctors: predictors of voluntary disenrollment from a primary physician’s practice. J Fam Pract. 2001;50(2):130–6.PubMed
10.
go back to reference Thom DH, et al. Patient trust in the physician: relationship to patient requests. Fam Pract. 2002;19(5):476–83.CrossRefPubMed Thom DH, et al. Patient trust in the physician: relationship to patient requests. Fam Pract. 2002;19(5):476–83.CrossRefPubMed
11.
go back to reference Ahmed NU, et al. Empowering factors for regular mammography screening in under-served populations: pilot survey results in tennessee. Ethn Dis. 2005;15(3):387–394.PubMed Ahmed NU, et al. Empowering factors for regular mammography screening in under-served populations: pilot survey results in tennessee. Ethn Dis. 2005;15(3):387–394.PubMed
12.
go back to reference Sheppard V, et al. Are health-care relationships important for mammography adherence in latinas? J Gen Intern Med. 2008;23(12):2024–30.CrossRefPubMed Sheppard V, et al. Are health-care relationships important for mammography adherence in latinas? J Gen Intern Med. 2008;23(12):2024–30.CrossRefPubMed
13.
go back to reference O'Malley AS, et al. The role of trust in use of preventive services among low-income African-American women. Prev Med. 2004;38(6):777–85.CrossRefPubMed O'Malley AS, et al. The role of trust in use of preventive services among low-income African-American women. Prev Med. 2004;38(6):777–85.CrossRefPubMed
14.
go back to reference Lansdown M, Martin L, Fallowfield L. Patient-physician interactions during early breast-cancer treatment: results from an international online survey. Curr Med Res Opin. 2008;24(7):1891–904.CrossRefPubMed Lansdown M, Martin L, Fallowfield L. Patient-physician interactions during early breast-cancer treatment: results from an international online survey. Curr Med Res Opin. 2008;24(7):1891–904.CrossRefPubMed
15.
go back to reference Penman DT, et al. Informed consent for investigational chemotherapy: patients' and physicians' perceptions. J Clin Oncol. 1984;2(7):849–55.PubMed Penman DT, et al. Informed consent for investigational chemotherapy: patients' and physicians' perceptions. J Clin Oncol. 1984;2(7):849–55.PubMed
16.
go back to reference Mainous AG III, et al. The relationship between continuity of care and trust with stage of cancer at diagnosis. Fam Med. 2004;6(1):35–9. Mainous AG III, et al. The relationship between continuity of care and trust with stage of cancer at diagnosis. Fam Med. 2004;6(1):35–9.
17.
go back to reference Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q. 2005;83(3):457–502.CrossRefPubMed Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q. 2005;83(3):457–502.CrossRefPubMed
18.
go back to reference Hickner J, et al. Physicians' and patients' views of cancer care by family physicians: a report from the american academy of family physicians national research network. Fam Med. 2007;39(2):126–31.PubMed Hickner J, et al. Physicians' and patients' views of cancer care by family physicians: a report from the american academy of family physicians national research network. Fam Med. 2007;39(2):126–31.PubMed
19.
go back to reference Bulsara C, Ward AM, Joske D. Patient perceptions of the GP role in cancer management. Aust Fam Physician. 2005;34(4):299–300.PubMed Bulsara C, Ward AM, Joske D. Patient perceptions of the GP role in cancer management. Aust Fam Physician. 2005;34(4):299–300.PubMed
20.
go back to reference Klabunde C, et al. The role of primary care physicians in cancer care. J Gen Intern Med. 2009;24(9):1029–36.CrossRefPubMed Klabunde C, et al. The role of primary care physicians in cancer care. J Gen Intern Med. 2009;24(9):1029–36.CrossRefPubMed
21.
go back to reference Keating N, et al. Patient Characteristics and experiences associated with trust in specialist physicians. Arch Intern Med. 2004;164:1015–20.CrossRefPubMed Keating N, et al. Patient Characteristics and experiences associated with trust in specialist physicians. Arch Intern Med. 2004;164:1015–20.CrossRefPubMed
22.
go back to reference Grumbach K, et al. Resolving the gatekeeper conundrum: what patients value in primary care and referrals to specialists. JAMA. 1999;282(3):261–6.CrossRefPubMed Grumbach K, et al. Resolving the gatekeeper conundrum: what patients value in primary care and referrals to specialists. JAMA. 1999;282(3):261–6.CrossRefPubMed
23.
go back to reference Boulware LE, et al. Race and trust in the health care system. Public health reports (Washington, DC: 1974), 2003. 118(4): p 358-365. Boulware LE, et al. Race and trust in the health care system. Public health reports (Washington, DC: 1974), 2003. 118(4): p 358-365.
