Trust in the Healthcare System and Physicians in Croatia: A Survey of the General Population

Trust in healthcare systems and physicians is considered important for the delivery of good healthcare. A cross-sectional survey was conducted on a random three-stage sample of the general population of Croatia (N = 1230), stratified by regions. Of respondents, 58.7% displayed a high or very high level of trust in the healthcare system, 65.6% in physicians, and 78.3% in their family physician. Respondents’ views regarding patients’ roles in the discussion of treatment options, confidence in physicians’ expertise, and underlying motives of physicians were mixed. Respondents with a lower level of education, those with low monthly incomes, and those from smaller settlements had lower levels of trust in physicians and the healthcare system. Trust in other institutions, religiosity and religious beliefs, tolerance of personal choice, and experience of caring for the seriously ill and dying were predictors of trust in healthcare and physicians. Our findings suggest that levels of healthcare-related trust in Croatia are increasing in comparison with previous research, but need improvement. Levels of trust are lowest in populations that are most vulnerable and most in need of care and protection.

Impact of Patient Communication Preferences on the Patient Trust in Physicians: A Cross-Sectional Study in Iranian Outpatient's Clinics

There are widely emerging concerns that patient confidence in physicians is diminishing as physician–patient communication is threatened globally. This study aimed to assess patient communication preferences and their impact on patient trust in physicians. A cross-sectional study was conducted among outpatient clinics of 2 public and private hospitals in Tabriz, Iran. A total of 704 patients were selected conveniently. Of the 704 patients, 6.39% had low trust, 36.79% moderate trust, 35.37% had a high trust, and 21.45% had blind trust in physicians. Overall patient communication preference score was more in a private clinic rather than a public one ( P = .008). Patients of private hospitals and those who were living in rural areas have been shown to have more trust in physicians. Patients’ trust in physicians showed a significant association with patient communication preference ( B = 0.58; 95% CI: 0.53-0.63, P < .001).

Multi-institutional intervention to improve patient perception of physician empathy in emergency care

BackgroundPhysician empathy has been linked to increased patient satisfaction, improved patient outcomes and reduced provider burnout. Our objective was to test the effectiveness of an educational intervention to improve physician empathy and trust in the ED setting.MethodsPhysician participants from six emergency medicine residencies in the US were studied from 2018 to 2019 using a pre–post, quasi-experimental non-equivalent control group design with randomisation at the site level. Intervention participants at three hospitals received an educational intervention, guided by acognitivemap (the ‘empathy circle’). This intervention was further emphasised by the use of motivational texts delivered to participants throughout the course of the study. The primary outcome was change in E patient perception of resident empathy (Jefferson scale of patient perception of physician empathy (JSPPPE) and Trust in Physicians Scale (Tips)) before (T1) and 3–6 months later (T2).ResultsData were collected for 221 residents (postgraduate year 1–4.) In controls, the mean (SD) JSPPPE scores at T1 and T2 were 29 (3.8) and 29 (4.0), respectively (mean difference 0.8, 95% CI: −0.7 to 2.4, p=0.20, paired t-test). In the intervention group, the JSPPPE scores at T1 and T2 were 28 (4.4) and 30 (4.0), respectively (mean difference 1.4, 95% CI: 0.0 to 2.8, p=0.08). In controls, the TIPS at T1 was 65 (6.3) and T2 was 66 (5.8) (mean difference −0.1, 95% CI: −3.8 to 3.6, p=0.35). In the intervention group, the TIPS at T1 was 63 (6.9) and T2 was 66 (6.3) (mean difference 2.4, 95% CI: 0.2 to 4.5, p=0.007). Hierarchical regression revealed no effect of time×group interaction for JSPPPE (p=0.71) nor TIPS (p=0.16).ConclusionAn educational intervention with the addition of text reminders designed to increase empathic behaviour was not associated with a change in patient-perceived empathy, but was associated with a modest improvement in trust in physicians.

Medical Pluralism in East and West Europe: A Comparison of People Visiting Alternative/Traditional/Folk Healthcare Practitioners

Using data from International Social Survey Programme (ISSP), the principal aim of this study was to conduct a cross-cultural comparision of medical pluralism in Eastern and Western European countries. In Easterne Europe, a total of 531 (5.5%) respondents reported and alternative/traditional/folk (A/T/F) healthcare practitioner visit during preceding 12 months, the results of the survey showed that in Western Europe, similar visits were reported by 17,881 (11.6%) individuals. In the Western region of Europe, CAM methods either provide a coping strategy for those on low incomes, with limited access to conventional healthcare or an alterantive option for members of the younger generation. However, in the Eastern region, A/T/F practitioners are mostly visited by city dwellers, who have a higher socio-economic status, a relatively high level of trust in physicians. <br>

Medical Pluralism in East and West Europe: A Comparison of People Visiting Alternative/Traditional/Folk Healthcare Practitioners

