The association between psychosocial care by physicians and patients’ trust: a retrospective analysis of severely injured patients in surgical intensive care units

Aim: Trust is an essential element in physician-patient interaction fostering in general adherence and improving patient- and physician-reported outcomes. Regarding severely injured patients, trust-building behaviour is important because of the severity of injuries and therefore potential associated physical and psychological consequences. The objective of this study was to identify significant and relevant determinants on trust of severely injured patients in their physicians in surgical intensive care units. Methods: Ninety-one severely injured patients completed a self-administered questionnaire after being transferred from surgical intensive care unit to surgical unit. All patients were treated in four hospitals of maximal care in North Rhine-Westphalia between 2001 and 2005. To assess different aspects of trust the “trust in physician” scale of the Cologne Patient Questionnaire (CPQ) was used. “Psychosocial care by physicians” is measured through: support, devotion, information and shared-decision making provided by physicians. Patient- and trauma related control variables are also included in a logistic regression model. Results: Stepwise logistic regression identified “psychosocial care provided by physicians” as a significant contributor to severely injured patients’ trust (Nagelkerke’s R(2): 41%). “Trust in physicians” is correlated with all four dimensions of “psychosocial care by physicians”: support (0.546), devotion (0.443), information (0.396), and shared-decision making behaviour (0.342) provided by physicians in surgical intensive care units. Conclusions: This finding confirms the importance of supportive communication style in physician-patient interaction concerning reported trust of severely injured patients on surgical intensive care units. Medical education should integrate sound knowledge about psychosocial aspects of interaction to provide effective emotional and informational support to build up and maintain patient trust.