Background/Objectives: Medical mistrust (MM) is associated with adverse health outcomes, but few studies have assessed MM in cancer patients. MM is frequently measured using the Medical Mistrust Inventory (MMI), measuring institutional MM (e.g., government), or the Group-Based Medical Mistrust Scale (GBMMS), measuring race-based MM. We sought to assess the prevalence of MM among cancer patients diverse by age, sex, race/ethnicity, and socioeconomic status (SES), recruited from an urban safety net hospital and a suburban comprehensive cancer center.Methods: Patients completed a one-time survey. The primary outcome was MM as measured by the GBMMS and MMI tools. Covariates included demographics, treatment campus (urban vs. suburban), and psychosocial measures relevant to MM.Results: Purposeful sampling recruitment resulted in 200 participants (survey completion: 74.6%). The median age was 60 years, with 62% female, 45% African-American, 15% Hispanic, 47.5% education ≤ HS diploma, and 51.5% income ≤ USD 50,000/yr. Elevated MMI and GBMMS scores (moderate-to-high) were seen, respectively, in Hispanic (20.7% and 33.4%) and African-American (AA) patients (31.8% and 48.9%), compared with White patients (14.3% and 9.9%). The MMI and GBMMS tools captured complimentary aspects of MM in cancer patients (Spearman’s 0.531,p< 0.0001). MMI was associated with lower education (0.034) and race (p= 0.04), while GBMMS was strongly associated with race (p< 0.001), urban campus (p= 0.035), and mistrust of government/health organization information (bothp< 0.05). Higher MMI/GBMMS scores were both associated with research mistrust and mistrust of information from physicians.Conclusions: Institutional and race-based MM are prevalent among cancer patients diverse by age, sex, race/ethnicity, and SES. Lower education was associated with institutional MM but not race-based MM.
背景/目的：医疗不信任与不良健康结局相关，但针对癌症患者医疗不信任的研究较少。医疗不信任常通过测量制度性不信任（如对政府机构）的医疗不信任量表，以及测量基于种族不信任的群体医疗不信任量表进行评估。本研究旨在评估来自城市安全网医院和郊区综合癌症中心、涵盖不同年龄、性别、种族/民族及社会经济地位的癌症患者中医疗不信任的流行情况。 方法：患者完成一次性问卷调查。主要结局指标为通过群体医疗不信任量表和医疗不信任量表工具测量的医疗不信任水平。协变量包括人口统计学特征、就诊院区（城市与郊区）以及与医疗不信任相关的心理社会指标。 结果：通过目的性抽样共招募200名参与者（问卷完成率74.6%）。中位年龄60岁，62%为女性，45%为非裔美国人，15%为西班牙裔，47.5%受教育程度≤高中文凭，51.5%年收入≤5万美元。与白人患者（14.3%和9.9%）相比，西班牙裔（20.7%和33.4%）和非裔美国患者（31.8%和48.9%）在医疗不信任量表和群体医疗不信任量表均呈现较高（中高水平）得分。两种工具捕捉到癌症患者医疗不信任的互补维度（斯皮尔曼相关系数0.531，p<0.0001）。医疗不信任量表得分与较低教育程度（p=0.034）和种族（p=0.04）相关，而群体医疗不信任量表得分与种族（p<0.001）、城市院区（p=0.035）及对政府/卫生机构信息的不信任显著相关（均p<0.05）。较高的医疗不信任量表/群体医疗不信任量表得分均与研究不信任及对医师信息的不信任相关。 结论：制度性和基于种族的医疗不信任在涵盖不同年龄、性别、种族/民族及社会经济地位的癌症患者中普遍存在。较低教育程度与制度性医疗不信任相关，但与基于种族的医疗不信任无显著关联。
肿瘤(癌症)患者之家