RT Journal Article
SR Electronic
T1 Trust in One’s Physician: The Role of Ethnic Match, Autonomy, Acculturation, and Religiosity Among Japanese and Japanese Americans
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 339
OP 347
DO 10.1370/afm.289
VO 3
IS 4
A1 Derjung M. Tarn
A1 Lisa S. Meredith
A1 Marjorie Kagawa-Singer
A1 Shinji Matsumura
A1 Seiji Bito
A1 Robert K. Oye
A1 Honghu Liu
A1 Katherine L. Kahn
A1 Shunichi Fukuhara
A1 Neil S. Wenger
YR 2005
UL http://www.annfammed.org/content/3/4/339.abstract
AB PURPOSE Trust is a cornerstone of the physician-patient relationship. We investigated the relation of patient characteristics, religiosity, acculturation, physician ethnicity, and insurance-mandated physician change to levels of trust in Japanese American and Japanese patients. METHODS A self-administered, cross-sectional questionnaire in English and Japanese (completed in the language of their choice) was given to community-based samples of 539 English-speaking Japanese Americans, 340 Japanese-speaking Japanese Americans, and 304 Japanese living in Japan. RESULTS Eighty-seven percent of English-speaking Japanese Americans, 93% of Japanese-speaking Japanese Americans, and 58% of Japanese living in Japan responded to trust items and reported mean trust scores of 83, 80, and 68, respectively, on a scale ranging from 0 to 100. In multivariate analyses, English-speaking and Japanese-speaking Japanese American respondents reported more trust than Japanese respondents living in Japan (P values &lt;.001). Greater religiosity (P &lt;.001), less desire for autonomy (P &lt;.001), and physician-patient relationships of longer duration (P &lt;.001) were related to increased trust. Among Japanese Americans, more acculturated respondents reported more trust (P &lt;.001), and Japanese physicians were trusted more than physicians of another ethnicity. Among respondents prompted to change physicians because of insurance coverage, the 48% who did not want to switch reported less trust in their current physician than in their former physician (mean score of 82 vs 89, P &lt;.001). CONCLUSIONS Religiosity, autonomy preference, and acculturation were strongly related to trust in one’s physician among the Japanese American and Japanese samples studied and may provide avenues to enhance the physician-patient relationship. The strong relationship of trust with patient-physician ethnic match and the loss of trust when patients, in retrospect, report leaving a preferred physician suggest unintended consequences to patients not able to continue with their preferred physicians.