Heather Coats1, Lois Downey2, Rashmi K Sharma3, J Randall Curtis2, Ruth A Engelberg2. 1. College of Nursing, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA. Electronic address: heather.coats@ucdenver.edu. 2. Cambia Palliative Care Center of Excellence, University of Washington, Seattle, Washington, USA; Division of Pulmonary, Critical Care & Sleep Medicine, School of Medicine, University of Washington, Seattle, Washington, USA. 3. Division of General Internal Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
Abstract
CONTEXT: Better understanding of clinicians' skill communicating with their patients and of patients' trust in clinicians is necessary to develop culturally sensitive palliative care interventions. Race/ethnicity, socioeconomic status, and religiosity have been documented as factors influencing quality of communication and trust. OBJECTIVES: The objective of this study was to explore associations of seriously ill patients' race/ethnicity, socioeconomic status, and religiosity with patients' ratings of the quality of clinicians' communication and trust in clinicians. METHODS: An observational analysis was performed using baseline data from a multicenter cluster-randomized trial of a communication intervention. We enrolled consecutive patients with chronic, life-limiting illnesses (n = 537) cared for by primary and specialty care clinicians (n = 128) between 2014 and 2016 in outpatient clinics in Seattle, Washington. We assessed patient demographics (age, gender, race/ethnicity, education, income, and self-rated health status), Duke University Religion Index, Quality of Communication Scale, and Wake Forest Physician Trust Scale. We used probit and linear regression and path analyses to examine associations. RESULTS: Patients providing higher ratings of clinician communication included those belonging to racial/ethnic minority groups (P = 0.001), those with lower income (P = 0.008), and those with high religiosity/spirituality (P = 0.004). Higher trust in clinicians was associated with minority status (P = 0.018), lower education (P = 0.019), and clinician skill in communication (P < 0.001). CONCLUSION: Contrary to prior studies, racial/ethnic minorities and patients with lower income rated communication higher and reported higher trust in their clinicians than white and higher income patients. More research is needed to identify and understand factors associated with quality communication and trust between seriously ill patients and clinicians to guide development of patient-centered palliative care communication interventions.
RCT Entities:
CONTEXT: Better understanding of clinicians' skill communicating with their patients and of patients' trust in clinicians is necessary to develop culturally sensitive palliative care interventions. Race/ethnicity, socioeconomic status, and religiosity have been documented as factors influencing quality of communication and trust. OBJECTIVES: The objective of this study was to explore associations of seriously ill patients' race/ethnicity, socioeconomic status, and religiosity with patients' ratings of the quality of clinicians' communication and trust in clinicians. METHODS: An observational analysis was performed using baseline data from a multicenter cluster-randomized trial of a communication intervention. We enrolled consecutive patients with chronic, life-limiting illnesses (n = 537) cared for by primary and specialty care clinicians (n = 128) between 2014 and 2016 in outpatient clinics in Seattle, Washington. We assessed patient demographics (age, gender, race/ethnicity, education, income, and self-rated health status), Duke University Religion Index, Quality of Communication Scale, and Wake Forest Physician Trust Scale. We used probit and linear regression and path analyses to examine associations. RESULTS:Patients providing higher ratings of clinician communication included those belonging to racial/ethnic minority groups (P = 0.001), those with lower income (P = 0.008), and those with high religiosity/spirituality (P = 0.004). Higher trust in clinicians was associated with minority status (P = 0.018), lower education (P = 0.019), and clinician skill in communication (P < 0.001). CONCLUSION: Contrary to prior studies, racial/ethnic minorities and patients with lower income rated communication higher and reported higher trust in their clinicians than white and higher income patients. More research is needed to identify and understand factors associated with quality communication and trust between seriously ill patients and clinicians to guide development of patient-centered palliative care communication interventions.
Authors: Thomas K Houston; Jeroan J Allison; Marc Sussman; Wendy Horn; Cheryl L Holt; John Trobaugh; Maribel Salas; Maria Pisu; Yendelela L Cuffee; Damien Larkin; Sharina D Person; Bruce Barton; Catarina I Kiefe; Sandral Hullett Journal: Ann Intern Med Date: 2011-01-18 Impact factor: 25.391
Authors: Matthew E Modes; Ruth A Engelberg; Lois Downey; Elizabeth L Nielsen; J Randall Curtis; Erin K Kross Journal: J Pain Symptom Manage Date: 2018-11-01 Impact factor: 3.612
Authors: Matthew E Modes; Susan R Heckbert; Ruth A Engelberg; Elizabeth L Nielsen; J Randall Curtis; Erin K Kross Journal: J Pain Symptom Manage Date: 2020-05-07 Impact factor: 3.612
Authors: Blair Wendlandt; Agathe Ceppe; Summer Choudhury; Christopher E Cox; Laura C Hanson; Marion Danis; James A Tulsky; Judith E Nelson; Shannon S Carson Journal: Intensive Care Med Date: 2019-02-21 Impact factor: 17.440
Authors: Rebecca E Ryan; Michael Connolly; Natalie K Bradford; Simon Henderson; Anthony Herbert; Lina Schonfeld; Jeanine Young; Josephine I Bothroyd; Amanda Henderson Journal: Cochrane Database Syst Rev Date: 2022-07-08
Authors: Matthew E Modes; Ruth A Engelberg; Elizabeth L Nielsen; Lyndia C Brumback; Thanh H Neville; Anne M Walling; J Randall Curtis; Erin K Kross Journal: J Pain Symptom Manage Date: 2022-06-11 Impact factor: 5.576
Authors: Elizabeth Chuang; Ryan J Fiter; Omar C Sanon; Ann Wang; Aluko A Hope; Clyde B Schechter; Michelle N Gong Journal: Am J Hosp Palliat Care Date: 2020-04-02 Impact factor: 2.500