PURPOSE: To examine the performance and properties of the Revised Health Care System Distrust Scale among surrogates in the intensive care unit (ICU). MATERIALS AND METHODS: Pilot, prospective cohort study of 50 surrogates of adult, mechanically ventilated patients surveyed on days 1, 3, and 7 of ICU admission. RESULTS: Responses on the Health Care System Distrust Scale on day 1 ranged from 9 to 34 (possible range 9-45, with higher scores indicating more distrust), with a mean and SD of 20.3 ± 6.9. Factor analysis demonstrated a 2-factor structure, corresponding to the domains of values and competence. Cronbach α for the overall scale was .83, for the competence subscale, .76, and for the values subscale, .74. Health-care system distrust was inversely correlated with trust in ICU physicians (Pearson coefficient -.63). When evaluated over the course of each patient's ICU stay, health-care system distrust ratings decreased by 0.31 per patient-day (95% CI 0.55-0.06, P = .015). Correlation between health-care system distrust and trust in ICU physicians decreased slightly over time. CONCLUSIONS: Among surrogates in the ICU, the Health Care System Distrust Scale has high internal consistency and convergent validity. There was substantial variability in surrogates' trust in the health-care system.
PURPOSE: To examine the performance and properties of the Revised Health Care System Distrust Scale among surrogates in the intensive care unit (ICU). MATERIALS AND METHODS: Pilot, prospective cohort study of 50 surrogates of adult, mechanically ventilated patients surveyed on days 1, 3, and 7 of ICU admission. RESULTS: Responses on the Health Care System Distrust Scale on day 1 ranged from 9 to 34 (possible range 9-45, with higher scores indicating more distrust), with a mean and SD of 20.3 ± 6.9. Factor analysis demonstrated a 2-factor structure, corresponding to the domains of values and competence. Cronbach α for the overall scale was .83, for the competence subscale, .76, and for the values subscale, .74. Health-care system distrust was inversely correlated with trust in ICU physicians (Pearson coefficient -.63). When evaluated over the course of each patient's ICU stay, health-care system distrust ratings decreased by 0.31 per patient-day (95% CI 0.55-0.06, P = .015). Correlation between health-care system distrust and trust in ICU physicians decreased slightly over time. CONCLUSIONS: Among surrogates in the ICU, the Health Care System Distrust Scale has high internal consistency and convergent validity. There was substantial variability in surrogates' trust in the health-care system.
Authors: Jean Carlet; Lambertus G Thijs; Massimo Antonelli; Joan Cassell; Peter Cox; Nicholas Hill; Charles Hinds; Jorge Manuel Pimentel; Konrad Reinhart; Boyd Taylor Thompson Journal: Intensive Care Med Date: 2004-04-20 Impact factor: 17.440
Authors: Paul J Hutchison; Katie McLaughlin; Tom Corbridge; Kelly N Michelson; Linda Emanuel; Peter H S Sporn; Megan Crowley-Matoka Journal: Crit Care Med Date: 2016-12 Impact factor: 7.598