Construction and validation of a preliminary Chinese version of the Wake Forest Physician Trust Scale

The development, validation, and psychometric properties of the Wake Forest Physician Trust Scale (WFPTS)-equivalent instrument for Chinese patients were investigated.

We approached 3442 randomly selected outpatients at 3 Shanghai (China) general hospitals, treated ≥2 times per year by the same physician, for participation between November 2008 and December 2008. A Chinese version of the WFPTS (C-WFPTS) was prepared and administered to eligible and consenting patients, and subjected to validity assessment using 5 patient behaviors: (1) recommendation of the physician; (2) occurrence of dispute; (3) seeking a second opinion; (4) treatment adherence; and (5) consideration of switching physicians.

A total of 352 (M: F, 149: 203; mean age, 40.67±17.31 years; age range, 14-94 years) consenting and eligible patients were included in the analysis. The unidimensionality and internal consistency of C-WFPTS was confirmed (Cronbach's α=0.833). Physician trust correlated significantly with physician satisfaction (r=0.73, P<0.001) and all 5 behaviors (1: r=0.453, 2: r=0.209, 3: r=0.406, 4: r=0.444, 5: r=0.471; P<0.001 for all), indicating validity and predictive validity, respectively. Patient trust increased significantly with increasing age and physician visits (P>0.05), but was not related to gender, birthplace, or insurance type.

C-WFPTS has good psychometric properties, reliability, and validity for the evaluation of patient trust in the patient-physician relationship, and thereby provides an essential tool for the characterization of patient-physician relationships in China, which is necessary for healthcare reform.