Existing scales to measure trust in physicians have differing content and limited testing. To improve on these measures, a large item pool (n = 78) was generated following a detailed conceptual model and expert review. After pilot testing, the best-performing items were validated with a random national sample (n = 9) and a regional sample of HMO members (n = 99). Various psychometric tests produced a 10-item unidimensional scale consistent with most aspects of the conceptual model.Compared with previous scales, the Wake Forest physician trust scale has a somewhat improved combination of internal consistency, variability, and discriminability. The scale is more strongly correlated with satisfaction, desire to remain with a physician, willingness to recommend to friends, and not seeking second opinions; it is less correlated with insurer trust, membership in managed care, and choice of physician; and correlations are equivalent with lack of disputes, length of relationship, and number of visits.
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References
1.
Anderson, L. , and R. F. Dedrick. 1990. Development of the Trust in Physician Scale: A measure to assess interpersonal trust in patient physician relationships. Psychological Reports67:1091-1100.
2.
Baier, A.1986. Trust and antitrust. Ethics96:231-260.
3.
Baker, J.1987. Trust and rationality. Pacific Philosophical Quarterly68:1-13.
4.
Barber, B.1983. The logic and limits of trust. New Brunswick, NJ: Rutgers University Press.
5.
Blackburn, S.1998. Trust, cooperation and human psychology. In Trust and governance, edited by Valerie Braithwaite and Margaret Levi, 28-45. New York: Russell Sage.
6.
Blendon, R. J. , M. Brodie, J. M. Benson, D. E. Altman, L. Levitt, T. Hoff, and L. Hugick. 1998. Understanding the managed care blacklash. Health Affairs17 (4): 80-94.
7.
Braithwaite, V. , and M. Levi. 1998. Trust and governance. New York: Russell Sage.
8.
Caterinicchio, R. P.1979. Testing plausible path models of interpersonal trust in patient-physician treatment relationships. Science and Medicine13A:81-99.
9.
Cook, K. S.2001. Trust in society. New York: Russell Sage.
10.
Gambetta, D.1988. Trust: Making and breaking cooperative relations. Oxford, UK: Basil Blackwell.
11.
Goold, S.1998. Money and trust: Relationships between patients, physicians, and health plans. Journal of Health Politics, Policy and Law23:688-695.
12.
Goold, S. , and G. Klipp. 2002. Managed care members talk about trust. Social Science & Medicine54:879-888.
13.
Gorsuch, R. L.1983. Factor analysis. Hillsdale, NJ: Lawrence Erlbaum.
14.
Govier, T.1997. Social trust and human communities. Montreal, Canada: McGill-Queen’s University Press.
15.
Govier, T. . 1998. Dilemmas of trust. Montreal, Canada: McGill-Queen’s University Press.
16.
Hall, J. A. , M. Feldstein, M. D. Fretwell, J. W. Rowe, and A. M. Epstein. 1990. Older patients’ health status and satisfaction with medical care in an HMO population. Medical Care28 (3): 261-270.
17.
Hall, M. A. , E. Dugan, R. Balkrishnan, and D. Bradley. 2002. How disclosing HMO physician incentives affects trust. Health Affairs21 (2): 197-206.
18.
Hall, M. A. , E. Dugan, B. Zheng, and A. K. Mishra. 2001. Trust in physicians and medical institutions: What is it, can it be measured, and does it matter?Milbank Quarterly79 (4): 613-639.
19.
Hardin, R.1991. Trusting persons, trusting institutions. In Strategy and choice, edited by Richard Zeckhauser, 185-209. Cambridge, MA: MIT Press.
20.
Hardin, R. . 2002. Trust and trustworthiness. New York: Russell Sage.
21.
Hollis, M.1998. Trust within reason. Cambridge, UK: Cambridge University Press.
22.
Holmes, J. G. , and J. K. Rempel. 1989. Trust in close relationships. In Close relationships, edited by Clyde Hendrick, 187-220. Newbury Park, CA: Sage.
23.
Johnson-George, C. , and W. C. Swap. 1982. Measurement of specific interpersonal trust: Construction and validation of a scale to assess trust in a specific other. Journal of Personality and Social Psychology43:1306-1317.
24.
Kao, A. , D. C. Green, N. A. Davis, J. P. Koplan, and P. D. Cleary. 1998. Patients’ trust in their physicians: Effects of choice, continuity, and payment method. Journal of General Internal Medicine13:681-686.
25.
Kao, A. , D. C. Green, A. Zaslavski, J. P. Koplan, and P. D. Cleary. 1998. The relationship between method of physician payment and patient trust. Journal of the American Medical Association280:1708-1714.
26.
Khattree, R. , and D. Naik. 2000. Multivariate data reduction and discrimination. Cary, NC: SAS Institute.
27.
Kramer, R. , and T. Tyler. 1996. Trust in organizations: Frontiers of theory and research. Thousand Oaks, CA: Sage.
28.
Luhmann, N.1973. Trust and power. Chichester, UK: Wiley.
29.
Mayer, R. C. , J. H. Davis, and F. D. Schoorman. 1995. An integrative model of organization trust. Academy of Management Review20:709-733.
30.
Mechanic, D.1996. Changing medical organization and the erosion of trust. Milbank Quarterly74:171-189.
31.
