Corona Assignment #3

1.Put the full bibliographic citation for the article on the top of page (use apa style).
Riva, S., Monti, M., Iannello, P., Pravettoni, G., Schulz, P. J., & Antonietti, A. (2014). A
Preliminary Mixed-Method Investigation of Trust and Hidden Signals in Medical Consultations.
PLoS ONE, 9(3). doi: 10.1371/journal.pone.0090941

2.What was the purpose of the study?

Analyze aspects of interaction between patients and general practitioners (GP) to understand
trust formation and maintenance- by focusing on communication channels. Socio-demographic
variables were also evaluated.

3.What was the problem addressed in the study (i.e., the gap in the literature)?
The trust level between patients and their doctors, specifically in the Trento region of Italy. They
were also analyzing the “honest signaling,” which were studied in the statements of: activity,
mimicry, consistency, and influence.

4.What were the quantitative variables measured?

The quantitative variables measured were the levels of trust in medicine, GP, health system, and
long lasting relationship with their GP- these were measured with the Lickert scale. The
participants were also asked their rankings of features affecting trust (competence,
relationship/communication, accessibility, and health system). The statements of honest
signaling were also measured with the Lickert scale.

5.What was the quantitative research design?

There were 3 sections to this design. It wasn’t fully quantitative; it was primarily an interview
design and within the interviews, quantitative data was taken. Section 1 covered age, gender,
health status, occupation, education, and the presence of long-standing impairment, illness, or
disability. Section 2 had two parts within it, the first being assessing the level of trust and the
second being answering questions (this was the quantitative measure since it was on a 1-10
scale). Section 3 covered the endorsement of the 4 statements as stated above, and it was also
quantitatively measured on a 1-10 scale.

6.What was the qualitative research data collection protocol?

The qualitative measure was the “word association” portion. They were asked to list five
associations that usually came to mind when they thought about trust in a medical context.
This was meant to be an indicator of the meaning association with their mental representation for
a variety of concepts.
 7.Draw a diagram of the provided mixed method study.

Quantitative Quantitative Quantitative

Design Design Design Interpretation

Qualitative
Element

8.What were the main quantitative findings?

In terms of demographic differences in trust relationship, there was more trust in less literate
people in comparison to high-schooling participants, and more trust in elderly population in
comparison to the younger participants.

Through the AMOS software, it constructed a path diagram to represent causal model and
linking variables of trust, good care, continuity, and satisfaction. Through this analysis, the
researchers found that variance was never negative, and always significant. This indicated that
understanding is the best predictor of trust in this model.

The participants showed a high level of trust in medicine and in their own GP, they say trustful
interactions and long lasting relationships (indicated with ratings of 8 or 9 out of 10). About half
of respondents were not very satisfied in the health system, others thought it was good or very
good. These images at the bottom are a quick summary of the results:
9.What were the main qualitative findings
The researchers observed that patients trust their GP greatly. Through strategies like heuristics,
they base their quality of their interaction on behavioral and relational aspects. They rely on the
honest signals than on content depending features. From the interviews, the researchers realized
that there is not a single non-verbal cue that determines a patients trustworthiness, but rather a set
of cues. These cues point to carefulness, clearness, and empathy.

10.What were the main mixed method findings

There were categories of findings. Results are showing that participants have high level of trust
in medicine and their GP, and that this trust is derived from a set of cues that point to the
carefulness, clearness, and empathetic nature of the physicians.