Learning Objective #1: Identify the dimensions of trust in patient-provider relationships

Learning Objective #2: Describe end-stage renal disease (ESRD) patients’ perceptions of trust and identify variables associated with trust in their physicians and nurse coordinators

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Problem/Significance: Health disparities related to the provision of, and access to, healthcare in the United States are documented across racial and ethnic groups. Of particular interest to health disparities researchers has been solid organ transplantation. Provider and patient behaviors including trust have been implicated as potential contributors to disparities in healthcare among patients with end-stage renal disease (ESRD). The literature identifies five dimensions of trust: competence, compassion, control, communication and confidentiality. Study Design: This descriptive, cross-sectional, mixed methods study examines the perceptions of trust among patients in the kidney transplant process. Patients are enrolled who are: 1) currently on dialysis, 2) on the transplantation waiting list receiving dialysis; 3) on the transplantation waiting list not receiving dialysis; 4) newly transplanted less than one year and 5) patients transplanted for greater than one year. Demographic variables, Trust in Physician Scale (TPS); Trust in Nurse Scale (TNS), Patient Trust Scale (PTS) and open-ended questions related to trust and provision of care and information are examined. Sample: To date, 47 patients with ESRD, 21 males, 26 females, with a mean age 46.7 (SD±14.2) have been enrolled. Analyses: Thematic analyses of qualitative data, bivariate correlation coefficients and analyses of variance were calculated. Results: There is a significant relationship (p =.025) between TNS scores and age. TPS mean scores differ by gender (p = .027). Additionally, our preliminary qualitative findings support the five dimensions of trust previously described. ESRD patients describe "Trust is everything. It's faith in their (health providers) competency...my best interest in their forethoughts. They tell you the truth...give you the facts...wonderful listeners...treat me like family." Implications for Clinical Practice: Providing patients with confidentiality and a sense of control while optimizing provider communication, competence, and compassion may ultimately impact health outcomes for ESRD patients who are at varying stages of the transplant process.