Proposal for a Multidimensional Scale to Measure Trust Between Physician and Patient in the Aesthetic Surgery Sector

Healthcare plays a crucial role in individuals' quality of life, with aesthetic surgery representing a particularly significant component for many patients. The global market for cosmetic medicine and surgery is projected to surpass $136 billion by 2028. Reflecting this trend, aesthetic surgery in Chile has become a sensitive area for patients, with demand for such services increasing by 30% in the past year. In this context, mutual trust between physicians and patients emerges as a key factor.

The aim of this study is to develop a multidimensional scale to measure trust between physicians and patients, encompassing not only aspects of personal interaction but also characteristics of the physical environment in which these interactions occur.

A scale to measure trust in the physician-patient relationship was developed through a literature review, critical incident analysis, and focus groups to refine the items. A validated questionnaire was created and pilot tested with 30 individuals, followed by exploratory factor analysis and reliability testing, which confirmed its multidimensional structure. The items were rated on a 7-point Likert scale. For the final data collection, the questionnaire was administered to 406 carefully selected aesthetic surgery patients using systematic sampling. A comprehensive psychometric analysis was conducted, including assessments of content, construct, and convergent validity, as well as evaluations of the instrument's dimensionality and reliability.

Based on the constructs obtained, a structural equation model was developed. The model fit indices converged toward the optimal thresholds established in the literature, thereby validating the three hypotheses proposed in this study.

Trust between physicians and patients is determined by the physician's charisma, the patient's cooperation, and willingness and access to the medical facility, with an appropriate coefficient of determination. Furthermore, the evidence indicates that physician charisma comprises honesty, competence, and empathy toward the patient. Likewise, willingness and access to the medical facility encompass the environment, facility layout, and accessibility features.

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