Using data from International Social Survey Programme (ISSP), the principal aim of this study was to conduct a cross-cultural comparision of medical pluralism in Eastern and Western European countries. In Easterne Europe, a total of 531 (5.5%) respondents reported and alternative/traditional/folk (A/T/F) healthcare practitioner visit during preceding 12 months, the results of the survey showed that in Western Europe, similar visits were reported by 17,881 (11.6%) individuals. In the Western region of Europe, CAM methods either provide a coping strategy for those on low incomes, with limited access to conventional healthcare or an alterantive option for members of the younger generation. However, in the Eastern region, A/T/F practitioners are mostly visited by city dwellers, who have a higher socio-economic status, a relatively high level of trust in physicians. <br>

Medical Pluralism in East and West Europe: A Comparison of People Visiting Alternative/Traditional/Folk Healthcare Practitioners

Using data from International Social Survey Programme (ISSP), the principal aim of this study was to conduct a cross-cultural comparision of medical pluralism in Eastern and Western European countries. In Easterne Europe, a total of 531 (5.5%) respondents reported and alternative/traditional/folk (A/T/F) healthcare practitioner visit during preceding 12 months, the results of the survey showed that in Western Europe, similar visits were reported by 17,881 (11.6%) individuals. In the Western region of Europe, CAM methods either provide a coping strategy for those on low incomes, with limited access to conventional healthcare or an alterantive option for members of the younger generation. However, in the Eastern region, A/T/F practitioners are mostly visited by city dwellers, who have a higher socio-economic status, a relatively high level of trust in physicians. <br>

Investigating the Relationships Between Public Health Literacy and Public Trust in Physicians in China's Control of COVID-19: A Cross-Sectional Study

Objective: Public trust in physicians and public health literacy (HL) are important factors that ensure the effectiveness of health-care delivery, particularly that provided during the SARS-CoV-2 pandemic. This study investigates HL as a predictor of public trust in physicians in China's ongoing efforts to control COVID-19.Methods: Data were gathered in February 2020 during the peak of the disease in China. Based on Nutbeam's conceptualization of HL, we measure HL vis-à-vis COVID-19 by using a six-item scale that includes two items each for functional, interactive, and critical HL. Trust in physicians was measured by assessing physicians' capability to diagnose COVID-19. A rank-sum test and ordinal logit regression modeling were used to analyze the data.Results: Two key findings: (a) trust in physician handling of treatment for COVID-19 is reported by about 74% of respondents; and (b) five of the six HL measures are positive predictors of public trust in physician treatment of the disease, with functional HL1 having the highest level of such association (coefficient 0.285, odds ratio 1.33%, p &lt; 0.01).Conclusions: Improving public HL is important for better public-physician relationships, as well as for nations' efforts to contain the pandemic, serving as a possible behavioral, non-clinical antidote to COVID-19. Being confronted with the unprecedented virus, humans need trust. Health education and risk communication can improve public compliance with physicians' requirements and build a solid foundation for collective responses.

Deferred Consent in an Acute Stroke Trial from a Patient, Proxy, and Physician Perspective: A Cross-Sectional Survey

Background In some acute care trials, immediate informed consent is not possible, but deferred consent is often considered problematic. We investigated the opinions of patients, proxies, and physicians about deferred consent in an acute stroke trial to gain insight into its acceptability and effects. Methods Paper-based surveys were sent to patients who were randomly assigned in the Ultra-early Tranexamic Acid After Subarachnoid Hemorrhage (ULTRA) trial between 2015 and 2018 in two tertiary referral centers and to physicians of centers who agreed or declined to participate. The primary outcome measure was the proportion of respondents who agreed with deferral of consent in the ULTRA trial. Secondary outcomes included respondents’ preferred consent procedure for the ULTRA trial, the effect of deferred consent on trust in physicians and scientific research, and the willingness to participate in future research. Results Eighty-nine of 135 (66%) patients or proxies and 20 of 30 (67%) physicians completed the survey. Of these, 82 of 89 (92%) patients or proxies and 14 of 20 (70%) physicians agreed with deferral of consent in the ULTRA trial. When asked for their preferred consent procedure for the ULTRA trial, 31 of 89 (35%) patients or proxies indicated deferred consent, 15 of 89 (17%) preferred immediate informed consent, and 32 of 89 (36%) had no preference. None of the patients’ or proxies’ trust in physicians or scientific research had decreased because of the deferred consent procedure. Willingness to participate in future studies remained the same or increased in 84 of 89 (94%) patients or proxies. Conclusions A large majority of the surveyed patients and proxies and a somewhat smaller majority of the surveyed physicians agreed with deferred consent in the ULTRA trial. Deferred consent may enable acute care trials in an acceptable manner without decreasing trust in medicine. Future research should investigate factors facilitating the responsible use of deferred consent, such as in-depth interviews, to study the minority of participants who agreed with deferred consent but still preferred immediate informed consent.