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Patient Educ Couns. 2011 Dec;85(3):406-12. doi: 10.1016/j.pec.2010.12.005. Epub 2011 Jan 26.

How much does trust really matter? A study of the longitudinal effects of trust and decision-making preferences on diabetic patient outcomes.

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Department of Health Management, I-Shou University, Taiwan.



To examine the impact of trust on patient outcomes (satisfaction, HbA(1C), physical and mental health-related quality of life (HRQoL)) and to investigate the role of decision-making preferences in the trust-outcome relationship.


We conducted a one-year longitudinal analysis of 614 type 2 diabetic patients (mean age: 59.3 years; mean disease duration: 6.7 years). Patients' self-administered questionnaires and medical record were used for the research. Multiple regression analyses were conducted to investigate the relationship among variables during a 12-month follow-up. Further, we used latent growth modeling (LGM) to assess changes in health outcomes and to examine how these changes were related to trust.


Regression analyses revealed that trust was positively related to glycemic control, physical HRQoL, and satisfaction at 12 months. Patients with higher decision-making preferences experienced a greater increase in subsequent satisfaction. The results of LGM showed that higher levels of trust were associated with greater increases in physical HRQoL.


Trust contributes to improvements in health outcomes. The relationship between trust and satisfaction may be stronger among patients with higher decision-making preferences.


For healthcare providers, efforts should be made to cultivate patients' trust and enhance their decision-making preferences to maximize satisfaction and improve outcomes.

[Indexed for MEDLINE]

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