A Survey on Distrust on Health Care System and Health Status Among the

General Community of San Isidro, Sawata

Submitted to:
Sergio Opena, PhD

Submitted by:
Dillera, Christel Ann, MD, DFM
MAHA
INTRODUCTION

The provision of healthcare depends in a setting characterized by uncertainty and a portion of risk
as to the competence and purposes of the healthcare providers. By tradition, it has been widely accepted
that the customers or clients of the service trust the judgement, knowledge and expertise of the health
professional to provide a competent service. The effective delivery of healthcare entails both the supply of
healthcare as well as the acceptance and use of services by the patient or clients. 1 In settings of increase
trust, transactions occur more easily and fewer resources are needed for “monitoring, negotiating,
litigating, and enforcing formal agreements. 2 Trust influences patient management outcomes, especially
in the treatment of long term disease, as well as influences outcomes of health promotion and prevention
initiatives. A trusting relationship between healthcare provider and patient can have a direct therapeutic
effect.
According to Blendon et at., critical incidents and sentinel events will contribute to loss of the
patients’ trust in healthcare, the institutions and health systems. Some theorists consider patient trust to
be a set of beliefs or expectations that a physician will perform in a certain way. 4 Some have stressed a
more affective nature of trust, identifying patient trust as a reassuring feeling of confidence or reliance in
the physician and the physician's intent.
While theoretical analyses of patient-physician trust flourish, only a few examples exist of
research attempts to ground a conceptualization of patient-physician trust in actual patient experience
and perspectives. Notable among this work is a study conducted by Thom and Campbell in which they
conducted focus groups with 29 patients from diverse practice settings. Participants were asked to
recount specific instances that had positively or negatively affected trust in a physician. The investigators
were able to distinguish 9 dimensions of trust among the patient reports, ranging from technical
competency and interpersonal attributes to organizational factors.

Currently, in our locality, no study as such was done. This study would describe the association of
distrust of the health care system and self-reported health status of some individual in San Isidro, Sawata.
Through this study, we will be able to demonstrate the potential public health impact of health care
system distrust and to provide the framework for studies of the pathways by which distrust affects health
and also, with this study, we can gather data on how we can improve the current system for people to
avail the services that is offered to them without hesitation.
Statement of the Problem

The purpose of this study is to investigate the association between distrust of the health care system
and self-reported health status among. The specific focus of the study is the following:
1. What is the sociodemographic profile of the respondents?
2. Is there a significant relationship between distrust and health status among the general
community in San Isidro Sawata?
Chapter II: Research Methodology

Study Design

This study utilizes a random interview among the residents in San Isidro Sawata. It utilizes a
descriptive correlational study design among random residents, where the researcher describes the
profile of the respondents and determines significant relationship between distrust and health status
among the community.
Setting

The study is conducted in San Isidro, Sawata locality.

Sampling Procedure

The study utilizes random sampling technique in gathering data in San Isidro Sawata.

Data Gathering

The research will conduct proper consenting of the participants. Identified prospective
respondents will be asked for their consent, the procedure of the study will be explained to them and they
will be allowed to ask questions prior to the signing of the consent.
Research Instrument

A structured and validated questionnaire is adapted and used as an interview guide. The
assessment variables will be measured using Likert’s five-point scale- 1. Strongly Disagree, 2. Disagree,
3. Neither agree nor disagree, 4. Agree and 5. Strongly Agree. Participants will be allowed to answer the
questionnaire, and collected data will be assigned with a unique code to preserve the patients’ anonymity
and confidentiality. The data will then be encoded in an excel file and analyzed accordingly.
Data handling, management and analysis

The respondents’ profile will be describe descriptively using mean and standard deviation and
frequency and percent for categorical data and to assess the association between distrust and health
status Chi square test for independence will be used.
Measures:

Distrust of the Health Care System and Health Status are the primary measures in this study.
Chapter III: Presentation of Results

Table 1. Demographic Profile of the Respondents

Table 1 presents the demographic profile of the respondents. There was a total of 9 random respondents
in the study with equal distribution as to age bracket 21-30, 41-50, 51-60 and more than 60 comprising
28.6 % respective. The remaining 14.4 % belongs to age bracket 31-40.

Table 2. Relationship of the Demographic Profile towards the Health Care Distrust

Table 2 shows the correlation of the demographic profile with the level of agreement. In this case, the
result shows all having p -values greater than 0.05. Therefore, the results suggest that the relationship is
not statistically significant.
Table 3. Evaluation of Health Care System Distrust

Table 3 reflects the evaluation of the Health care system. Questions reflected were measured using
standard deviation. Statements having neutral description means the respondents agree nor disagree
with the statement.

Table 4. Health Perception Status

 Pearson Correlation
Health Perception
Distrust r -0.254421635
P-value 0.696040713
N 9

Table 4 reflects the evaluation of the Health Perception of the respondents. Questions used were
measure standard deviation. In this analysis, it is revealed that when we correlate level of distrust and
health perception. The result shows that the correlation coefficient of r=-0.254 shows an inverse very
weak relationship between distrust and health perception. Test for significance revealed that it is not
statistically significant at 5% level of significance suggesting that there is no relationship between the two
variables.

Chapter IV: Discussion and Findings

This project demonstrates that there is no relationship as to the respondent’s self- health perception
towards the level of distrust to the health care system. This is important because regardless of what the
health status of the respondents, the health care system is not involved to it. Health care system is a
stand-alone system, it serves its purpose as a system expected to assist those who needs it. Several
factors should be explored as to why the result of the study. This finding is in contrast to the study done
by Armstrong, et al which shows that there is high distrust of the health care system and is strongly
associated with worse self-reported health status.
This study has several limitations. The imperfect nature of our measures may have contributed to the lack
of respondents, the questionnaire was not expressed in vernacular and comprehension, the interview
location maybe a factor.
Despite these limitations, this study provides the first evidence that there is no relationship of distrust of
the health care system and to self-health perception. The people of Sawata will believe in their health
care system for the reason that it is their primary function – to provide service and that is to cure or
alleviate whatever they are feeling. Further studies are needed to determine whether this association
between health care system distrust and health is causal and the pathways by which it may occur.

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