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Article: Differences in trust in physician under 50 years between native and non-native patients: a single Dutch institute experience of 170 patients

Differences in trust in physician under 50 years between native and non-native patients: a single Dutch institute experience of 170 patients

BackgroundLiterature suggests that a patient’s ethnicity influences the degree of trust a patient has in his physician. This is of major importance, as trust influences health seeking behavior. No studies on ethnic differences in trust in physicians have been conducted yet in the Netherlands.
Objective To compare trust in physicians between native and non-native patients.
Methods To examine trust, we handed out questionnaires from December 2012 until April 2013, at the outpatient clinic of Internal Medicine at the AMC in Amsterdam. The questionnaires included the 10-item validated Wake Forest trust in physician scale. We examined both global trust and three different aspects: fidelity, competence and honesty.
Results One hundred seventy patients were included in the analysis of which 111 native Dutch and 59 non-native. Natives rated trust in their physicians on average 1.1 points (on a 10 point scale) higher (P=0.002). Especially natives in the age category of 18-50 years had more trust in their physicians than non-natives (P=0.002). However, this difference could not be found in the age category of >50 years. Furthermore, non-natives rated trust in their physician less often as ‘sufficient’ (at least 7 out of 10 points) (OR 0.37, 95% CI [0.16 – 0.88]). This especially accounted for the group 18-50 years (OR 0.19, 95% CI [0.045 – 0.76]). Of the three different aspects of trust, perceived physician competence was the strongest driver of ethnic differences in physician trust (OR 0.27, P<0.001, 95% CI [-0.33 – -0.10]).
Conclusion Native patients of 18-50 years show more trust in their physicians than non-natives. The knowledge obtained in this study should become a basis of a new strategy to improve physician trust in non-native patients.

Introduction

Cultural differences are known to cause a gap among citizens in general, but also between non-natives and their physicians1. This could affect the quality of healthcare these patients receive.

A premise for any patient-physician relationship is trust. The most important predictors of trust are similar to the predictors of patient satisfaction2. Furthermore, several studies have shown that patients who have more trust in their doctors show better therapy compliance3,4,5­. Also, research has shown that patients are more satisfied with female than male physicians6.

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