Measuring trust in one’s physician: A scoping review

Trust in one’sphysician drives positive health practices. However, the conceptualization and subsequentoperationalization of trust have become clouded due to the multitude ofapproaches that have resulted in several different measures with varieddimensions and indicators. The objectives of this scoping review were: 1) toidentify those measures of trust, whether newly created or refined in the last10 years, whose reliability and validity had been studied, 2) to compare thoseinstruments’ conceptualizations, dimensions, andindicators, and 3) to discover any new developments in the measurement of trust.This researcher conducted an electronic search of three databases (PubMed,SOCAB, and PsycINFO). Two reviewers screened those selected studies andextracted six distinct keymeasurement tools, of which three had shorter more abbreviated derivatives; ofthese six distinct tools, only one was developed and validated in non-USpopulations. Also extracted were ten dimensions of trust: fidelity, technicalcompetence, communicative competence, interpersonal competence (i.e., caring), honesty,confidentiality, global, behavioral, fairness, and system trust/accountability.Interpersonal competence and fairness emerged as newer dimensions that deservefurther study. A comparative analysis of the indicators of these trustdimensions revealed some discrepancies that deserve further theoretical andpsychometric attention. In addition, the use of item-response theory to assessmeasurement invariance has been a productive addition to the assessment ofexternal validity. This review provides a resource for researchers that willlead to a more uniform understanding of trust thereby setting the basis forfuture theoretical integration and measurement development.