Patient-physician trust among adults of rural Tamil Nadu: a community-based survey.

BACKGROUND: Trust is the acceptance of a vulnerable situation in which the truster believes that the trustee will act in the truster's best interests. The cornerstone of the patient-physician relationship is "trust". Despite the intensity and importance of trust relationship of patients toward their physician, the phenomenon is rarely studied in developing countries. OBJECTIVE: Our study aimed to explore the concept of patient-physician trust among adults of rural Tamil Nadu to assess the factors affecting patient-physician trust relationship and patient satisfaction. MATERIALS AND METHODS: A cross-sectional descriptive household survey was carried out on 112 individuals selected by a multistage random sampling method. Men and women aged above 40 years who have visited a health care service at least once during the last 5 years were included in the study. Thom et al's modification of the Anderson and Dedrick Physician Trust scale was used to measure patient trust in physician. RESULTS: Trust is a one-dimensional construct in the surveyed population as revealed by an exploratory factor analysis which extracted one component explaining 50% of the overall variance. Trust influences patient's self-reported satisfaction (ß coefficient of 0.048; P < 0.001) and remains independent of all the other factors assessed in the study such as, age, gender, education, self-reported health status, time spent with the physician, physician's gender, physician's age, and medical specialty that the physician belongs to. Physician's gender, physician's age, self-reported health status, and time spent with the physician were significantly associated with satisfaction with the physician. CONCLUSION: Trust in physicians seems to not depend on any of the assessed factors and largely seems to be implicit in the physician-patient relationship. Trust in physician is associated with patient satisfaction. Further studies are needed to assess trust in physicians in developing country settings.

Nucleophilicities and carbon basicities of DBU and DBN.

The nucleophilicity and Lewis basicity of DBU and DBN toward C(sp(2)) centers have been measured: nucleophilicities increase in the series DMAP < DBU < DBN < DABCO while Lewis basicities are DABCO < DMAP < DBU < DBN.