Establishing trust between physicians and patients with rheumatic diseases

Trust between a patient and doctor is a key factor in promoting improved quality of life, compliance with treatment, and better health outcomes. Without trust, the patient-doctor relationship may not become firmly established, thus potentially hindering physicians' ability to help patients. This is of special concern in the setting of rheumatic diseases, which are chronic and involve patient-doctor relationships that need to be established over a lifetime of disease; yet few studies have been conducted to identify the components of establishing trust in these patients. A new study published in the June 2006 issue of Arthritis Care & Research (http://www.interscience.wiley.com/journal/arthritiscare) examined ethnically diverse patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) to determine the elements of the patient-doctor relationship associated with trust in physicians.

Led by Javier P. Berrios-Rivera of the Baylor College of Medicine in Houston, Texas, researchers assessed 102 patients with SLE or RA who were being treated at outpatient rheumatology clinics at publicly funded hospitals in Houston between September and November 2003. Patients responded to a questionnaire that assessed various aspects of the medical encounter, including doctors' informativeness, sensitivity to concerns, reassurance and support, and patient-centered behavior (e.g. "My doctors always ask me what I need"). Patients were also evaluated in terms of their willingness to disclose information to their physicians and their trust in the U.S. heath care system. Thirty-one percent of the patients were African-American, 43% were Latino and 25% were White.

The results showed that patients' trust of their doctors was independently associated with ethnicity, quality of the patient-doctor relationship, disease activity, and trust in the U.S. health care system. There was a lower level

Contact: Amy Molnar
John Wiley & Sons, Inc.

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