Predictors of Trust in the Medical Profession among Cancer Patients Receiving Palliative Care: A Preliminary Study

Abstract

Background: Trust influences healthcare through the willingness to seek care, disclose sensitive information, adhere to treatment, and satisfaction with care. Understanding factors that influence trust may help in physician–patient relationship particularly at end of life.

Objectives: We explored the association between trust and other demographic and psychosocial factors. We also explored the performance of the single-item Degree of Trust scale (0 best to 10 worst) compared with the validated five-item Trust in Medical Profession scale (5 best to 25 worst).

Design: A secondary analysis of prospectively collected data was performed. Trust scores completed by 100 patients were correlated with age, gender, ethnicity, educational level, anxiety, depression, and hopefulness (Herth Hope Index [12 best to 48 worst]).

Setting/Subjects: The study was conducted on 100 patients in an outpatient Supportive Care Center in a cancer center in Houston, Texas.

Results: Median age was 57 years (49–65), depression was 6 (3–9), and hopefulness was 22 (20–25). Trust in Medical Profession score was 13, 11–14 (median, IQR) and Degree of Trust score was 2, 1–4 (median, IQR) with moderate correlation ( r = 0.587, p < 0.001). On evaluating performance of Degree of Trust scale to the validated Trust in Medical Profession scale, a moderately high performance was found (Youden's J = 0.73; Topleft = 0.21). Older age ( p = 0.02) lower depression scores ( p < 0.01) and more hopefulness ( p = 0.01) were associated with higher levels of trust.

Conclusions: Trust was associated with older age, less depressed, and more hopeful patients. A single 0–10 item trust scale was found to perform adequately compared with a multiple-item questionnaire.