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Abstract: FR-PO415

Trust in Physicians Among Hospitalized Patients Receiving Maintenance Dialysis: Prevalence and Correlates

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Dahl, Spencer, University of Rochester Medical Center, Rochester, New York, United States
  • Syed, Musaib, University of Rochester Medical Center, Rochester, New York, United States
  • Kazi, Basil S., University of Illinois Chicago, Chicago, Illinois, United States
  • Saeed, Fahad, University of Rochester Medical Center, Rochester, New York, United States
Background

Trust between physicians and patients is crucial for a therapeutic patient-physician relationship and effective healthcare delivery. However, there is limited research on the prevalence and correlates of physician trust in chronic disease populations, especially among acutely ill hospitalized individuals receiving maintenance dialysis.

Methods

We surveyed 223 hospitalized individuals undergoing maintenance dialysis (59% response rate) at Strong Memorial Hospital, an academic tertiary care center. Our sample included 120 patients (53%) over 65 years, 105 women (47.1%), and 91 (41%) White, 82 (37%) Black/African American and 36 (16%) patients from other self-identified racial groups. Patients had been on dialysis for an average of 3.16 years (SD ± 2.369, IQR 1-4). Physician trust was assessed using the validated Primary Care Assessment Survey (PCAS) trust scale. Dependent variables included quality of life measured by Kidney Disease Quality of Life Scale (KDQOL-36) and 30-days self-reported hospitalizations. Co-variates, included age, gender, race, education, annual household income and time on dialysis.

Results

Out of the 223 respondents, 72 (32%) reported not trusting their doctor, and 91 (41%) reported not trusting their doctor's judgments about their medical care. Linear regression analysis revealed a statistically significant correlations between trust and symptom burden subscale (estimate 0.10, CI 0.05-0.016, p<0.0002) and number of hospitalizations in the last 30 days (estimate -0.56, CI -1.08, -0.03, p<0.037). Female participants reported lower trust scores than their male counterparts (estimate -1.56, CI -3.07, -0.05, p<0.043).

Conclusion

Mistrust of physicians is prevalent among hospitalized patients receiving dialysis care. Hospitalized women receiving maintenance dialysis were more likely to mistrust their physicians than men. Higher trust scores were associated with lower symptom burden while lower scores were associated with greater number of hospitalizations in the last 1 month. Interventions to improve patient-physician communication and patients symptoms may improve trust.