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Trust, mistrust, and communication in the neonatal intensive care unit
Thesis

Trust, mistrust, and communication in the neonatal intensive care unit

Wesley C. Tang
Master of Public Health (M.P.H.), Drexel University
May 2011
DOI:
https://doi.org/10.17918/etd-3610
pdf
Tang_Wesley_20111.03 MB
PDF Access upon request, Email title, URL, or DOI to archives@drexel.edu

Abstract

Trust Communication Neonates Intensive Care Units Public Health
Background: Parental trust in physicians is an important aspect of care in the neonatal intensive care unit (NICU). Multiple studies have shown that a parent's race and ethnicity influence his or her trust in physicians. Low levels of trust have been associated with lowered patient satisfaction, less frequent medical utilization, and worse health outcomes. Objective: This study evaluated how race and ethnicity in parents could predict an individual's trust and mistrust in their child's physician. Methods: Parents who had a child admitted to the NICU for a minimum of 48 hours were recruited to this study. Three questionnaires were administered by an interviewer at the bedside. The instruments used were: a Demographics questionnaire, the Pediatric Trust in Physicians Survey (Pedi-TIPS), and the Group Based Medical Mistrust Scales (GBMMS). The outcome variables of interest were the total aggregate scores generated by the Pedi-TIPS and the GBMMS. Results: Sixty-one parents participated in this study. 68.9% of respondents indicated they were African American, Multiracial, or Other. The mean score on the Pedi-TIPS questionnaire was 42.5 out of a total of 55 points, indicating high levels of medical trust in individual providers. The mean difference between Caucasians and African Americans on the Pedi-TIPS was 0.78, p<0.96. The mean score on the GBMMS questionnaire was 23.0 out of a total of 60 points, indicating low levels of medical mistrust of the wider health care provider community. The mean difference between Caucasians and African Americans on the GBMMS questionnaire was 4.91, p<0.03. Conclusions: There does not appear to be a statistically significant difference in trust of a parent's individual physician in racial and ethnic minorities. However, there is a difference in mistrust of health care providers in African Americans vs. Caucasians. This may be the case because parents involved in this study trust their individual providers. At the same time, these same parents may mistrust the medical profession due to a historical context of racial discrimination. Further research with greater power is recommended to detect small mean differences between racial groups.

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