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The effects of trust in physician on self-efficacy, adherence and diabetes outcomes

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  • Lee, Yin-Yang
  • Lin, Julia L.

Abstract

Trust in physicians has been associated with a range of patient behaviors. However, previous research has not focused on the mechanisms by which trust affects health outcomes and mostly has made use of self-rated health. This study tested a theoretical model of variables influencing the relations of trust to both objective and self-rated health. We hypothesized that patients who trust their physicians more were likely to have stronger self-efficacy and outcome expectations. We expected this, in turn, to be associated with better treatment adherence and objective health outcomes. In addition, we hypothesized that highly trusting patients would be more likely to report better health status through enhanced self-efficacy. Data for this research came from a sample of 480 adult patients with type 2 diabetes in Taiwan. Patients completed measures of trust, self-efficacy, outcome expectations, adherence, and the SF-12 health survey. Objective outcomes, including body mass index, glycosylated hemoglobin, blood lipid, and diabetes-related complications, were assessed by follow-up chart review. The structural equation analyses which were implemented by LISREL VIII resulted in a proper solution that exhibited adequate fit. All hypothesized paths were statistically significant and in the predicted directions. The mediation roles of self-efficacy and outcome expectations were further confirmed by the results of structural equation modeling and bootstrap analyses. In the multivariate regression, although the relations of patient trust to blood lipid and self-rated health were confirmed, the direct link of trust to glycosylated hemoglobin was only significant in the bivariate model. This study clarifies the association of trust with different types of health outcomes and provides the empirical evidence that trust in physicians is associated with both self-rated health and therapeutic response. However, a more longitudinal study design is necessary to precisely determine both the strength and causality of these relationships.

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  • Lee, Yin-Yang & Lin, Julia L., 2009. "The effects of trust in physician on self-efficacy, adherence and diabetes outcomes," Social Science & Medicine, Elsevier, vol. 68(6), pages 1060-1068, March.
    • Handle: RePEc:eee:socmed:v:68:y:2009:i:6:p:1060-1068
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    References listed on IDEAS

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    1. Ergeneli, Azize & Ari, Guler Sag[caron]lam & Metin, Selin, 2007. "Psychological empowerment and its relationship to trust in immediate managers," Journal of Business Research, Elsevier, vol. 60(1), pages 41-49, January.
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    2. Ozawa, Sachiko & Sripad, Pooja, 2013. "How do you measure trust in the health system? A systematic review of the literature," Social Science & Medicine, Elsevier, vol. 91(C), pages 10-14.
    3. Gill, Liz & Cassia, Fabio & Cameron, Ian D. & Kurrle, Susan & Lord, Stephen & Fairhall, Nicola & Lockwood, Keri & Langron, Colleen, 2014. "Exploring client adherence factors related to clinical outcomes," Australasian marketing journal, Elsevier, vol. 22(3), pages 197-204.
    4. Talia Goren & Dana R. Vashdi & Itai Beeri, 2022. "Count on trust: the indirect effect of trust in government on policy compliance with health behavior instructions," Policy Sciences, Springer;Society of Policy Sciences, vol. 55(4), pages 593-630, December.
    5. Thomas Guffey & Philip Q. Yang, 2012. "Trust in Doctors," SAGE Open, , vol. 2(4), pages 21582440124, December.
    6. Ngai, Steven Sek-yum & Jiang, Shan & Cheung, Chau-kiu & Wang, Lin & Tang, Hon-yin, 2021. "Trust in mutual aid group members, self-management of chronic illness, and well-being among young patients with chronic illness in Hong Kong," Children and Youth Services Review, Elsevier, vol. 130(C).
    7. Junbo Son & Yeongin Kim & Shiyu Zhou, 2022. "Alerting patients via health information system considering trust-dependent patient adherence," Information Technology and Management, Springer, vol. 23(4), pages 245-269, December.
    8. Megan M McLaughlin & Louis Simonson & Xia Zou & Li Ling & Joseph D Tucker, 2015. "African Migrant Patients’ Trust in Chinese Physicians: A Social Ecological Approach to Understanding Patient-Physician Trust," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-13, May.
    9. Runtong Zhang & Xinyi Lu & Wen Wu & Xiaopu Shang & Manlu Liu, 2018. "Mature or Emerging? The Impact of Treatment-Related Internet Health Information Seeking on Patients’ Trust in Physicians," IJERPH, MDPI, vol. 15(9), pages 1-17, August.
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    11. Smirnova, Michelle & Owens, Jennifer Gatewood, 2017. "Medicalized addiction, self-medication, or nonmedical prescription drug use? How trust figures into incarcerated women's conceptualization of illicit prescription drug use," Social Science & Medicine, Elsevier, vol. 183(C), pages 106-115.
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