TY - JOUR
KW - Adult
KW - Communication
KW - Female
KW - Focus Groups
KW - Humans
KW - Male
KW - Middle Aged
KW - Opioid-Related Disorders/psychology
KW - Patient Education as Topic
KW - Physician-Patient Relations
KW - Physicians/psychology
KW - Primary Health Care
KW - Psychometrics/standards
KW - Qualitative Research
KW - Quality of Health Care
KW - Reproducibility of Results
KW - San Francisco
KW - Statistics as Topic
KW - Substance-Related Disorders
KW - Surveys and Questionnaires
KW - Trust/psychology
AU - D. H. Thom
AU - S. T. Wong
AU - D. Guzman
AU - A. Wu
AU - J. Penko
AU - C. Miaskowski
AU - M. Kushel
A1 - 
AB - PURPOSE: Mutual trust is an important aspect of the patient-physician relationship with positive consequences for both parties. Previous measures have been limited to patient trust in the physician. We set out to develop and validate a measure of physician trust in the patient. METHODS: We identified candidate items for the scale by content analysis of a previous qualitative study of patient-physician trust and developed and validated a scale among 61 primary care clinicians (50 physicians and 11 nonphysicians) with respect to 168 patients as part of a community-based study of prescription opioid use for chronic, nonmalignant pain in HIV-positive adults. Polychoric factor structure analysis using the Pratt D matrix was used to reduce the number of items and describe the factor structure. Construct validity was tested by comparing mean clinician trust scores for patients by clinician and patient behaviors expected to be associated with clinician trust using a generalized linear mixed model. RESULTS: The final 12-item scale had high internal reliability (Cronbach alpha =.93) and a distinct 2-factor pattern with the Pratt matrix D. Construct validity was demonstrated with respect to clinician-reported self-behaviors including toxicology screening (P <.001), and refusal to prescribe opioids (P <.001) and with patient behaviors including reporting opioids lost or stolen (P=.008), taking opioids to get high (P <.001), and selling opioids (P<.001). CONCLUSIONS: If validated in other populations, this measure of physician trust in the patient will be useful in investigating the antecedents and consequences of mutual trust, and the relationship between mutual trust and processes of care, which can help improve the delivery of clinical care.
BT - Annals of family medicine
C5 - Opioids & Substance Use; Education & Workforce
CP - 2
CY - United States
DO - 10.1370/afm.1224
IS - 2
JF - Annals of family medicine
N2 - PURPOSE: Mutual trust is an important aspect of the patient-physician relationship with positive consequences for both parties. Previous measures have been limited to patient trust in the physician. We set out to develop and validate a measure of physician trust in the patient. METHODS: We identified candidate items for the scale by content analysis of a previous qualitative study of patient-physician trust and developed and validated a scale among 61 primary care clinicians (50 physicians and 11 nonphysicians) with respect to 168 patients as part of a community-based study of prescription opioid use for chronic, nonmalignant pain in HIV-positive adults. Polychoric factor structure analysis using the Pratt D matrix was used to reduce the number of items and describe the factor structure. Construct validity was tested by comparing mean clinician trust scores for patients by clinician and patient behaviors expected to be associated with clinician trust using a generalized linear mixed model. RESULTS: The final 12-item scale had high internal reliability (Cronbach alpha =.93) and a distinct 2-factor pattern with the Pratt matrix D. Construct validity was demonstrated with respect to clinician-reported self-behaviors including toxicology screening (P <.001), and refusal to prescribe opioids (P <.001) and with patient behaviors including reporting opioids lost or stolen (P=.008), taking opioids to get high (P <.001), and selling opioids (P<.001). CONCLUSIONS: If validated in other populations, this measure of physician trust in the patient will be useful in investigating the antecedents and consequences of mutual trust, and the relationship between mutual trust and processes of care, which can help improve the delivery of clinical care.
PP - United States
PY - 2011
SN - 1544-1717; 1544-1709
SP - 148
EP - 154
EP - 
T1 - Physician trust in the patient: development and validation of a new measure
T2 - Annals of family medicine
TI - Physician trust in the patient: development and validation of a new measure
U1 - Opioids & Substance Use; Education & Workforce
U2 - 21403142
U3 - 10.1370/afm.1224
VL - 9
VO - 1544-1717; 1544-1709
Y1 - 2011
ER -