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J Crit Care. 2012 Feb;27(1):3-10. doi: 10.1016/j.jcrc.2011.04.006. Epub 2011 Jun 28.

Health-care system distrust in the intensive care unit.

Author information

1
Division of General Internal Medicine, Section of Palliative Care and Medical Ethics, University of Pittsburgh, USA. schenkery@upmc.edu

Abstract

PURPOSE:

To examine the performance and properties of the Revised Health Care System Distrust Scale among surrogates in the intensive care unit (ICU).

MATERIALS AND METHODS:

Pilot, prospective cohort study of 50 surrogates of adult, mechanically ventilated patients surveyed on days 1, 3, and 7 of ICU admission.

RESULTS:

Responses on the Health Care System Distrust Scale on day 1 ranged from 9 to 34 (possible range 9-45, with higher scores indicating more distrust), with a mean and SD of 20.3 ± 6.9. Factor analysis demonstrated a 2-factor structure, corresponding to the domains of values and competence. Cronbach α for the overall scale was .83, for the competence subscale, .76, and for the values subscale, .74. Health-care system distrust was inversely correlated with trust in ICU physicians (Pearson coefficient -.63). When evaluated over the course of each patient's ICU stay, health-care system distrust ratings decreased by 0.31 per patient-day (95% CI 0.55-0.06, P = .015). Correlation between health-care system distrust and trust in ICU physicians decreased slightly over time.

CONCLUSIONS:

Among surrogates in the ICU, the Health Care System Distrust Scale has high internal consistency and convergent validity. There was substantial variability in surrogates' trust in the health-care system.

PMID:
21715134
PMCID:
PMC3184334
DOI:
10.1016/j.jcrc.2011.04.006
[Indexed for MEDLINE]
Free PMC Article
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