PATIENTS' TRUST FOR INVOLVEMENT IN SHARED DECISION MAKING: A LONGITUDINAL STUDY

Purpose:

Aims were to investigate the reliability and validity of the patients’ trust for participates in medical decision-making and to explore the linkage of patients’ trust to shared medical decision-making (SMDM) among women with cervical cancer.

Method:

The patients’ trust (PT) questionnaire of Hall et al. (2002) was independently translated into Chinese by two native speakers, and checked by a schoolteacher of Chinese. Further, an expert panel discussed some language differences and agreed upon the final version of the questionnaire. In addition, valid PT questionnaire and SMDM questionnaire were then assessed at 6 (T1) and 12 months (T2), respectively. Cross-sectional regression analyses were used to examine the linear and quadratic components of the relation between PT and SMDM. Longitudinal regression analyses were used to examine the linear and quadratic relations between T1 PT and T2 SMDM. Quadratic components of the longitudinal relations between T1 PT and T2 SMDM were examined by adding the quadratic component of the predictor to the equation.

Result:

70 consecutive women were recruited from ChungShan Medical University Hospital. Taiwanese Patients’ Trust Questionnaire (TPTQ) is a 10 items normative instrument. The intraclass correlation coefficient for the PTQ index was 0.86, and the Cohen's kappa values for the PTQ dimensions ranged from 0.52 to 0.84. In addition, we found the curvilinear relations linking PT to SMDM. That is, individuals with high or low levels of PT at study-start had lower levels of trust in physician than those with moderate levels of PT, and individuals with high or low PT 3 months later had better trust in the medical profession than those with moderate levels of PT.

Conclusion:

Trust is a key feature of the patient–physician relationship. Based on the result of this study, the TPTQ is reliable and valid for the assessment of trust in patients with cervical cancer in Taiwan. Overall, it is important for clinicians to consider the notion that more trust may sometimes, but not always, be better.