The import of trust in regular providers to trust in cancer physicians among white, African American, and Hispanic breast cancer patients

Karen Kaiser*, Garth H. Rauscher, Elizabeth A. Jacobs, Teri A. Strenski, Carol Estwing Ferrans, Richard B. Warnecke

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

52 Scopus citations

Abstract

BACKGROUND: Interpersonal trust is an important component of the patient-doctor relationship. Little is known about patients' trust in the multiple providers seen when confronting serious illness. OBJECTIVES: To characterize breast cancer patients' trust in their regular providers, diagnosing physicians, and cancer treatment team and examine whether high trust in one's regular provider confers high trust to cancer physicians. DESIGN: In-person interviews. PARTICIPANTS: 704 white, black, and Hispanic breast cancer patients, age 30 to 79, with a first primary in situ or invasive breast cancer who reported having a regular provider. MEASURES: We measure trust in: (1) regular provider, (2) diagnosing doctors, and (3) cancer treatment team. Other variables include demographic variables, preventive health care, comorbidities, time with regular provider, time since diagnosis, cancer stage, and treatment modality. RESULTS: Sixty-five percent of patients reported high trust in their regular provider, 84% indicated high trust in their diagnosing doctors, and 83% reported high trust in their treatment team. Women who reported high trust in their regular provider were significantly more likely to be very trusting of diagnosing doctors (OR: 3.44, 95% CI: 2.27-5.21) and cancer treatment team (OR: 3.09, 95% CI: 2.02-4.72 ). Black women were significantly less likely to be very trusting of their regular doctor (OR: 0.58, 95% CI: 0.38-0.88) and cancer treatment team (OR: 0.45, 95% CI: 0.25-0.80). English-speaking Hispanic women were significantly less trusting of their diagnosing doctors (OR: 0.29, 95% CI: 0.11-0.80). CONCLUSIONS: Our results suggest that patients are very trusting of their breast cancer providers. This is an important finding given that research with other populations has shown an association between trust and patient satisfaction and treatment adherence. Our findings also suggest that a trusting relationship with a regular provider facilitates trusting relationships with specialists. Additional work is needed to increase interpersonal trust among black women.

Original languageEnglish (US)
Pages (from-to)51-57
Number of pages7
JournalJournal of general internal medicine
Volume26
Issue number1
DOIs
StatePublished - Jan 2011

Funding

Acknowledgement: This work was funded by the National Cancer Institute (Grant no. 5 P50 CA 106743) to the University of Illinois at Chicago Center for Population Health and Health Disparities, National Institutes of Health Grants R01 AG033172-01 and 1R21HD057473-01A1, and National Cancer Institute Training Program R25TCA57699-14. This work was presented at the annual meeting of the American Society of Preventive Oncology, March 2010.

Keywords

  • breast cancer
  • doctor-patient relationships
  • primary care
  • specialty care

ASJC Scopus subject areas

  • Internal Medicine

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