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Examining patients' trust in physicians and the VA healthcare system in a prospective cohort followed for six-months after an exacerbation of heart failure.

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posted on 26.04.2016 by Howard S. Gordon, Oksana Pugach, Michael L. Berbaum, Marvella E. Ford
OBJECTIVE: To examine the associations of several characteristics with patients’ trust in physician and the healthcare system. METHODS: A 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. RESULTS: After adjusting for covariates, post-visit trust in physician was significantly higher than pre-visit trust (P<.001), but was not significantly different by race. Trust in VA did not change significantly over time (P>.20), but was significantly lower for Black patients (P<.001). High self-efficacy to communicate was independently associated with both trust in physician and VA (P<0.001). CONCLUSIONS: Trust 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 IMPLICATIONS: Trust 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.

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Publisher Statement

NOTICE: This is the author’s version of a work that was accepted for publication in [Journal title]. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Patient Education and Counseling [Volume 97, Issue 2, 1 November 2014] DOI:10.1016/j.pec.2014.07.022.

Publisher

Elsevier Inc.

issn

07383991

Issue date

01/11/2014

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