Development of abbreviated measures to assess patient trust in a physician, a health insurer, and the medical profession

Data from two samples were used. The first was a telephone survey of English-speaking adults in the United States (N = 1117) and the second was a telephone survey of English-speaking adults residing in North Carolina who were members of a health maintenance organization (N = 1024). Data were analyzed to examine data completeness, scaling assumptions, internal consistency properties, and factor structure.Abbreviated measures (5-items) were developed for each of the three scales. Cronbach's alpha was 0.87 for trust in a physician (test-retest reliability = 0.71), 0.84 for trust in a health insurer (test-retest reliability = 0.73), and 0.77 for trust in the medical profession.Assessment of data completeness, scale score dispersion characteristics, reliability and validity test results all provide evidence for the soundness of the abbreviated 5-item scales.Trust is a key element of therapeutic relationships. Patient trust may influence health status through continuity of care, adherence to treatment regimens, the willingness to seek care [1,2], and perhaps via the mind~body pathway, which is not yet well understood. Biomedical researchers have paid increasing attention to trust as theoretical and measurement developments have occurred [3-45], driven in part by a concern about the potential negative influence of managed care on the doctor-patient relationship. Additional causes for concern about the doctor-patient relationship include the near daily release of conflicting health information about diet, lifestyle, or medications, and well-publicized, yet rarely occurring, outrageous examples of malpractice and medical errors.The relationship between doctors and their patients has received philosophical, legal, and literary attention since Hippocrates, and is the subject of more than 8,000 articles monographs, chapters, and books in the modern medical literature [3]. At the conclusion of an extended, competitive, and expensive period of education and training required to e