Predictors of Trust in the Medical Profession among Cancer Patients Receiving Palliative Care: A Preliminary Study

Background: Trust influences healthcare through the willingness to seek care, disclose sensitive information, adhere to treatment, and satisfaction with care. Understanding factors that influence trust may help in physician-patient relationship particularly at end of life. Objectives: We explored the association between trust and other demographic and psychosocial factors. We also explored the performance of the single-item Degree of Trust scale (0 best to 10 worst) compared with the validated five-item Trust in Medical Profession scale (5 best to 25 worst). Design: A secondary analysis of prospectively collected data was performed. Trust scores completed by 100 patients were correlated with age, gender, ethnicity, educational level, anxiety, depression, and hopefulness (Herth Hope Index [12 best to 48 worst]). Setting/Subjects: The study was conducted on 100 patients in an outpatient Supportive Care Center in a cancer center in Houston, Texas. Results: Median age was 57 years (49-65), depression was 6 (3-9), and hopefulness was 22 (20-25). Trust in Medical Profession score was 13, 11-14 (median, IQR) and Degree of Trust score was 2, 1-4 (median, IQR) with moderate correlation (r = 0.587, p < 0.001). On evaluating performance of Degree of Trust scale to the validated Trust in Medical Profession scale, a moderately high performance was found (Youden's J = 0.73; Topleft = 0.21). Older age (p = 0.02) lower depression scores (p < 0.01) and more hopefulness (p = 0.01) were associated with higher levels of trust. Conclusions: Trust was associated with older age, less depressed, and more hopeful patients. A single 0-10 item trust scale was found to perform adequately compared with a multiple-item questionnaire.