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Concepts of trust in patients with serious illness focused on physician interpersonal and technical competence

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QUESTION: How do patients with serious medical conditions conceptualise and assess trust in their physicians?


Exploratory descriptive study.


New Jersey, USA.


30 women (mean age 56 y) with breast cancer, 30 patients (mean age 48 y, 83% women) with Lyme disease, and 30 patients (mean age 43 y, 53% men) with a serious psychiatric illness.


In semi-structured interviews, patients were asked about various aspects of their interactions with their physicians, medical institutions, and healthcare plans. The interview schedule was based on a conceptualisation of 5 dimensions of trust that were identified from a literature review (competence, fiduciary responsibility and agency, control, confidentiality, and disclosure). Interviews were audiotaped and transcribed; individual phrases were coded using the above conceptualisation.

Main findings

Patient responses to the question “what does trust mean to …

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  • Source of funding: in part, Robert Wood Johnson Foundation.

  • For correspondence: Dr D Mechanic, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ 08901, USA. Fax +1 732 932 1253.