Measuring Patients' Trust in Their Primary Care Providers

Abstract

Existing scales to measure trust in physicians have differing content and limited development and testing. To advance the ability to measure trust, a detailed conceptual model was constructed and a large item pool (n=78) was generated, pilot tested, and revised using focus groups, expert reviewers, and convenience samples. The best performing items were validated with a random national sample (n=959) and a regional sample of HMO members (n=1199). Factor analysis and other psychometric tests produced a 10-item unidimensional scale consistent with most aspects of the conceptual model. This scale is similar to previous ones, but it has important differences, as well as an improved combination of internal consistency, variability, and discriminability. Compared with the most recently published trust scale, the Wake Forest physician trust scale is more strongly correlated with satisfaction, desire to remain with a physician, willingness to recommend to friends, and not seeking second opinions; it is somewhat less correlated with insurer trust, membership in managed care, and choice of physician; and correlations are equivalent with lack of disputes with a physician and length of relationship and number of visits.

Keywords: trust, doctor-patient relationship, instrument development