Literature DB >> 16046567

Trust in one's physician: the role of ethnic match, autonomy, acculturation, and religiosity among Japanese and Japanese Americans.

Derjung M Tarn1, Lisa S Meredith, Marjorie Kagawa-Singer, Shinji Matsumura, Seiji Bito, Robert K Oye, Honghu Liu, Katherine L Kahn, Shunichi Fukuhara, Neil S Wenger.   

Abstract

PURPOSE: Trust is a cornerstone of the physician-patient relationship. We investigated the relation of patient characteristics, religiosity, acculturation, physician ethnicity, and insurance-mandated physician change to levels of trust in Japanese American and Japanese patients.
METHODS: A self-administered, cross-sectional questionnaire in English and Japanese (completed in the language of their choice) was given to community-based samples of 539 English-speaking Japanese Americans, 340 Japanese-speaking Japanese Americans, and 304 Japanese living in Japan.
RESULTS: Eighty-seven percent of English-speaking Japanese Americans, 93% of Japanese-speaking Japanese Americans, and 58% of Japanese living in Japan responded to trust items and reported mean trust scores of 83, 80, and 68, respectively, on a scale ranging from 0 to 100. In multivariate analyses, English-speaking and Japanese-speaking Japanese American respondents reported more trust than Japanese respondents living in Japan (P values <.001). Greater religiosity (P <.001), less desire for autonomy (P <.001), and physician-patient relationships of longer duration (P <.001) were related to increased trust. Among Japanese Americans, more acculturated respondents reported more trust (P <.001), and Japanese physicians were trusted more than physicians of another ethnicity. Among respondents prompted to change physicians because of insurance coverage, the 48% who did not want to switch reported less trust in their current physician than in their former physician (mean score of 82 vs 89, P <.001).
CONCLUSIONS: Religiosity, autonomy preference, and acculturation were strongly related to trust in one's physician among the Japanese American and Japanese samples studied and may provide avenues to enhance the physician-patient relationship. The strong relationship of trust with patient-physician ethnic match and the loss of trust when patients, in retrospect, report leaving a preferred physician suggest unintended consequences to patients not able to continue with their preferred physicians.

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Year:  2005        PMID: 16046567      PMCID: PMC1466902          DOI: 10.1370/afm.289

Source DB:  PubMed          Journal:  Ann Fam Med        ISSN: 1544-1709            Impact factor:   5.166


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