Trust in the health care professional and health outcome: A meta-analysis
Trust in the health care professional and health outcome: A meta-analysis
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DOI：
10.1371/journal.pone.0170988
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发表时间：
2017-02-07
期刊：
影响因子：
3.7
通讯作者：
Gerger, Heike
中科院分区：
文献类型：
--
作者：
Birkhauer, Johanna;Gaab, Jens;Gerger, Heike
目的探讨患者对医疗保健专业人员的信任是否与健康结果相关。研究选择：我们搜索了4个主要的电子数据库，以寻找关于患者对医疗保健专业人员的信任与健康结果之间关联的定量数据的研究。数据提取与数据合成我们进行了随机效应元分析和元回归，并计算了相关系数和相应的95%可信区间。两名相互依赖的研究人员使用《加强流行病学指南中观察性研究的报告》对纳入研究的质量进行了评估。结果总的来说，我们发现信任和健康结果之间存在轻微到中等的相关性(r=0.24，95%CI：0.19-0.29)。亚组分析显示，信任与自评主观健康结果之间存在中等程度的相关性(r=0.30，0.24~0.35)。信任与客观(r=-0.02，-0.08-0.03)以及观察者评价结果(r=0.10，-0.16-0.36)之间的相关性不显著。探索性分析显示，信任和患者满意度之间存在很大的相关性，而与健康行为、生活质量和症状严重程度之间的相关性较小。结论从临床角度来看，患者报告了更多有益的健康行为，症状更少，生活质量更高，当他们对自己的卫生保健专业人员更信任时，他们对治疗更满意。在总结的结果中，有证据表明存在向上的偏见。需要进行前瞻性研究，以加深我们对信任和健康结果之间复杂相互作用的理解。
ObjectiveTo examine whether patients' trust in the health care professional is associated with health outcomes.Study selectionWe searched 4 major electronic databases for studies that reported quantitative data on the association between trust in the health care professional and health outcome. We screened the full-texts of 400 publications and included 47 studies in our meta-analysis.Data extraction and data synthesisWe conducted random effects meta-analyses and meta-regressions and calculated correlation coefficients with corresponding 95% confidence intervals. Two interdependent researchers assessed the quality of the included studies using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.ResultsOverall, we found a small to moderate correlation between trust and health outcomes (r = 0.24, 95% CI: 0.19-0.29). Subgroup analyses revealed a moderate correlation between trust and self-rated subjective health outcomes (r = 0.30, 0.24-0.35). Correlations between trust and objective (r = -0.02, -0.08-0.03) as well as observer-rated outcomes (r = 0.10, -0.16-0.36) were non-significant. Exploratory analyses showed a large correlation between trust and patient satisfaction and somewhat smaller correlations with health behaviours, quality of life and symptom severity. Heterogeneity was small to moderate across the analyses.ConclusionsFrom a clinical perspective, patients reported more beneficial health behaviours, less symptoms and higher quality of life and to be more satisfied with treatment when they had higher trust in their health care professional. There was evidence for upward bias in the summarized results. Prospective studies are required to deepen our understanding of the complex interplay between trust and health outcomes.