Am J Perinatol 2020; 37(07): 666-670
DOI: 10.1055/s-0039-3401795
SMFM Fellowship Series Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Coping with the Unexpected: Patient Trust in Physicians following Delivery

Martha B. Kole
1  Division of Maternal Fetal Medicine, Women and Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
,
Nina K. Ayala
1  Division of Maternal Fetal Medicine, Women and Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
,
Melissa A. Clark
2  Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island
3  Department of Obstetrics and Gynecology, Women and Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
,
Phinnara Has
1  Division of Maternal Fetal Medicine, Women and Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
,
Erika F. Werner
1  Division of Maternal Fetal Medicine, Women and Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
› Author Affiliations
Funding This study was funded by American Diabetes Association grant #1-16-ICTS-118.
Further Information

Publication History

06 September 2019

04 November 2019

Publication Date:
31 December 2019 (online)

Abstract

Objective Patient's trust in physicians is a significant predictor of continuity, adherence, and satisfaction with care. However, it is unclear what influences a woman's trust in her physician. This study sought to determine if women's trust in their clinicians was affected by unexpected outcomes at the time of delivery.

Study Design This is a secondary analysis of a prospective cohort of 300 postpartum women with gestational diabetes mellitus. Participants completed the validated Trust in Physician Scale during their postpartum hospitalization. Participants' scores were compared based on their exposure to an unexpected pregnancy outcome.

Results Of the 300 women consented to participate in this study, 294 completed the Trust in Physician Scale. The mean overall trust score was 80/100 with a range of 42 to 100. Unexpected pregnancy outcomes occurred in 41% (120) of women in this cohort. There was no significant difference in the trust score between women who did and did not have at least one unexpected outcome (0.79 vs. 0.79, p = 0.93). Additionally, there was no significant association between the trust score and any individual unexpected pregnancy outcome.

Conclusion Unexpected pregnancy outcomes are not associated with changes in women's trust in their obstetric clinicians. These results emphasize the antepartum period as the essential time for patient–physician relationship building which has important implications for postpartum follow-up and long-term psychiatric sequelae from unexpected outcomes.

Supplementary Material