Trust in Physician Scale: Factor structure, reliability, validity and correlates of trust in a sample of Nigerian psychiatric outpatients

• This is the first study in Nigeria to examine the psychometric characteristics of the Trust in Physician Scale among psychiatric outpatients.
• The mean trust score was high.
• We found a two factor construct.
• The internal consistency was relatively low compared to previous studies in developed countries.
• The construct validity was fair.
• The scale is useful but requires further exploration among other Nigerian patients.

BackgroundTrust is essential in the patient–physician relationship and has not been explored among Nigerian psychiatric outpatients.ObjectivesThe purpose of this study was to evaluate the psychometric characteristics of the Trust in Physician Scale among a cross-sectional sample of stable Nigerian outpatients receiving treatment for psychiatric disorders.MethodsA consecutive sample of outpatients attending a Nigerian university teaching hospital psychiatric clinic in South-western Nigeria completed the scale (N = 223). Factorial analysis, internal consistency, validity and correlates of the scale were evaluated.ResultsThe structure of the Trust in Physician Scale was best explained by a 2 factor construct. Cronbach's alpha was 0.68, indicating a rather modest degree of internal consistency. The 2 factors extracted also had modest internal consistencies (Cronbach's alpha 0.66 and 0.76). A fair degree of construct validity was indicated by weak positive correlation of trust with medication adherence and the numbers of previous admissions. The mean trust score was relatively high. Significant positive correlations were observed between trust scores and adherence score, number of previous admissions and the number of schizophrenic relapses.ConclusionThe results suggest that despite the comparatively weak psychometric properties of the Trust in Physician Scale, it is still useful in the evaluation of trust among Nigerian psychiatric outpatients. More studies are needed to further explore and compare the properties of this scale across a wider range of patient groups in Nigeria, and to identify other factors that could interact with trust among the different patient populations in our environment.