No, Is the Subject Area "Questionnaires" applicable to this article? Clinical Psychology and Psychotherapy, Department of Psychology, University of Basel, Basel, Switzerland, Affiliations The concept of trust has been predominantly associated with situations of uncertainty and risk, relations of dependency between experts and non-experts, and expectations about future behaviour/interactions. This type of review does not aim to provide an overview of study findings or synthesize evidence, rather it involves a search of the literature to determine what sorts of studies addressing the systematic review question have been carried out, where they are published, what sorts of outcomes they have assessed, in which populations [8] and using which methods. 4). Therefore, a comprehensive and differentiated summary of the available evidence is needed. Incivility, lateral violence, and bullying are symptoms of an environment lacking in trust. 15 studies reported objective health outcomes; two studies reported observer-rated outcomes and 42 studies reported subjective self-rated outcomes. Whenever data was reported for subgroups of study participants in one publication, we calculated the weighted mean correlation [22]. Also, only six studies reported details on treatment duration. In cases of uncertainty (e.g. The establishment of trust in the registered nurse (RN)-patient relationship promotes patient engagement and improves the likelihood that the patient will be an active member of the patient … Studies were published between 1981 and 2013 (median: 2009). What is meant by “relationship” is developing a trust that allows you to effectively and unashamedly discuss your medical concerns and question treatment options with your doctor. Research shows that open lines of communication create trust, and vice versa, and that trusting relationships are key to better healthcare outcomes. We used the SPICE framework [11] to generate our research question:
numbers / proportions of events) or the provided odds ratios in order to estimate the association between trust in the health care provider and health outcome. Binary data and odds ratios were transformed into log odds ratios, then into Fisher’s Z and finally into correlations. However, since meta-analyses described an enhanced risk of bias with regard to self-rated subjective outcomes, possibly due to inadequate allocation concealment and inappropriate blinding [40, 41], the particularly large associations in our analyses may result—at least partly—from an upward bias. Data were extracted independently using a standard form by the same two reviewers (N.B. trust in the nurse, physician, GP, psychiatrist) with a valid, reliable and established trust questionnaire (i.e. Trust was viewed as a dynamic process evolving over time where reliance on others, The association between trust and outcome was smaller in high quality studies. here. Clinical Psychology and Psychotherapy, Department of Psychology, University of Basel, Basel, Switzerland, For instance,in a sample of patients with diabetes, trust in the health care professional was found to be positively related to objective and subjective health outcomes (glycemic control, health-related quality of life, and patient satisfaction) [12]. The author N.B. 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Heterogeneity between studies was low to moderate. However, public trust in the medical profession and the U.S. health care system has plummeted over this same period of time. Forty-one per cent of included studies actually set out to examine trust with the remaining 59% being studies where trust emerged as secondary outcome. Figure 1 summarizes the results of the literature search based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flow diagram [14]. Linking trust to the fabric of nursing and investing in its measurement will become essential to nursing's valuation and the resulting investment in nursing. PRISMA [14] diagram to show the literature identified. Associations between patients’ trust and their perceptions of communication within the consultation have been identified, but the influence of patients’ demographic characteristics on these associations is unknown. We extracted the diagnoses in the patient sample, the country in which the study was conducted, the duration of treatment and characteristics of the trust scale. We excluded outcomes whenever it remained unclear whether an increase or decrease on the respective measure was a beneficial outcome for the patient (see S1 Table for a list of the included health outcomes). The healthcare environment is constantly and rapidly changing with new regulations, new technology and workforce transformations. depression, worries, mood), (c) treatment-related indicators (e.g. This is mainly because of the lack of intervention studies or quasi-experimental studies, but also because in contrast to the sizable literature assessing trust from the patient perspective, studies examining either the value and/or impact of trust from the provider perspective are very limited [4]. (2017) Trust in the health care professional and health outcome: A meta-analysis. This work was supported by a research initiation funding award from the Foundation for the Sociology of Health and Illness. Study quality ranged from 7.5 to 18.5 STROBE points (median: 15 mean: 13.5). Nicola Brennan, Rebecca Barnes, Mike Calnan, Oonagh Corrigan, Paul Dieppe, Vikki Entwistle, Trust in the health-care provider–patient relationship: a systematic mapping review of the evidence base, International Journal for Quality in Health Care, Volume 25, Issue 6, December 2013, Pages 682–688, https://doi.org/10.1093/intqhc/mzt063. Overall, we found a small to moderate correlation between trust and health outcomes (r = 0.24, 95% CI: 0.19–0.29). We searched 4 major electronic databases for studies that reported quantitative data on the association between trust in the health care professional and health outcome. The extracted data were collated and are presented in Figs 2–5. Six trust questionnaires were only used in one study (see S1 Table for details). Furthermore, we checked whether the type of questionnaire moderated study results and confirmed the robustness of the overall finding in a subgroup of 24 studies that all used the same trust questionnaire. Systematic reviews and meta-analyses of RCTs have found small to moderate associations between such factors on health outcomes [13, 34]. Six studies defined the duration of treatment with a median of 1.7 months (range: 10 days to 5 years). Stratified analyses revealed small and non-significant correlations in case of objective outcomes and observer-rated outcomes (r = -0.02, -0.08 to 0.03 and r = 0.10, -0.16 to 0.36 respectively; see S2 File for the respective forest plots), as well as a moderate correlation with regard to subjective self-rated outcomes (r = 0.30, 0.24 to 0.35). One limitation of the review is that despite the wide-ranging literature searched there may have been some literature missed, including the literature published in languages other than English or studies that were about trust but used other related terms, e.g. Empirical studies examining the factors that influence providers' trust in patients and how this might affect the quality of care and patient health-related behaviours are urgently needed to readdress this imbalance. In an exploratory sub-analysis we divided subjective experiences into patient satisfaction, quality of life and symptom-related outcomes and conducted individual subgroup-analyses. It’s