| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 3816152 | Patient Education and Counseling | 2014 | 7 Pages |
•Trust in physician improved from before to after visits.•Trust in VA healthcare did not change from before to after or between visits.•When compared to white patients, Black patients had lower trust in VA health care.•Trust in physician and VA were lower for low-income Black, compared to white patients.•Trust is positively associated with ratings of doctors’ and patients’ communication.
ObjectiveTo examine the associations of several characteristics with patients’ trust in physician and the healthcare system.MethodsA prospective cohort of patients were followed after an exacerbation of heart failure at one of two veterans affairs (VA) hospitals. Patients rated pre-visit and post-visit trust in physician and in the VA healthcare system at follow-up outpatient visits. The associations of trust in physician and VA with covariates were analyzed using multivariate mixed-effects regression.ResultsAfter adjusting for covariates, post-visit trust in physician was significantly higher than pre-visit trust (P < 0.001), but was not significantly different by race. Trust in VA did not change significantly over time (P > 0.20), but was significantly lower for Black patients (P < 0.001). High self-efficacy to communicate was independently associated with both trust in physician and VA (P < 0.001).ConclusionsTrust in physician improved over the course of each visit. Trust in VA was not associated with time, but was lower among Black patients. Trust was higher when ratings of communication were higher.Practice implicationsTrust in physician improved at each visit and was independently associated with communication. Interventions designed to improve communication should be tested for their ability to improve trust in physician and trust in the healthcare system.
