Trust, social support and patient type--associations between patients perceived trust, supportive communication and patients preferences in regard to paternalism, clarification and participation of severely injured patients

Abstract

Objective: Trust is an important aspect of physician-patient-interaction, both in terms of compliance and patient- and physician-reported outcomes. Trust-building communication is especially important in terms of severely injured patients because of severity of their injuries and frequently associated physical and psychological consequences. Patients preferences concerning medical treatment (patient type) is also regarded to be important in terms of trust. The objective of this study was to investigate the relationships between patients perceived trust, supportive communication of physicians and patient type of severely injured patients.

Methods: Seventy-one severely injured patients, who were predominantly injured in the workplace or in traffic accidents and were treated in one of four hospitals in Northrhine-Westfalia between 2001 and 2005, completed a self-administered questionnaire. "Trust in physicians_short form" (TRIP_sf) describes different aspects, such as general trust, competence of doctors and the feeling to be in good hands. "Informational support" and "emotional support" comprise verbal and non-verbal aspects, such as clear and understandable information or devotion and empathic manner. "Patient type" measures patients preferences in regard to paternalism of physician, clarification of medical facts and participation in treatment.

Results: Trust is strongly correlated with informational (.628**) and emotional support (.542**) and is less correlated with patients preferences of "paternalism" (.250*)", "clarification" (.438**) and participation" (.378**). Informational and emotional support are in general not significantly correlated with type of patient, all correlations were adjusted for age, gender, marital and socioeconomic status, length of hospital stay, and severity of injury.

Conclusions: Trust is significantly related to patient type but more related to doctor support: the results confirm the importance of supportive communication in terms of emotional and informational support.

Practice implications: Medical education should integrate sound knowledge about the psychosocial aspects of physician patient interaction to enable doctors to provide effective social support and to identify and consider patients preferences.