Abstract
Objective: Based on the embeddedness theory, the present study aimed to investigate the association between patients' trust in family doctors (Interpersonal Trust), trust in community health centers (Institutional Trust), and trust in society as a whole (Social Trust).
Methods: A cross-sectional survey was conducted in six community health centers from February to April 2022 in Wuhan, China. Structural equation modeling through partial least squares method (PLS-SEM) was employed to assess the reliability and validity of the multidimensional trust scales and test the study hypotheses.
Results: 228 valid questionnaires were collected and the scores of Interpersonal Trust, Institutional Trust, and Social Trust were 3.761, 3.636, and 3.635, respectively. Through PLS-SEM, the study outcomes substantiated hypotheses that Interpersonal Trust has a positive effect on Institutional Trust (β = 0.916, p < 0.001), Institutional Trust has a positive effect on Social Trust (β = 0.617, p < 0.001), Institutional Trust has a positive effect on Interpersonal Trust (β = 0.864, p < 0.001) and Social Trust has a positive effect on Institutional Trust (β = 0.784, p < 0.001). However, the relationship between Interpersonal Trust and Social Trust were not demonstrated.
Conclusions: This study provides a more comprehensive understanding of the relationship between family doctors and patient trust. By adopting the lens of embeddedness theory, we reveal positive correlations between Social Trust and Institutional Trust, as well as between Institutional Trust and Interpersonal Trust. Moreover, we have identified Institutional Trust as a crucial mediating factor between Interpersonal Trust and Social Trust. However, to further enhance the validity of our findings, future research should conduct longitudinal studies to examine trust development over time, and develop more comprehensive measures to capture the multidimensional nature of trust accurately.
Keywords: Family doctors; doctor – patient relationship; embeddedness theory; trust model.