Mechanic, D. . 1998. The functions and limitations of trust in the provision of medical care. Journal of Health Politics, Policy and Law23:661-686.
32.
Mechanic, D. , and S. Meyer. 2000. Concepts of trust among patients with serious illness. Social Science & Medicine51:657-668.
33.
Mechanic, D. , and M. Schlesinger. 1996. The impact of managed care on patients’ trust in medical care and their physicians. Journal of the American Medical Association275:1693-1697.
34.
Mishra, A. K. , and G. M. Spreitzer. 1998. Explaining how survivors respond to downsizing: The roles of trust, empowerment, justice, and work redesign. Academy of Management Review23:567-588.
35.
Murray, S. L. , and J. G. Holmes. 1997. A leap of faith? Positive illusions in romantic relationships. Personality and Social Psychology Bulletin23 (6): 586-604.
36.
Oldendick, R. W. , G. F. Bishop, S. B. Sorenson, and A. J. Tuchfarber. 1988. Acomparison of the next and last birthday methods of respondent selection in telephone surveys. Journal of Official Statistics4:307-318.
37.
Parsons, T.1951. The social system. Glencoe, IL: Free Press.
38.
Peabody, F. W.1927. The care of the patient. Journal of the American Medical Association88 (12): 877-882.
39.
Pearson, S. D. , and L. H. Raeke. 2000. Patients’ trust in physicians: Many theories, few measures, and little data. Journal of General Internal Medicine15:509-513.
40.
Pellegrino, E. D. , R. M. Veatch, and J. P. Langan. 1991. Ethics, trust, and the professions: Philosophical and cultural aspects. Washington, DC: Georgetown University Press.
41.
Rempel, J. K. , J. G. Holmes, and M. P. Zanna. 1985. Trust in close relationships. Journal of Personality and Social Psychology49:95-112.
42.
Roberts, C. A. , and M. S. Aruguete. 2000. Task and socioemotional behaviors of physicians: A test of reciprocity and social interaction theories in analogue physician-patient encounters. Social Science & Medicine50 (3): 309-315.
43.
Rogers, D. E.1994. On trust: A basic building block for healing doctor-patient interactions. Journal of the Royal Society of Medicine87:2-5.
44.
Rotter, J. B.1967. Anew scale for the measurement of interpersonal trust. Journal of Personality35: 651-665.
45.
Safran, D. , M. Kosinski, A. R. Tarlov, W. H. Rogers, D. A. Taira, N. Lieberman, and J. E. Ware. 1998. The Primary Care Assessment Survey: Tests of data quality and measurement performance. Medical Care36:728-739.
46.
Sandman, D. , E. Simantov, and C. An. 2000. Out of touch: American men and the health care system. New York: Commonwealth Fund.
47.
Seligman, A. B.1997. The problem of trust. Princeton, NJ: Princeton University Press.
48.
Semmes, C. E.1991. Developing trust: Patient-practitioner encounters in natural health care. Journal of Contemporary Ethnography19 (4): 450-470.
49.
Shapiro, S. , and M. Wilk. 1965. An analysis of variance test for normality (complete samples). Biometrika52:591-611.
50.
Streiner, D. L. , and G. R. Norman. 1991. Health measurement scales. New York: Oxford University Press.
51.
Thom, D. , and B. Campbell. 1997. Patient-physician trust: An exploratory study. Journal of Family Practice44:169-176.
52.
Thom, D. H. , D. A. Bloch, and E. S. Segal. 1999. An intervention to increase patients’ trust in their physicians. Academic Medicine74 (2): 195-198.
53.
Thom, D. H. , K. M. Ribisl, A. L. Steward, D. A. Luke, and The Stanford Trust Study Physicians. 1999. Further validation and reliability testing of the Trust in Physician Scale. Medical Care37:510-517.
54.
Thorne, S. E. , and C. A. Robinson. 1988. Reciprocal trust in health care relationships. Journal of Advanced Nursing13:782-789.
55.
Trojan, L. , and O. Yonge. 1993. Developing trusting, caring relationships: Home care nurses and elderly clients. Journal of Advanced Nursing18:1903-1910.
56.
Tucker, L. R. , and C. Lewis. 1973. A reliability coefficient for maximum likelihood factor analysis. Psychometrika38:1-10.
57.
U.S. Department of Health and Human Services . 2000. Health insurance status of the civilian noninstitutionalized population: 1998. Agency for Healthcare Research and Quality.
58.
Ware, J. E.1978. Effects of acquiescent response set on patient satisfaction ratings. Medical Care16:327-336.
59.
Ware, J. E., Jr . and A. R. Davies. 1983. Behavioral consequences of consumer dissatisfaction with medical care. Evaluation and Program Planning6:291-297.
60.
Ware, J. E., Jr. , M. K. Snyder, W. R. Wright, and A. R. Davies. 1983. Defining and measuring patient satisfaction with medical care. Evaluation and Program Planning6:247-263.
61.
Yamagishi, T. , and M. Yamagishi. 1994. Trust and commitment in the United States and Japan. Motivation and Emotion18:129-166.
62.
Zheng, B. , M. A. Hall, E. Dugan, K. E. Kidd, and D. Levine. 2002. Development of a scale to measure patients’ trust in health insurers. Health Services Research37:187-204.