time that South Africa built a health system that demonstrates care and restores trust for both patients and workers. This work suggests that healthcare professionals, like patients, generally view patient involvement positively. On the whole, healthcare providers trust patients to seek medical advice in a timely fashion unmotivated by other concerns [40]. The quality of the relationship between the patient and health professional can be therapeutic for the patient. Further exploration of this area using observational methods is recommended. Brown et al. One study, for example, has shown that poor communication among the staff in a pediatric hospital influenced their trust levels and how they cared for patients. Trust as an inter- [personal and essential element of all patient-nurse relationships was the clearest result in a literature review of trust and trustworthiness. Clinical speciality study was carried out in—studies were classified using the UK General Medical Council A–Z medical speciality list [13]. Create trust: It is natural for a patient to ask as little as possible from a new caregiver. No, Is the Subject Area "Mental health and psychiatry" applicable to this article? Understanding the ways that trust manifests and how trust relations are forged necessitates the observation of verbal and non-verbal aspects of healthcare consultations such as facial expression and other forms of ‘body language’. disorders and treatment duration varied across as well as within studies and studies were conducted in diverse geographic regions with possibly diverse health care systems. Records were excluded if we were unable to obtain the full-text (Fig 1). The procedure of study selection, including reasons for exclusion after full-text review, is shown in Fig 1. Study method/design utilized—studies were classified as experimental, mixed-methods, observation, focus groups, interviews, mixed qualitative and questionnaire survey. here. To reduce human error and bias, and increase transparency, the first 10% of included abstracts were then double screened by N.B. The following information was extracted from the abstracts of included papers:
The relationship established between patients and health care providers is fiduciary in nature, which means that it is based on trust. “Although further studies are required to test the direction of the association between trust and health outcome, trust in the health care professional may not only be a deontological constituent of clinical care, but it might also be consequential for patients’ treatment satisfaction, health behaviors, symptom severity and quality of life.” Studies were conducted in Asia (2), Europe (6), North America (34), and Australia (2). Funding: Johanna Birkhäuer's contributions to this study were supported by the Swiss National Science Foundation (http://www.snf.ch), grant project (P0BSP1_155446). The complex interactions between trust and health outcome, including potentially time-delayed effects, reverse causality, as well as the existence of moderators and mediators should further be investigated in prospective studies. We explored the presence of small study bias and publication bias by assessing funnel plot asymmetry (i.e. From a clinical perspective, patients reported more beneficial health behaviours, less symptoms and higher quality of life and to be more satisfied with treatment when they had higher trust in their health care professional. Taking a medical history in childhood illness: representations of parents in pediatric texts since 1850, Being in the patient position: experiences of health care among people with irritable bowel syndrome, Situations in which women living in a violent relationship condition refer to health care services, Planning older people's discharge from acute hospital care: linking risk management and patient participation in decision-making, Patients' complaints about doctors in surgical training, Telephonic nurse case management for patients with diabetes and mental illnesses: a qualitative perspective, Modesty and recognition–a qualitative study of the lived experience of recovery from anal cancer, Advocacy of women family caregivers: response to nonsupportive interactions with professionals, Nurses and the ‘therapeutic relationship’: caring for adolescents with anorexia nervosa, Why are patients removed from their doctors’ lists? Subgroup analyses revealed a moderate correlation between trust and self-rated subjective health outcomes (r = 0.30, 0.24–0.35). Most reported on patients' trust in providers; were carried out in the USA; collected data in family care or oncology/palliative care settings; used questionnaires and interviews and elicited patients' perspectives. No, Is the Subject Area "Physicians" applicable to this article? We included 47 studies that were published in 45 reports (see S1 Table for descriptive information and the references of the included studies) with 34 817 participants (median: 200 participants, range: 24 to 8392). Healthcare workers are the life-blood of people-centred health systems. As a measure of heterogeneity, τ2 has been shown to be independent of the number of studies and patients included in a meta-analysis (i.e. Yes Collegium Helveticum, University of Zurich and ETH Zurich, Zurich, Switzerland. These methods could provide important and much-needed insight into how trust relations are enacted between patients and providers in consultations across different specialities. In some instances, that means emphasizing the importance of accessing the patient portal, or enlisting a family member to help the patient do so. This may be because there are more universities/research institutes and for most topics there would be higher levels of research. whether negative or non-significant findings are missing) with a regression test [23]. Our review found that researchers are still focusing on the same types of question identified in the Rowe review rather than building on the evidence. Prospective studies are required to deepen our understanding of the complex interplay between trust and health outcomes. Country study was carried out in—where the information was not present in the abstract, the address of the first author was used as a proxy measure for where the research study was conducted. Tel: +44 117 9287213; Fax: +, School of Social Policy, Sociology and Social Research. In order to access potential studies in the medical, social science and grey literature to address our research question, we searched the following electronic databases from January 2004 to November 2010: EMBASE, MEDLINE, PsychINFO, The Cochrane Library, Applied Social Sciences Index and Abstracts (ASSIA), Soc Index, Web of Science, ETHOS, SIGLE. These toxic behaviors perpetuate high turnover, absenteeism, low retention, and low satisfaction for both nurses and patients. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. Yes Patients must trust that their healthcare providers will make the best decisions for their well-being. Synthetic dual-energy CT for MRI-only based proton therapy treatment planning using label-GAN. Whether the study examined providers' trust in patients or providers' trust in patients was reported as an outcome. online search behaviour) we required that the authors provide at least one reference to an article that showed an association between a particular outcome and one of the previously outlined health dimensions. diagnosis by a professional) as well as self-rated subjective outcomes.
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