CHAPTER 6. CONCLUSION
6.4 Conclusion
Chronic disease is a major cause of disability and a main reason why people seek health care. Neither the disease course nor its consequences are static; therefore, continuous and complex management is required. The current study provides the only empirical evidence to our knowledge that trust in physicians is associated with both self-rated and objective health outcomes. We make an important contribution by highlighting the importance of patient trust, which we believe is critical to the improvement of health outcomes through patients’
expectations and adherence behaviors. We also illustrate the importance of autonomy
preferences as a moderator of the trusting relationships. As health care organizations continue to devote vast resources to quality of care improvement, the need for a better understanding of effective health care relationships continues to grow. Because both an absence of trust and an overreliance on trust are associated with dangers and costs, advocates of patients’ autonomy have gained a renewed respect for trust. This renewal has led to recommendations for health care providers to develop the relationships that can cultivate not only the patients’ trust but also their preferences for autonomy to ensure full cooperation. Such relationships are
characterized by expertise and caring and are driven by repeated communication and actions that help patients to actively cope with the uncertainties of their illnesses and gaps in our medical knowledge. We have sought to develop a framework for understanding simultaneous trust and autonomy preferences as potential contributors to health care, deriving implications for the roles of health care providers and policymakers in the future development of patient trust and autonomy. Our study adds to the growing body of evidence that “trust, but verify”
approach might put patients in the best position for achieving their health-related goals.
Although barriers may hinder the simultaneous promotion of both trust and autonomy preferences, the reality is that patients depend on their physicians and health organizations to involve them in partnerships regarding their medical care. Increased efforts are needed to
identify the best practices for evaluating strategies and programs to facilitate the formation of such new trust relationships.
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