24.
go back to reference Gordon HS, et al. Racial differences in trust and lung cancer patients' perceptions of physician communication. J Clin Oncol. 2006;24(6):904–9.CrossRefPubMed Gordon HS, et al. Racial differences in trust and lung cancer patients' perceptions of physician communication. J Clin Oncol. 2006;24(6):904–9.CrossRefPubMed
25.
go back to reference Halbert CH, et al. Racial differences in trust in health care providers. Arch Intern Med. 2006;166(8):896–901.CrossRefPubMed Halbert CH, et al. Racial differences in trust in health care providers. Arch Intern Med. 2006;166(8):896–901.CrossRefPubMed
26.
go back to reference Masi C, Gehlert S. Perceptions of breast cancer treatment among african-american women and men: implications for interventions. J Gen Intern Med. 2009;24(3):408–14.CrossRefPubMed Masi C, Gehlert S. Perceptions of breast cancer treatment among african-american women and men: implications for interventions. J Gen Intern Med. 2009;24(3):408–14.CrossRefPubMed
28.
go back to reference Shenolikar R, Balkrishnan R, Hall M. How patient-physician encounters in critical medical situations affect trust: results of a national survey. BMC Health Serv Res. 2004;4(1):24.CrossRefPubMed Shenolikar R, Balkrishnan R, Hall M. How patient-physician encounters in critical medical situations affect trust: results of a national survey. BMC Health Serv Res. 2004;4(1):24.CrossRefPubMed
29.
go back to reference Mechanic D, Meyer S. Concepts of trust among patients with serious illness. Soc Sci Med. 2000;51(5):657–68.CrossRefPubMed Mechanic D, Meyer S. Concepts of trust among patients with serious illness. Soc Sci Med. 2000;51(5):657–68.CrossRefPubMed
30.
go back to reference Thom DH, Hall MA, Pawlson LG. Measuring patients' trust in physicians when assessing quality of care. Health Aff. 2004;23(4):124–32.CrossRef Thom DH, Hall MA, Pawlson LG. Measuring patients' trust in physicians when assessing quality of care. Health Aff. 2004;23(4):124–32.CrossRef
31.
go back to reference Haywood C, et al. The association of provider communication with trust among adults with sickle cell disease. J Gen Intern Med. 2010;25(6):543–8.CrossRefPubMed Haywood C, et al. The association of provider communication with trust among adults with sickle cell disease. J Gen Intern Med. 2010;25(6):543–8.CrossRefPubMed
32.
go back to reference Cooper LA, et al. Patient-centered communication, ratings of care, and concordance of patient and physician race. Ann Intern Med. 2003;139(11):907–15.PubMed Cooper LA, et al. Patient-centered communication, ratings of care, and concordance of patient and physician race. Ann Intern Med. 2003;139(11):907–15.PubMed
33.
go back to reference Bowles EJA, et al. Understanding high-quality cancer care. Cancer. 2008;112(4):934–42.CrossRef Bowles EJA, et al. Understanding high-quality cancer care. Cancer. 2008;112(4):934–42.CrossRef
34.
go back to reference Jacobs EA, et al. Understanding African Americans' views of the trustworthiness of physicians. J Gen Intern Med. 2006;21(6):642–7.CrossRefPubMed Jacobs EA, et al. Understanding African Americans' views of the trustworthiness of physicians. J Gen Intern Med. 2006;21(6):642–7.CrossRefPubMed
Metadata
Title
The Import of Trust in Regular Providers to Trust in Cancer Physicians among White, African American, and Hispanic Breast Cancer Patients
Authors
Karen Kaiser, PhD
Garth H. Rauscher, PhD
Elizabeth A. Jacobs, MD, MPP
Teri A. Strenski, MS
Carol Estwing Ferrans, PhD, RN, FAAN
Richard B. Warnecke, PhD
Publication date
01-01-2011
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue 1/2011
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-010-1489-4

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